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Published in: International Journal of Computer Assisted Radiology and Surgery 1/2018

Open Access 01-01-2018 | Original Article

Anthropomorphic liver phantom with flow for multimodal image-guided liver therapy research and training

Authors: Anna Rethy, Jørn Ove Sæternes, Jostein Halgunset, Ronald Mårvik, Erlend F. Hofstad, Juan A. Sánchez-Margallo, Thomas Langø

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 1/2018

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Abstract

Purpose

The objective of this study was to develop a multimodal, permanent liver phantom displaying functional vasculature and common pathologies, for teaching, training and equipment development in laparoscopic ultrasound and navigation.

Methods

Molten wax was injected simultaneously into the portal and hepatic veins of a human liver. Upon solidification of the wax, the surrounding liver tissue was dissolved, leaving a cast of the vessels. A connection was established between the two vascular trees by manually manipulating the wax. The cast was placed, along with different multimodal tumor models, in a liver shaped mold, which was subsequently filled with a polymer. After curing, the wax was melted and flushed out of the model, thereby establishing a system of interconnected channels, replicating the major vasculature of the original liver. Thus, a liquid can be circulated through the model in a way that closely mimics the natural blood flow.

Results

Both the tumor models, i.e., the metastatic tumors, hepatocellular carcinoma and benign cyst, and the vessels inside the liver model, were clearly visualized by all the three imaging modalities: CT, MR and ultrasound. Doppler ultrasound images of the vessels proved the blood flow functionality of the phantom.

