Automatic estimation of a resected liver region using a tumor domination ratio - Emerging Trends in Image Processing, Computer Vision, and Pattern Recognition - page 304

CHAPTER 23
Automatic estimation of a
resected liver region using a
tumor domination ratio
M. Hariyama 1 ; M. Shimoda 2 1 Graduate School of Information Sciences, Tohoku University, Sendai, Miyagi, Japan
2 Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
Abstract
This chapter presents an automatic approach to estimate optimal resected liver regions for oncologic sur-
gery planning. Usually, resected liver regions are determined by selecting cut-points on the portal ves-
sels on 3D simulation software. Since the liver has complex vessel structure, it is difficult for human to
ind optimal resected liver regions. To solve this problem, a tumor domination ratio (TDR) is proposed to
ind all portal vessels related to tumors. The TDR allows us to compute the ideal resected region, that is,
all the perfusion territories related to the tumor. Moreover, some types of conditions such as the radius
of vessels are considered for practical surgical use. The experimental results demonstrate that the resec-
ted liver regions of the proposed approach are much smaller than those of the conventional approach in
most cases.
Keywords
Medical imaging
3D simulation analysis
Anatomical hepatectomy
1 Introduction
3D simulation, recently, plays an important role in surgical planning for hepatectomy since the
liver has a complex structure, that is, some different vessels exist complexly as shown in Figure
1 . The estimation of regions perfused by the portal vein is especially one important task in ana-
tomical hepatectomy, since the hepatocellular carcinoma (HCC), cancerous liver tumor, tends
to metastasize via the portal vein [ 1 - 3 ] . Figure 2 explains how HCC metastasizes through the
portal vein and what a perfused region is. The tumor is fed by the nearest parts of the portal