The National Centre for 3D Ultrasound in Surgery

The main goal is to improve diagnostics and therapy guidance of the vascular system using advanced 2D, 3D and 4D ultrasound imaging and micronavigation inside the vessels during endovascular procedures.

The team focuses on improving diagnostics and therapy of the vascular system with emphasis on carotid plaque, abdominal aortic aneurysm and endovascular procedures. Sicne 1995, the researchers have been joining the operating team to improve the endovascular procedures and reduce trauma and radiation for the patient. Navigation during endovascular procedures can make it easier to perform stentgraft implantation. The use of intraoperative imaging as Dyna CT makes it possible to update the map for navigation and control the procedure with satisfying quality, accuracy and efficiency.

Advanced 2D, 3D and 4D Ultrasound imaging and sophisticated signal processing methods in combination with advances in blood flow imaging and simulation can improve diagnostics of patients suffering from carotid plaque and abdominal aortic aneurysm (AAA). We have explored new methods based on strain detection in the vessel wall as well as diagnostics of carotid plaque using various ultrasound signal processing and image analysis methods.

Our main project activities are:

• Minimally invasive image-guided endovscular treatment using micropositioning sensors and navigation of stent grafts based on advanced display
• Advanced diagnostics and follow up of patients with abdominal aortic aneurysms (AAA) using new ultrasound-based technologies
• Improved diagnostics and therapy of patients with carotid plaque

Facts:

• More than 300 operations with endovascular procedures
• Medical technology award in 1998 for pioneer work in endovascular procedures
• Micropositioning of catheters using navigation, advanced display combined with intraoperative imaging for safer and more efficient stent graft deployment
• Teleradiological follow up of patients with AAA using interactive 3D visualization for more efficient and user friendly health care (2004)
• Patent of stent graft with side branches for improved endovascular procedures (2002)
• Improved diagnostics of vessel wall by development of new ultrasound based strain imaging
• Improved diagnostics of carotid plaque by movement detection using ultrasound technologies and advanced image processing and analysis

The unique and close collaboration between clinicians at St. Olavs Hospital and research scientists at SINTEF has resulted in new ways of using navigation technology and image-guided therapy methods in laparoscopic procedures.

The group aim to improve laparoscopy by applying novel solutions and methods such as navigation technology and ultrasound to improve patient outcome and allow more advanced procedures to be performed by laparoscopic techniques.

The core activity is research and development as well as clinical testing of navigation technology in laparoscopic surgery. In addition we perform laboratory research and experimental studies to develop advanced guidance and monitoring methods based on ultrasound.

Main project activities are:

• Image guided laparoscopy using navigation technology
• Laparoscopic 3D uultrasound imaging
• Ultrasound monitoring and navigation of radio frequency ablation
• Improving ergonomics in laparoscopic surgery

Facts:

• Patent on SonoDoppler(R) - Technology for detecting blood vessels in laparoscopic surgery
• Award for best Norwegian invention 1999 (SonoDoppler(R))
• Award for best experimental study /ultrasound monitoring of radio frequency ablation) at annual meeting in Norwegian Society of Srugeons 2002
• Award for best technological presentation at AMIC (Arbeitsgemeinschaft für Minimal Invasive Chirurgie, Austria) 2003
• Award for best technology development in laparoscopic surgery presented at EAES 2003 (Glasgow) - Pointer for laparoscopic navigation
• Award for best technology development in laparoscopic surgery presented at EAES 2004 (Barcelona) - Video laparoscope as an advanced navigation tool
• Award for best scientific paper in medical technology 2004 - Laparoscopic pointer study

The technology has been adapted for several applications in neurosurgery, including neuroendoscopic procedures, spinal cord surgery, vascular surgery and brain tumour surgery.

Advanced 3D visualization techniques have been developed and are used for navigation with functional data /fMRI/DTI( and guidance in vascular surgery. Ultrasound strain imaging techniques have been developed for mapping elastic properties of brain tumours. The clinical demands are highly emphasized in our research activities. This also includes the patients perspective. An ongoing clinical study is evaluating the quality of life for brain tumour patients operated with intraoperative 3D ultrasound guidance.

Main clinical project activities are:

• Clinical research and evaluation of intraoperative 3D ultrasound for guidance of brain tumour surgery
• 3D guidance and control in vascular brain surgery (aneurysms and AVMs)
• Ultrasound-guided spinal cord surgery
• Clinical evaluation of new ultrasound imaging techniques such as strain imaging of tumours and blood flow imaging (BFI) of vascular structures
• Clinical evaluation of multimodal visualization for optimal integration between intraoperative 3D ultrasound and preoperative MRI

Fakta

• More than 450 project operations performed with 3D ultrasound (1996-2006)
• Over 270 brain tumours
• Over 60 vascular lesions
• Worlds first brain tumour operation assisted by navigated intraoperative 3D ultrasound (1997)
• First cerebrovascular operation assisted by navigated intraoperative 3D US angiography and stereoscopic visualization (1999)
• Navigation with preoperative fMRI/DTI showing functional areas and nerve tracks of the brain (2004)
• Technology is patented, commercialized by Mison AS, and isntalled at several hospitals in Europe
• Several medical-technological awards received, including: Most innovative research on spinal disorders, 2004-2005 (F. Kolstad), Norgeian Society for Spinal Research. Best research in Medical Technology, 2002 (G. Unsgård), NTNU