Complete tumor coverage by the thermal ablation zone and with a safety margin (5 or 10 mm) is required to achieve the entire tumor eradication in liver tumor ablation procedures. However, 2D ultrasound (US) imaging has limitations in evaluating the tumor coverage by imaging only one or multiple planes, particularly for cases with multiple inserted applicators or irregular tumor shapes. In this paper, we evaluate the intra-procedural tumor coverage using 3D US imaging and investigate whether it can provide clinically needed information. Using data from 14 cases, we employed surface- and volume-based evaluation metrics to provide information on any uncovered tumor region. For cases with incomplete tumor coverage or uneven ablation margin distribution, we also proposed a novel margin uniformity -based approach to provide quantitative applicator adjustment information for optimization of tumor coverage. Both the surface- and volume-based metrics showed that 5 of 14 cases had incomplete tumor coverage according to the estimated ablation zone. After applying our proposed applicator adjustment approach, the simulated results showed that 92.9% (13 of 14) cases achieved 100% tumor coverage and the remaining case can benefit by increasing the ablation time or power. Our proposed method can evaluate the intra-procedural tumor coverage and intuitively provide applicator adjustment information for the physician. Our 3D US-based method is compatible with the constraints of conventional US-guided ablation procedures and can be easily integrated into the clinical workflow.

中文翻译：

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基于美国的 3D 评估和优化美国引导经皮肝脏热消融的肿瘤覆盖率

在肝肿瘤消融过程中，需要热消融区完全覆盖肿瘤并具有安全余量（5 或 10 毫米）以实现整个肿瘤根除。然而，二维超声 (US) 成像在通过仅对一个或多个平面成像来评估肿瘤覆盖范围方面存在局限性，特别是对于具有多个插入施源器或不规则肿瘤形状的病例。在本文中，我们使用 3D US 成像评估手术中的肿瘤覆盖范围，并研究它是否可以提供临床所需的信息。我们使用 14 个病例的数据，采用基于表面和体积的评估指标来提供有关任何未发现肿瘤区域的信息。对于肿瘤覆盖不全或消融边缘分布不均匀的病例，我们还提出了一种新的基于边缘均匀性的方法来提供定量涂药器调整信息以优化肿瘤覆盖率。基于表面和体积的指标均显示，根据估计的消融区，14 例病例中有 5 例肿瘤覆盖不完整。在应用我们提出的施源器调整方法后，模拟结果显示 92.9%（14 例中的 13 例）实现了 100% 的肿瘤覆盖，其余病例可以通过增加消融时间或功率而受益。我们提出的方法可以评估手术中的肿瘤覆盖率，并直观地为医生提供涂药器调整信息。我们基于 3D US 的方法与传统的 US 引导消融程序的限制兼容，并且可以轻松集成到临床工作流程中。