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Optimized Clinical Workflow for UFE (Uterine Fibroid Embolization) Interventions - Endpoint Detection with Catheter(s), Capable of Measuring the Blood Flow

IP.com Disclosure Number: IPCOM000202214D
Original Publication Date: 2010-Dec-09
Included in the Prior Art Database: 2010-Dec-09
Document File: 3 page(s) / 160K

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Siemens

Related People

Juergen Carstens: CONTACT

Abstract

Uterine Fibroid Embolization (UFE) is a new interventional treatment of women, suffering on fibroid tumors. Fibroid tumors, also known as myomas, are benign tumors that arise from the muscular wall of the uterus. UFE is a relatively new alternative to hysterectomy for treating fibroids. The word embolization means to stop or block the flow of blood. Embolization is a non-surgical, minimally-invasive procedure performed by an interventional radiologist and interventional neuroradiologists. It involves the selective occlusion of blood vessels by purposely introducing so called emboli. Thus, uterine fibroid embolization is a way of stopping the blood supply to the fibroid.

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Optimized Clinical Workflow for UFE (Uterine Fibroid Embolization) Interventions - Endpoint Detection with Catheter(s), Capable of Measuring the Blood Flow

Idea: Stefan Lautenschläger, DE-Forchheim; Dr. Hayo Knoop, DE-Forchheim; Kerstin Sonntag, DE- Forchheim; Jessica Amberg, DE-Forchheim

Uterine Fibroid Embolization (UFE) is a new interventional treatment of women, suffering on fibroid tumors. Fibroid tumors, also known as myomas, are benign tumors that arise from the muscular wall of the uterus. UFE is a relatively new alternative to hysterectomy for treating fibroids. The word embolization means to stop or block the flow of blood. Embolization is a non-surgical, minimally- invasive procedure performed by an interventional radiologist and interventional neuroradiologists. It involves the selective occlusion of blood vessels by purposely introducing so called emboli. Thus, uterine fibroid embolization is a way of stopping the blood supply to the fibroid.

A typical state of the art workflow for an UFE is presented schematically in Figure 1 and by the following stepwise description:

1. Patient:

After talking about the options, doctor and patient decide to perform an UFE intervention.

2. Acquisition of pre-interventional volume:

A MRI (Magnetic Resonance Imaging) scan, covering at least the uterus region, is performed. Optionally volume scans from other modalities like CT (Computed Tomography) or DynaCT (Dynamic Computed Tomography) can be performed.

3. Lesion/fibroid segmentation:

A dedicated software tool segments the lesion/fibroid. This step can be repeated if there are multiple fibroids.

4. Optional: Interactive/manual adjustments of segmentation:

If the result of the segmentation (step 3) has to be improved, the user has the chance to enhance the segmentation result interactively until the segmentation result is sufficient.

5. Detection of fibroid-feeding vessel(s):

A dedicated software tool (e.g. syngo embolization guidance) calculates the centerline of the vessel(s) feeding the fibroid. The result of this computation (centerline of fibroid-feeding vessel(s)) is stored together with the corresponding segmentation of the fibroid (known from step 3).

If there are multiple fibroids, which shall be treated, steps 3-6 can be repeated. Steps 1-5 are pre-interventional steps; this means these steps do not need to be performed in the angio-lab. The following steps are performed in the angio-lab, with the patient on the angio-table.

6. Acquisition of LowDose DynaCT / 3DAngio:

A LowDose DynaCT / 3DAngio scan of the uterus region is performed. Some amount of dose is needed for this acquisition, but there are multiple points to understand:

a. This scan is a rotational scan Dose gets spread

b. The dose for each 2D image of the rotational run is very low (see (c) as well).

c. The dose can be very low, because the image quali...