Conclusion

By a two-step casting procedure, we produced a multimodal liver phantom, with open vascular channels, and tumor models, that is the next best thing to practicing imaging and guidance procedures in animals or humans. The technique is in principle applicable to any organ of the body.
Literature
1.
go back to reference Rethy A, Langø T, Mårvik R (2013) Laparoscopic ultrasound for hepatocellular carcinoma and colorectal liver metastasis: an overview. Surg Laparosc Endosc Percutaneous Tech 23(2):135–144CrossRef Rethy A, Langø T, Mårvik R (2013) Laparoscopic ultrasound for hepatocellular carcinoma and colorectal liver metastasis: an overview. Surg Laparosc Endosc Percutaneous Tech 23(2):135–144CrossRef
2.
go back to reference Langø T, Vijayan S, Rethy A, Våpenstad C, Solberg OV, Mårvik R, Johnsen G, Hernes TN (2012) Navigated laparoscopic ultrasound in abdominal soft tissue surgery: technological overview and perspectives. Int J Comput Assist Radiol Surg 7(4):585–599CrossRefPubMed Langø T, Vijayan S, Rethy A, Våpenstad C, Solberg OV, Mårvik R, Johnsen G, Hernes TN (2012) Navigated laparoscopic ultrasound in abdominal soft tissue surgery: technological overview and perspectives. Int J Comput Assist Radiol Surg 7(4):585–599CrossRefPubMed
4.
go back to reference Shevchenko N, Schwaiger J, Markert M, Flatz W, Lueth TC (2011) Evaluation of a resectable ultrasound liver phantom for testing of surgical navigation systems. Conf Proc IEEE Eng Med Biol Soc 2011:916–919PubMed Shevchenko N, Schwaiger J, Markert M, Flatz W, Lueth TC (2011) Evaluation of a resectable ultrasound liver phantom for testing of surgical navigation systems. Conf Proc IEEE Eng Med Biol Soc 2011:916–919PubMed
7.
go back to reference Banovac F, Tang J, Xu S, Lindisch D, Chung HY, Levy EB, Chang T, McCullough MF, Yaniv Z, Wood BJ, Cleary K (2005) Precision targeting of liver lesions using a novel electromagnetic navigation device in physiologic phantom and swine. Med Phys 32:2698–2705CrossRefPubMed Banovac F, Tang J, Xu S, Lindisch D, Chung HY, Levy EB, Chang T, McCullough MF, Yaniv Z, Wood BJ, Cleary K (2005) Precision targeting of liver lesions using a novel electromagnetic navigation device in physiologic phantom and swine. Med Phys 32:2698–2705CrossRefPubMed
8.
go back to reference Herline AJ, Herring JL, Stefansic JD, Chapman WC, Galloway RL, Dawant BM (2000) Surface registration for use in interactive, image-guided liver surgery. Comput Aided Surg 5:11–17PubMed Herline AJ, Herring JL, Stefansic JD, Chapman WC, Galloway RL, Dawant BM (2000) Surface registration for use in interactive, image-guided liver surgery. Comput Aided Surg 5:11–17PubMed
9.
go back to reference Joe E, Kim SH, Lee KB, Jang J-J, Lee JY, Lee JM, Han JK, Choi BI (2012) Feasibility and accuracy of dual-source dual-energy CT for noninvasive determination of hepatic iron accumulation. Radiology 262:126–135CrossRefPubMed Joe E, Kim SH, Lee KB, Jang J-J, Lee JY, Lee JM, Han JK, Choi BI (2012) Feasibility and accuracy of dual-source dual-energy CT for noninvasive determination of hepatic iron accumulation. Radiology 262:126–135CrossRefPubMed
10.
go back to reference Murotani K, Kazuhiro M, Kawai N, Sato M, Minamiguchi H, Nakai M, Sonomura T, Hosokawa S, Nishioku T (2013) Optimum CT reconstruction parameters for vascular and hepatocellular carcinoma models in a liver phantom with multi-level dynamic computed tomography with 64 detector rows: a basic study. Radiol Phys Technol 6:317–325CrossRefPubMed Murotani K, Kazuhiro M, Kawai N, Sato M, Minamiguchi H, Nakai M, Sonomura T, Hosokawa S, Nishioku T (2013) Optimum CT reconstruction parameters for vascular and hepatocellular carcinoma models in a liver phantom with multi-level dynamic computed tomography with 64 detector rows: a basic study. Radiol Phys Technol 6:317–325CrossRefPubMed
11.
go back to reference Olerud HM, Olsen JB, Skretting A (1999) An anthropomorphic phantom for receiver operating characteristic studies in CT imaging of liver lesions. Br J Radiol 72:35–43CrossRefPubMed Olerud HM, Olsen JB, Skretting A (1999) An anthropomorphic phantom for receiver operating characteristic studies in CT imaging of liver lesions. Br J Radiol 72:35–43CrossRefPubMed
12.
