Clinical Application of Image-Guided Liver Surgery

NCT ID: NCT00878215

Last Updated: 2018-02-13

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-10-24

Study Completion Date

2011-05-25

Brief Summary

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Image-guided surgery is a new technology, which is used to create 3-D pictures that generate a map of the liver. This map will allow surgeons to know the exact anatomical location of their instruments, including instances when direct visualization is not possible. This study is designed to determine the safety and feasibility of using image-guided techniques for treatment of liver tumors. The overall goal of this study is to use image-guided surgery for the improvement of the surgeon's ability to remove liver tumors.

Detailed Description

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Conditions

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Hepatocellular Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Phase 1:Localize Anatomical Points on Liver Surface

-The surgeon will use image-guided surgery equipment to create the mapping with 3-D pictures of the participants liver. Laser range scanning will also be used to take 3-D pictures of the liver surface. The participant will then have planned standard surgery.

Group Type EXPERIMENTAL

Explorer Liver Image Guided System

Intervention Type DEVICE

Explorer Liver Passive Tracking

Intervention Type DEVICE

Liver surgery

Intervention Type PROCEDURE

-Standard of care

Phase 2: Ceramic bead

-The surgeon will use image-guided surgery to create the mapping with 3-D pictures of the liver. During the surgery, a ceramic bead will be placed in a pre-operatively determined target location within the tumor using image-guided surgery. Standard surgical procedures will then be used to remove the tumors. Magnetic resonance (MR) images of the resected liver will confirm targeting accuracy.

Group Type EXPERIMENTAL

Explorer Liver Image Guided System

Intervention Type DEVICE

Explorer Liver Passive Tracking

Intervention Type DEVICE

Liver surgery

Intervention Type PROCEDURE

-Standard of care

Phase 3: Ablative therapy

-The surgeon will use image-guided surgery to create the mapping with 3-D pictures of the liver. The liver tumors will be ablated using image-guided surgery. Standard surgical procedures will then be used to remove the portion of the liver that has the ablated tumors. The accuracy of the ablation will be confirmed via pathology sectioning.

Group Type EXPERIMENTAL

Explorer Liver Image Guided System

Intervention Type DEVICE

Explorer Liver Passive Tracking

Intervention Type DEVICE

Liver surgery

Intervention Type PROCEDURE

-Standard of care

Liver abalation

Intervention Type PROCEDURE

-Standard of care

Phase 4: Ablative therapy (not liver resection candidates)

-This phase is for patients who otherwise do not qualify to have a portion of their liver to be surgically removed. The surgeon will use image-guidance to create the mapping with 3-D pictures of the liver. The tumors will be ablated using image-guided therapy.

Group Type EXPERIMENTAL

Explorer Liver Image Guided System

Intervention Type DEVICE

Explorer Liver Passive Tracking

Intervention Type DEVICE

Liver abalation

Intervention Type PROCEDURE

-Standard of care

Interventions

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Explorer Liver Image Guided System

Intervention Type DEVICE

Explorer Liver Passive Tracking

Intervention Type DEVICE

Liver surgery

-Standard of care

Intervention Type PROCEDURE

Liver abalation

-Standard of care

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Written informed consent must be obtained.
* Patient must be 18 years or older.
* Are male or non-pregnant, non-lactating females. Liver resection or ablation could be harmful to an unborn child therefore, is not recommended during pregnancy. After informed consent is obtained, women of childbearing potential will be required to have a blood or urine pregnancy test. All consented patients of childbearing potential will be advised to use adequate birth control (oral, implanted, or barrier methods) along with their sexual partners while being considered for liver tumor resection or ablation and at least up to a month following surgery.
* Patients enrolled in Phase I must be candidates for surgical liver resection per a treating surgeon's discretion. Patients enrolled in Phase 2-3 must be candidates for surgical liver resection of liver mass. Patients enrolled in Phase 4 must be candidates for surgical ablation, but not candidates for surgical resection.
* Patients are scheduled clinically for use of the Pathfinder Explorer Liver Image Guided System which is indicated for open liver surgical procedures where image-guidance may be appropriate and where the patient can tolerate long apneic periods under general anesthesia.

