Real-time fusion of ultrasound and gamma probe for navigated localization of liver metastases

Liver metastases are an advanced stage of several types of cancer, usually treated with surgery. Intra-operative localization of these lesions is currently facilitated by intra-operative ultrasound (IOUS) and palpation, yielding a high rate of false positives due to benign abnormal regions. In this paper we present the integration of functional nuclear information from a gamma probe with IOUS, to provide a synchronized, real-time visualization that facilitates the detection of active metastases intra-operatively. We evaluate the system in an ex-vivo setup employing a group of physicians and medical technicians and show that the addition of functional imaging improves the accuracy of localizing and identifying malignant and benign lesions significantly. Furthermore we are able to demonstrate that the inclusion of an advanced, augmented visualization provides more reliability and confidence on classifying these lesions in the presented evaluation setup.