go back to reference Schindera ST, Torrente JC, Ruder TD, Hoppe H, Marin D, Nelson RC, Szucs-Farkas Z (2011) Decreased detection of hypovascular liver tumors with MDCT in obese patients: a phantom study. Am J Roentgenol 196:W772–W776CrossRef Schindera ST, Torrente JC, Ruder TD, Hoppe H, Marin D, Nelson RC, Szucs-Farkas Z (2011) Decreased detection of hypovascular liver tumors with MDCT in obese patients: a phantom study. Am J Roentgenol 196:W772–W776CrossRef
13.
go back to reference Widmann G, Wallach D, Toporek G, Schullian P, Weber S, Bale R (2013) Angiographic C-arm CT- versus MDCT-guided stereotactic punctures of liver lesions: nonrigid phantom study. Am J Roentgenol 201:1136–1140CrossRef Widmann G, Wallach D, Toporek G, Schullian P, Weber S, Bale R (2013) Angiographic C-arm CT- versus MDCT-guided stereotactic punctures of liver lesions: nonrigid phantom study. Am J Roentgenol 201:1136–1140CrossRef
14.
go back to reference In E, Naguib H, Haider M (2014) Mechanical stability analysis of carrageenan-based polymer gel for magnetic resonance imaging liver phantom with lesion particles. J Med Imaging (Bellingham) 1(3):035502CrossRef In E, Naguib H, Haider M (2014) Mechanical stability analysis of carrageenan-based polymer gel for magnetic resonance imaging liver phantom with lesion particles. J Med Imaging (Bellingham) 1(3):035502CrossRef
15.
go back to reference Rube MA, Holbrook AB, Cox BF, Buciuc R, Melzer A (2015) Wireless mobile technology to improve workflow and feasibility of MR-guided percutaneous interventions. Int J Comput Assist Radiol Surg 10:665–676CrossRefPubMed Rube MA, Holbrook AB, Cox BF, Buciuc R, Melzer A (2015) Wireless mobile technology to improve workflow and feasibility of MR-guided percutaneous interventions. Int J Comput Assist Radiol Surg 10:665–676CrossRefPubMed
16.
go back to reference Pacioni A, Carbone M, Freschi C, Viglialoro R, Ferrari V, Ferrari M (2015) Patient-specific ultrasound liver phantom: materials and fabrication method. Int J Comput Assist Radiol Surg 10:1065–1075CrossRefPubMed Pacioni A, Carbone M, Freschi C, Viglialoro R, Ferrari V, Ferrari M (2015) Patient-specific ultrasound liver phantom: materials and fabrication method. Int J Comput Assist Radiol Surg 10:1065–1075CrossRefPubMed
17.
go back to reference Schwaiger J, Markert M, Shevchenko N, Lueth TC (2011) The effects of real-time image navigation in operative liver surgery. Int J Comput Assist Radiol Surg 6:785–796CrossRefPubMed Schwaiger J, Markert M, Shevchenko N, Lueth TC (2011) The effects of real-time image navigation in operative liver surgery. Int J Comput Assist Radiol Surg 6:785–796CrossRefPubMed
18.
go back to reference Sugimoto K, Moriyasu F, Shiraishi J, Yamada M, Imai Y (2011) A phantom study comparing ultrasound-guided liver tumor puncture using new real-time 3D ultrasound and conventional 2D ultrasound. Am J Roentgenol 196:W753–W757CrossRef Sugimoto K, Moriyasu F, Shiraishi J, Yamada M, Imai Y (2011) A phantom study comparing ultrasound-guided liver tumor puncture using new real-time 3D ultrasound and conventional 2D ultrasound. Am J Roentgenol 196:W753–W757CrossRef
19.
go back to reference Bao P, Warmath J, Galloway R, Herline A (2005) Ultrasound-to-computer-tomography registration for image-guided laparoscopic liver surgery. Surg Endosc 19:424–429CrossRefPubMed Bao P, Warmath J, Galloway R, Herline A (2005) Ultrasound-to-computer-tomography registration for image-guided laparoscopic liver surgery. Surg Endosc 19:424–429CrossRefPubMed
20.
go back to reference Kao YH, Luddington OS, Culleton SR, Francis RJ, Boucek JA (2014) A gelatin liver phantom of suspended 90Y resin microspheres to simulate the physiologic microsphere biodistribution of a postradioembolization liver. J Nucl Med Technol 42:265–268CrossRefPubMed Kao YH, Luddington OS, Culleton SR, Francis RJ, Boucek JA (2014) A gelatin liver phantom of suspended 90Y resin microspheres to simulate the physiologic microsphere biodistribution of a postradioembolization liver. J Nucl Med Technol 42:265–268CrossRefPubMed
21.
go back to reference Culjat MO, Goldenberg D, Tewari P, Singh RS (2010) A review of tissue substitutes for ultrasound imaging. Ultrasound Med Biol 36(6):861–873CrossRefPubMed Culjat MO, Goldenberg D, Tewari P, Singh RS (2010) A review of tissue substitutes for ultrasound imaging. Ultrasound Med Biol 36(6):861–873CrossRefPubMed
22.
