Image-guided surgery — a technology that first grew in the fields of neurosurgery and breast cancer treatment —  is available to treat liver cancer thanks to about 10 years of research by William Chapman, MD, chief of the Section of Transplant Surgery at Washington University School of Medicine, and a team of bioengineers at Vanderbilt University in Nashville, TN.

That image-guided system for liver surgery is approved by the FDA.

Starting with preoperative imaging studies (computed tomography [CT] and magnetic resonance imaging [MRI]), Dr. Chapman and his team developed a system to scan the liver surface in the OR and perform a registration, matching the actual liver to its appearance on the pre-operative scan. Once this is accomplished, surgical team members can visualize the liver, including all internal structures, in three dimensions on a monitor. Surgical instruments also are tracked, and the surgeon can see the locations of instrument tips throughout the procedure.

Image-guided surgery has found widespread acceptance in the treatment of brain tumors and other neurological disorders and then was used in the diagnosis and treatment of breast cancer. As with other applications, image-guided liver surgery can provide more accurate navigation and excision through three-dimensional imaging. It also can be used for guidance in liver ablation surgery and in living donor liver resections.

The work of Chapman and the bioengineering team was supported by the National Institutes of Health and the National Science Foundation.