The principles and role of medical imaging in surgery

Abstract

This chapter reviews the current uses of medical imaging in surgery, from pre-operative planning to recent advances in image-guided interventions and its future trends. Imaging has assumed an increasingly important role in surgery since the dawn of the X-ray era, moving from being a primarily diagnostic modality towards a therapeutic and interventional aid, facilitated by advances in surgical technology and the emergence of novel biomarkers, prostheses and targeted therapies. The continuing evolution of imaging techniques, particularly in bringing laboratory-based tissue characterisation techniques to an in vivo, in situ setting will see a paradigm shift in how imaging is used in future surgery. It is feasible that advanced keyhole techniques will be based entirely on image guidance, seamlessly integrating pre-operative data with intra-operative tissue morphology and function. To provide an overview of the current and future trends of medical imaging in surgery, this chapter first summarises the main modalities used for pre-operative imaging in surgery, including ultrasound, X-rays/CT, magnetic resonance imaging (MRI) and radionuclide techniques. In each section, the current state of the art is described, together with their potential future developments. Next, the current use of intra-operative imaging and image-guided intervention is described, outlining the existing techniques and current major developments in progress. This includes endoscopy, optical-imaging methods, stereotactic frameworks, augmented reality (AR) and robotic-assisted interventions.For further information on medical imaging, we refer the reader to the texts by Suetens [1], Bankman [2], Sonka [3] and Webb [4], as well as reviews on current surgical-imaging methods [5, 6]. © Springer-Verlag Berlin Heidelberg 2010.