go back to reference Kato H, Kuroda M, Yoshimura K, Yoshida A, Hanamoto K, Kawasaki S, Shibuya K, Kanazawa S (2005) Composition of MRI phantom equivalent to human tissues. Med Phys 32(10):3199–3208CrossRefPubMed Kato H, Kuroda M, Yoshimura K, Yoshida A, Hanamoto K, Kawasaki S, Shibuya K, Kanazawa S (2005) Composition of MRI phantom equivalent to human tissues. Med Phys 32(10):3199–3208CrossRefPubMed
23.
go back to reference Pogue BW, Patterson MS (2006) Review of tissue simulating phantoms for optical spectroscopy, imaging and dosimetry. J Biomed Opt 11(4):041102CrossRefPubMed Pogue BW, Patterson MS (2006) Review of tissue simulating phantoms for optical spectroscopy, imaging and dosimetry. J Biomed Opt 11(4):041102CrossRefPubMed
24.
go back to reference Kondo T, Kitatuji M, Kanda H (2005) New tissue mimicking materials for ultrasound phantoms. Ultrason Symp IEEE 3:1664–1667 Kondo T, Kitatuji M, Kanda H (2005) New tissue mimicking materials for ultrasound phantoms. Ultrason Symp IEEE 3:1664–1667
25.
go back to reference Fromageau J, Brusseau E, Vray D, Gimenez G, Delachartre P (2003) Characterization of PVA cryogel for intravascular ultrasound elasticity imaging? IEEE Trans Ultrason Ferroelectr 50:1318–1324CrossRef Fromageau J, Brusseau E, Vray D, Gimenez G, Delachartre P (2003) Characterization of PVA cryogel for intravascular ultrasound elasticity imaging? IEEE Trans Ultrason Ferroelectr 50:1318–1324CrossRef
26.
go back to reference Surry KJ, Austin HJ, Fenster A, Peters TM (2004) Poly(vinyl alcohol) cryogel phantoms for use in ultrasound and MR imaging. Phys Med Biol 49:5529–5546 Surry KJ, Austin HJ, Fenster A, Peters TM (2004) Poly(vinyl alcohol) cryogel phantoms for use in ultrasound and MR imaging. Phys Med Biol 49:5529–5546
27.
go back to reference Mazzara GP, Briggs RW, Wu Z, Steinbach BG (1996) Use of a modified polysaccharide gel in developing breast phantom for MRI. Magn Reson Imaging 14(6):639–648CrossRefPubMed Mazzara GP, Briggs RW, Wu Z, Steinbach BG (1996) Use of a modified polysaccharide gel in developing breast phantom for MRI. Magn Reson Imaging 14(6):639–648CrossRefPubMed
28.
go back to reference Zell K, Sperl JI, Vogel MW, Niessner R, Haisch C (2007) Acoustical properties of selected tissue phantom materials for ultrasound imaging. Phys Med Biol 52:N475–N484CrossRefPubMed Zell K, Sperl JI, Vogel MW, Niessner R, Haisch C (2007) Acoustical properties of selected tissue phantom materials for ultrasound imaging. Phys Med Biol 52:N475–N484CrossRefPubMed
29.
go back to reference Bays R, Wagnières G, Robert D, Theumann JF, Vitkin A, Savary JF, Monnier P, van den Bergh H (1997) Three-dimensional optical phantom and its application in photodynamic therapy. Lasers Surg Med 21(3):227–234CrossRefPubMed Bays R, Wagnières G, Robert D, Theumann JF, Vitkin A, Savary JF, Monnier P, van den Bergh H (1997) Three-dimensional optical phantom and its application in photodynamic therapy. Lasers Surg Med 21(3):227–234CrossRefPubMed
30.
go back to reference Waterworth MD, Tarte BJ, Joblin AJ, van Doorn T, Niesler HE (1995) Optical transmission properties of homogenised milk used as a phantom material in visible wavelength imaging. Aust Phys Eng Sci Med 18(1):39–44 Waterworth MD, Tarte BJ, Joblin AJ, van Doorn T, Niesler HE (1995) Optical transmission properties of homogenised milk used as a phantom material in visible wavelength imaging. Aust Phys Eng Sci Med 18(1):39–44
31.
go back to reference Mitic G, Kölzer J, Otto J, Plies E, Sölkner G, Zinth W (1994) Time-gated transillumination of biological tissues and tissue-like phantoms. Appl Opt 33:6699–6710CrossRefPubMed Mitic G, Kölzer J, Otto J, Plies E, Sölkner G, Zinth W (1994) Time-gated transillumination of biological tissues and tissue-like phantoms. Appl Opt 33:6699–6710CrossRefPubMed
32.
go back to reference Inford J, Shalev S, Bews J, Brown R, Schipper H (1986) Development of a tissue-equivalent phantom for diaphanography. Med Phys 13(6):869–875CrossRef Inford J, Shalev S, Bews J, Brown R, Schipper H (1986) Development of a tissue-equivalent phantom for diaphanography. Med Phys 13(6):869–875CrossRef
33.
