3D imaging may improve accuracy of liver cancer treatment: London researchers

Dr. Derek Cool performs a demonstration using the 3D ultrasound. Photo courtesy of Lawson Health Research Institute.

London-based researchers believe a new robotic 3D ultrasound could make liver cancer thermal ablation therapy, an alternative to surgery, more accurate.

In a simulated study using data from 14 patients from the London Health Sciences Centre (LHSC), scientists from Lawson Health Research Institute and Western University found the 3D technology could better guide the needle used in the treatment.

“It’s very important that we get the needle right in the centre of the tumour,” said Dr. Derek Cool, Lawson associate scientist, Western assistant professor and LHSC interventional radiologist. “If the treatment area doesn’t fully cover the tumour, patients are left with a small amount of residual cancer, risking recurrence and the need for additional treatment.”

Thermal ablation therapy uses heat to destroy cancerous tumours and is known to have fewer complications and a shorter recovery time than surgery. Traditionally, ultrasound or CT imaging has been used to guide needle placement, but each has a disadvantage. An ultrasound can be done in real-time, however, it only provides 2D images. A CT scan offers 3D images, but not in real-time.

To form the new 3D ultrasound images, researchers used a robotic cradle to move a standard ultrasound probe and collect images. They then stacked them like puzzle pieces to create the 3D image.

Researchers said 64.3 per cent of cases analyzed for the study showed “complete tumour coverage” using the old imaging method. With the new 3D system, complete coverage rises to 92.9 per cent of cases or 13 of the 14 cases examined.

“Our next step is to move from simulation studies to a clinical trial,” said Dr. Cool.

The study, published in IEEE Transactions on Medical Imaging, added that if proven an effective method, the robotic 3D imaging could be utilized by smaller health care centres and shorten imagine wait times by eliminating the need for CT scans.

“If a clinical trial shows the approach is more accurate and more precise than conventional techniques, there would be a direct impact on patient care,” said Dr. Aaron Fenster, a professor at Western University’s Schulich School of Medicine & Dentistry and scientist at Robarts Research Institute. “We hope to explore commercialization to license the technology and distribute it worldwide.”