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Mar 2

Improving outcomes for liver cancer patients through image-guided surgery

Katie Konyn

in News

Technical advances in image-guided surgery are being used to improve treatment for liver cancer patients following a research collaboration between UCL and the Royal Free Hospital, London.

  • Since the late 1970s liver cancer incidence rates have more than tripled in the UK, with around 5,600 new cases of liver cancer in 2014. Around 6% of patients are treated through major surgical resection, which removes the affected part of the liver. The procedure is less commonly used in older age groups and, overall, liver cancer has high mortality rates.

    Whilst minimally-invasive surgery has less post-operative pain and recovery time compared to open surgery it is not commonly used for liver cancer resections. This is due to the difficulty in identifying and dividing blood vessels in the liver using the laparoscopic tools available. In addition, the movement in the abdomen caused by the patient’s breathing and the nature of liver tissue cause the position of the tumour and vessels of interest to move during surgery.

  • Researchers from the UCL Translational Imaging Group led by Dr Matt Clarkson have developed a novel computational modelling and image-guided surgery platform which provides surgeons with additional data to make minimally-invasive liver resections more viable. The SmartLiver platform takes a pre-operative CT scan and converts it to a patient-specific model of the liver [1], which clearly identifies vessels, surrounding organs and tumours. This model is merged with the live laparoscopic video feed, thereby enhancing the view of the surgeon by providing awareness of critical sub-surface structures. The platform also provides the surgeon with electromagnetic device tracking, integrated ultrasound and automatic tissue classification using deep learning techniques.

  • Brian Davidson, Professor of Surgery at UCL, says:

  • “By bringing all these areas of expertise together it is hoped that the number of cancer patients suitable for liver resections can be increased due to the less invasive techniques. It also hoped that the software can be applied to other abdominal procedures such as pancreas, kidney and gallbladder surgery.”

  • Following successful testing in pre-clinical biological models led by Dr Kurinchi Gurusamy, a feasibility study has been launched at the Royal Free Hospital to further develop the prototype, which has been used on 10 patients to date.

    This research is funded by the Wellcome Trust and Department of Health under the Healthcare Innovation Challenge Fund (HICF-T4-317) and led by Prof Brian Davidson and Prof David Hawkes.