go back to reference Moes CJM, van Gemert MJ, Star WM, Marijnissen JPA, Prahl SA (1989) Measurements and calculations of the energy fluence rate in a scattering and absorbing phantom at 633 nm. Appl Opt 28(12):2292–2296CrossRefPubMed Moes CJM, van Gemert MJ, Star WM, Marijnissen JPA, Prahl SA (1989) Measurements and calculations of the energy fluence rate in a scattering and absorbing phantom at 633 nm. Appl Opt 28(12):2292–2296CrossRefPubMed
34.
go back to reference van Staveren HJ, Moes CJM, van Marle J, Prahl SA, van Gemert MJC (1991) Light scattering in intralipid-10% in the wave-length range of 400–1100 nm. Appl Opt 30(31):4507–4514CrossRefPubMed van Staveren HJ, Moes CJM, van Marle J, Prahl SA, van Gemert MJC (1991) Light scattering in intralipid-10% in the wave-length range of 400–1100 nm. Appl Opt 30(31):4507–4514CrossRefPubMed
35.
go back to reference Flock ST, Jacques SL, Wilson BC, Star WM, Vangemert MJC (1992) Optical properties of Intralipid: a phantom medium for light propagation studies. Lasers Surg Med 12(5):510–519CrossRefPubMed Flock ST, Jacques SL, Wilson BC, Star WM, Vangemert MJC (1992) Optical properties of Intralipid: a phantom medium for light propagation studies. Lasers Surg Med 12(5):510–519CrossRefPubMed
36.
go back to reference Krucker T, Lang A, Meyer EP (2006) New polyurethane-based material for vascular corrosion casting with improved physical and imaging characteristics. Microsc Res Tech 69(2):138–147CrossRefPubMed Krucker T, Lang A, Meyer EP (2006) New polyurethane-based material for vascular corrosion casting with improved physical and imaging characteristics. Microsc Res Tech 69(2):138–147CrossRefPubMed
37.
go back to reference Verli FD, Rossi-Schneider TR, Schneider FL, Yurgel LS, de Souza MAL (2007) Vascular corrosion casting technique steps. Scanning 29(3):128–132CrossRefPubMed Verli FD, Rossi-Schneider TR, Schneider FL, Yurgel LS, de Souza MAL (2007) Vascular corrosion casting technique steps. Scanning 29(3):128–132CrossRefPubMed
38.
go back to reference Askeland C, Solberg OV, Bakeng JBL, Reinertsen I, Tangen GA, Hofstad EF, Iversen DH, Våpenstad C, Selbekk T, Langø T, Hernes TAN, Olav Leira H, Unsgård G, Lindseth F (2016) CustusX: an open-source research platform for image-guided therapy. Int J Comput Assist Radiol Surg 11:505–519CrossRefPubMed Askeland C, Solberg OV, Bakeng JBL, Reinertsen I, Tangen GA, Hofstad EF, Iversen DH, Våpenstad C, Selbekk T, Langø T, Hernes TAN, Olav Leira H, Unsgård G, Lindseth F (2016) CustusX: an open-source research platform for image-guided therapy. Int J Comput Assist Radiol Surg 11:505–519CrossRefPubMed
39.
go back to reference Bø LE, Hofstad EF, Lindseth F, Hernes TA (2015) Versatile robotic probe calibration for position tracking in ultrasound imaging. Phys Med Biol 60(9):3499–5137CrossRefPubMed Bø LE, Hofstad EF, Lindseth F, Hernes TA (2015) Versatile robotic probe calibration for position tracking in ultrasound imaging. Phys Med Biol 60(9):3499–5137CrossRefPubMed
40.
go back to reference O’Brien EK, Wayne DB, Barsness KA, McGaghie WC, Barsuk JH (2016) Use of 3D printing for medical education models in transplantation medicine: a critical review. Curr Transplant Rep 3:109–119CrossRef O’Brien EK, Wayne DB, Barsness KA, McGaghie WC, Barsuk JH (2016) Use of 3D printing for medical education models in transplantation medicine: a critical review. Curr Transplant Rep 3:109–119CrossRef
41.
go back to reference Kusaka M, Sugimoto M, Fukami M, Sasaki H, Takenaka M, Anraku T, Ito T, Kenmochi T, Shiroki R, Hoshinaga K (2015) Initial experience with a tailor-made simulation and navigation program using a 3-D printer model of kidney transplantation surgery. Transplant Proc 47(3):596–599CrossRefPubMed Kusaka M, Sugimoto M, Fukami M, Sasaki H, Takenaka M, Anraku T, Ito T, Kenmochi T, Shiroki R, Hoshinaga K (2015) Initial experience with a tailor-made simulation and navigation program using a 3-D printer model of kidney transplantation surgery. Transplant Proc 47(3):596–599CrossRefPubMed
Metadata
Title
Anthropomorphic liver phantom with flow for multimodal image-guided liver therapy research and training
Authors
Anna Rethy
Jørn Ove Sæternes
Jostein Halgunset
Ronald Mårvik
Erlend F. Hofstad
Juan A. Sánchez-Margallo
Thomas Langø
Publication date
01-01-2018
Publisher
Springer International Publishing
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 1/2018
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-017-1669-3

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