A fiber optoacoustic guide with augmented reality for precision breast-conserving surgery

Lu Lan; Yan Xia; Rui Li; Kaiming Liu; Jieying Mai; Jennifer Anne Medley; Samilia Obeng-Gyasi; Linda K. Han; Pu Wang; Ji-Xin Cheng

doi:10.1038/s41377-018-0006-0

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A fiber optoacoustic guide with augmented reality for precision breast-conserving surgery

Original Articles

- A fiber optoacoustic guide with augmented reality for precision breast-conserving surgery
- A fiber optoacoustic guide with augmented reality for precision breast-conserving surgery
- LSA 2018年7卷第4期页码：41-51
- Affiliations：
  
  1.Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
  2.Vibronix, Inc., 1281 Win Hentschel Boulevard, West Lafayette, IN 47906, USA
  3.Department of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907, USA
  4.Department of Precision Instrument, Tsinghua University, Beijing 10084, China
  5.Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd, Indianapolis, IN 46202, USA
  6.Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN 46202, USA
  7.Parkview Cancer Institute, 11109 Parkview Plaza Drive, Fort Wayne, IN 46845, USA
  8.Department of Electrical & Computer Engineering, Boston University, 8 Saint Mary's Street, Boston, MA 02215, USA
- Author bio：
  
  Linda K. Han (linda.han@parkview.com)
  Pu Wang (puwang@vibronixinc.com)
  J-X. Cheng (jxcheng@bu.edu)
- Funds：
- DOI：10.1038/s41377-018-0006-0
  中图分类号：
- 纸质出版日期：2018，
  
  网络出版日期：2018-05-18，
  
  收稿日期：2017-10-15，
  
  修回日期：2018-02-07，
  
  录用日期：2018-02-07
- Accepted：
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A fiber optoacoustic guide with augmented reality for precision breast-conserving surgery[J]. LSA, 2018,7(4):41-51.

Lan, L. et al. A fiber optoacoustic guide with augmented reality for precision breastconserving surgery. Light: Science & Applications, 7, 41-51 (2018).
A fiber optoacoustic guide with augmented reality for precision breast-conserving surgery[J]. LSA, 2018,7(4):41-51. DOI： 10.1038/s41377-018-0006-0.

Lan, L. et al. A fiber optoacoustic guide with augmented reality for precision breastconserving surgery. Light: Science & Applications, 7, 41-51 (2018). DOI： 10.1038/s41377-018-0006-0.

摘要

Abstract

Lumpectomy

also called breast-conserving surgery

has become the standard surgical treatment for early-stage breast cancer. However

accurately locating the tumor during a lumpectomy

especially when the lesion is small and nonpalpable

is a challenge. Such difficulty can lead to either incomplete tumor removal or prolonged surgical time

which result in high re-operation rates (~25%) and increased surgical costs. Here

we report a fiber optoacoustic guide (FOG) with augmented reality (AR) for sub-millimeter tumor localization and intuitive surgical guidance with minimal interference. The FOG is preoperatively implanted in the tumor. Under external pulsed light excitation

the FOG omnidirectionally broadcasts acoustic waves through the optoacoustic effect by a specially designed nano-composite layer at its tip. By capturing the acoustic wave

three ultrasound sensors on the breast skin triangulate the FOG tip's position with 0.25-mm accuracy. An AR system with a tablet measures the coordinates of the ultrasound sensors and transforms the FOG tip's position into visual feedback with < 1-mm accuracy

thus aiding surgeons in directly visualizing the tumor location and performing fast and accurate tumor removal. We further show the use of a head-mounted display to visualize the same information in the surgeons' first-person view and achieve hands-free guidance. Towards clinical application

a surgeon successfully deployed the FOG to excise a "pseudo tumor" in a female human cadaver. With the high-accuracy tumor localization by FOG and the intuitive surgical guidance by AR

the surgeon performed accurate and fast tumor removal

which will significantly reduce re-operation rates and shorten the surgery time.

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Keywords

references

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