Exclusion Criteria

* Any condition which, in the judgment of the investigator, might increase the risk to the subject or decrease the chance of obtaining satisfactory data to achieve the objectives of the study.
* Mental condition rendering the subject or his/her legal representative unable to understand informed consent to the nature, scope, and possible consequences of the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Washington University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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William C Chapman, MD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Locations

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Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Countries

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United States

References

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Rosen CB. Management of Hepatic Metastases. Cancer Control. 1998 May;5(3 Suppl 1):30-31. doi: 10.1177/107327489800503S11. No abstract available.

Reference Type BACKGROUND
PMID: 10762479 (View on PubMed)

Sardi A, Akbarov A, Conaway G. Management of primary and metastatic tumors to the liver. Oncology (Williston Park). 1996 Jun;10(6):911-25; discussion 926, 929-30.

Reference Type BACKGROUND
PMID: 8823803 (View on PubMed)

Dick EA, Taylor-Robinson SD, Thomas HC, Gedroyc WM. Ablative therapy for liver tumours. Gut. 2002 May;50(5):733-9. doi: 10.1136/gut.50.5.733.

Reference Type BACKGROUND
PMID: 11950826 (View on PubMed)

Parikh AA, Curley SA, Fornage BD, Ellis LM. Radiofrequency ablation of hepatic metastases. Semin Oncol. 2002 Apr;29(2):168-82. doi: 10.1053/sonc.2002.31673.

Reference Type BACKGROUND
PMID: 11951215 (View on PubMed)

Arun KS, Huang TS, Blostein SD. Least-squares fitting of two 3-d point sets. IEEE Trans Pattern Anal Mach Intell. 1987 May;9(5):698-700. doi: 10.1109/tpami.1987.4767965.

Reference Type BACKGROUND
PMID: 21869429 (View on PubMed)

Horn BKP.closed-form solution of absolute orientation using unit quaternions 4:629-642,1987

Reference Type BACKGROUND

Besl PM,McKay ND.A method for registraion of 3-D shapes.IEEE Transaactions on Pattern Analysis and Machine Intelligence 14:239-256,1992

Reference Type BACKGROUND

Cash DM,Siha Tk,Chapman,WC.Fast, accurate surface acquistion using a laser range scanner for image-guided surgical system.SPIE Medical Imaging,2002

Reference Type BACKGROUND

Stefansic JD, Bass WA, Hartmann SL, Beasley RA, Sinha TK, Cash DM, Herline AJ, Galloway RL Jr. Design and implementation of a PC-based image-guided surgical system. Comput Methods Programs Biomed. 2002 Nov;69(3):211-24. doi: 10.1016/s0169-2607(01)00192-4.

Reference Type BACKGROUND
PMID: 12204449 (View on PubMed)

Herline AJ, Stefansic JD, Debelak JP, Hartmann SL, Pinson CW, Galloway RL, Chapman WC. Image-guided surgery: preliminary feasibility studies of frameless stereotactic liver surgery. Arch Surg. 1999 Jun;134(6):644-9; discussion 649-50. doi: 10.1001/archsurg.134.6.644.

Reference Type BACKGROUND
PMID: 10367875 (View on PubMed)

Herline AJ, Herring JL, Stefansic JD, Chapman WC, Galloway RL Jr, Dawant BM. Surface registration for use in interactive, image-guided liver surgery. Comput Aided Surg. 2000;5(1):11-7. doi: 10.1002/(SICI)1097-0150(2000)5:13.0.CO;2-G.

Reference Type BACKGROUND
PMID: 10767091 (View on PubMed)

Pan S,Dawant BM.Automatic 3-D segmentation of the liver from abdominal CT images: a level-set approach. Proceedings of SPIE 4322:128-138,2001.

Reference Type BACKGROUND

Related Links

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http://www.siteman.wustl.edu

Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

Other Identifiers

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201104308

Identifier Type: -

Identifier Source: org_study_id

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