Evaluation of targeting accuracy of cone beam CT guided histotripsy in an in vivo porcine model

Purpose The application of histotripsy, an emerging noninvasive, non-ionizing, and non-thermal tumor treatment, is currently limited by the inherent limitations of diagnostic ultrasound as the sole targeting modality. This study evaluates the feasibility and accuracy of cone beam computed tomography...

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Main Authors: Martin G. Wagner, Grace M. Minesinger, Katrina L. Falk, Ayca Z. Kutlu, Meridith A. Kisting, Michael A. Speidel, Timothy J. Ziemlewicz, J. Louis Hinshaw, John F. Swietlik, Fred T. Lee, Paul F. Laeseke
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:International Journal of Hyperthermia
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Online Access:https://www.tandfonline.com/doi/10.1080/02656736.2025.2455138
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author Martin G. Wagner
Grace M. Minesinger
Katrina L. Falk
Ayca Z. Kutlu
Meridith A. Kisting
Michael A. Speidel
Timothy J. Ziemlewicz
J. Louis Hinshaw
John F. Swietlik
Fred T. Lee
Paul F. Laeseke
author_facet Martin G. Wagner
Grace M. Minesinger
Katrina L. Falk
Ayca Z. Kutlu
Meridith A. Kisting
Michael A. Speidel
Timothy J. Ziemlewicz
J. Louis Hinshaw
John F. Swietlik
Fred T. Lee
Paul F. Laeseke
author_sort Martin G. Wagner
collection DOAJ
description Purpose The application of histotripsy, an emerging noninvasive, non-ionizing, and non-thermal tumor treatment, is currently limited by the inherent limitations of diagnostic ultrasound as the sole targeting modality. This study evaluates the feasibility and accuracy of cone beam computed tomography (CBCT) guidance for histotripsy treatments in an in vivo porcine model.Materials and methods Histotripsy treatments were performed in the liver of seven healthy swine under the guidance of a C-arm CBCT system that was calibrated to the robotic arm of the histotripsy system. For each treatment, pseudotumors (small histotripsy treatments of 15 mm) were created using conventional US guidance to serve as targets for subsequent CBCT guided treatments. A pretreatment CBCT with intravenous contrast was acquired for each swine and the center of the pseudotumor was selected as the target. The robotic arm automatically aligned the transducer to the selected target location. Ultrasound based aberration offset correction was performed when possible, and a 25 mm diameter treatment was performed. A post-treatment CBCT with intravenous contrast was then acquired to evaluate coverage, treatment size, and distance between the pseudotumor target and actual treatment zone center.Results Treatments were technically successful and pseudotumors were completely covered in all seven treatments (7/7). The average treatment diameter was 39.3 ± 4.2 mm. The center-to-center distance between pseudotumor and actual treatments was 3.8 ± 1.3 mm.Conclusion CBCT provides accurate targeting for histotripsy treatment in vivo. While future work is required to assess safety and efficacy in the presence of obstructions, the proposed approach could supplement ultrasound imaging for targeting.
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spelling doaj-art-f3b027d1dae0472981673cffa7bd675f2025-01-23T00:55:10ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572025-12-0142110.1080/02656736.2025.2455138Evaluation of targeting accuracy of cone beam CT guided histotripsy in an in vivo porcine modelMartin G. Wagner0Grace M. Minesinger1Katrina L. Falk2Ayca Z. Kutlu3Meridith A. Kisting4Michael A. Speidel5Timothy J. Ziemlewicz6J. Louis Hinshaw7John F. Swietlik8Fred T. Lee9Paul F. Laeseke10Department of Radiology, University of Wisconsin, Madison, WI, USADepartment of Medical Physics, University of Wisconsin, Madison, WI, USADepartment of Radiology, University of Wisconsin, Madison, WI, USADepartment of Radiology, University of Wisconsin, Madison, WI, USADepartment of Radiology, University of Wisconsin, Madison, WI, USADepartment of Medical Physics, University of Wisconsin, Madison, WI, USADepartment of Radiology, University of Wisconsin, Madison, WI, USADepartment of Radiology, University of Wisconsin, Madison, WI, USADepartment of Radiology, University of Wisconsin, Madison, WI, USADepartment of Radiology, University of Wisconsin, Madison, WI, USADepartment of Radiology, University of Wisconsin, Madison, WI, USAPurpose The application of histotripsy, an emerging noninvasive, non-ionizing, and non-thermal tumor treatment, is currently limited by the inherent limitations of diagnostic ultrasound as the sole targeting modality. This study evaluates the feasibility and accuracy of cone beam computed tomography (CBCT) guidance for histotripsy treatments in an in vivo porcine model.Materials and methods Histotripsy treatments were performed in the liver of seven healthy swine under the guidance of a C-arm CBCT system that was calibrated to the robotic arm of the histotripsy system. For each treatment, pseudotumors (small histotripsy treatments of 15 mm) were created using conventional US guidance to serve as targets for subsequent CBCT guided treatments. A pretreatment CBCT with intravenous contrast was acquired for each swine and the center of the pseudotumor was selected as the target. The robotic arm automatically aligned the transducer to the selected target location. Ultrasound based aberration offset correction was performed when possible, and a 25 mm diameter treatment was performed. A post-treatment CBCT with intravenous contrast was then acquired to evaluate coverage, treatment size, and distance between the pseudotumor target and actual treatment zone center.Results Treatments were technically successful and pseudotumors were completely covered in all seven treatments (7/7). The average treatment diameter was 39.3 ± 4.2 mm. The center-to-center distance between pseudotumor and actual treatments was 3.8 ± 1.3 mm.Conclusion CBCT provides accurate targeting for histotripsy treatment in vivo. While future work is required to assess safety and efficacy in the presence of obstructions, the proposed approach could supplement ultrasound imaging for targeting.https://www.tandfonline.com/doi/10.1080/02656736.2025.2455138Histotripsycone beam CTimage-to-robot registrationhand-eye calibrationfocused ultrasound
spellingShingle Martin G. Wagner
Grace M. Minesinger
Katrina L. Falk
Ayca Z. Kutlu
Meridith A. Kisting
Michael A. Speidel
Timothy J. Ziemlewicz
J. Louis Hinshaw
John F. Swietlik
Fred T. Lee
Paul F. Laeseke
Evaluation of targeting accuracy of cone beam CT guided histotripsy in an in vivo porcine model
International Journal of Hyperthermia
Histotripsy
cone beam CT
image-to-robot registration
hand-eye calibration
focused ultrasound
title Evaluation of targeting accuracy of cone beam CT guided histotripsy in an in vivo porcine model
title_full Evaluation of targeting accuracy of cone beam CT guided histotripsy in an in vivo porcine model
title_fullStr Evaluation of targeting accuracy of cone beam CT guided histotripsy in an in vivo porcine model
title_full_unstemmed Evaluation of targeting accuracy of cone beam CT guided histotripsy in an in vivo porcine model
title_short Evaluation of targeting accuracy of cone beam CT guided histotripsy in an in vivo porcine model
title_sort evaluation of targeting accuracy of cone beam ct guided histotripsy in an in vivo porcine model
topic Histotripsy
cone beam CT
image-to-robot registration
hand-eye calibration
focused ultrasound
url https://www.tandfonline.com/doi/10.1080/02656736.2025.2455138
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