Spectral imaging of thermal damage induced during microwave ablation in the liver

Induction of thermal damage to tissue through delivery of microwave energy is frequently applied in surgery to destroy diseased tissue such as cancer cells. Minimization of unwanted harm to healthy tissue is still achieved subjectively, and the surgeon has few tools at their disposal to monitor the spread of the induced damage. This work describes the use of optical methods to monitor the time course of changes to the tissue during delivery of microwave energy in the porcine liver. Multispectral imaging and diffuse reflectance spectroscopy are used to monitor temporal changes in optical properties in parallel with thermal imaging. The results demonstrate the ability to monitor the spatial extent of thermal damage on a whole organ, including possible secondary effects due to vascular damage. Future applications of this type of imaging may see the multispectral data used as a feedback mechanism to avoid collateral damage to critical healthy structures and to potentially verify sufficient application of energy to the diseased tissue.Comment: 4pg,6fig. Copyright 2018 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other work

Almost Commuting Matrices, Localized Wannier Functions, and the Quantum Hall Effect

For models of non-interacting fermions moving within sites arranged on a surface in three dimensional space, there can be obstructions to finding localized Wannier functions. We show that such obstructions are $K$-theoretic obstructions to approximating almost commuting, complex-valued matrices by commuting matrices, and we demonstrate numerically the presence of this obstruction for a lattice model of the quantum Hall effect in a spherical geometry. The numerical calculation of the obstruction is straightforward, and does not require translational invariance or introducing a flux torus. We further show that there is a $Z_2$ index obstruction to approximating almost commuting self-dual matrices by exactly commuting self-dual matrices, and present additional conjectures regarding the approximation of almost commuting real and self-dual matrices by exactly commuting real and self-dual matrices. The motivation for considering this problem is the case of physical systems with additional antiunitary symmetries such as time reversal or particle-hole conjugation. Finally, in the case of the sphere--mathematically speaking three almost commuting Hermitians whose sum of square is near the identity--we give the first quantitative result showing this index is the only obstruction to finding commuting approximations. We review the known non-quantitative results for the torus.Comment: 35 pages, 2 figure

Augmented Reality needle ablation guidance tool for Irreversible Electroporation in the pancreas

Irreversible electroporation (IRE) is a soft tissue ablation technique suitable for treatment of inoperable tumours in the pancreas. The process involves applying a high voltage electric field to the tissue containing the mass using needle electrodes, leaving cancerous cells irreversibly damaged and vulnerable to apoptosis. Efficacy of the treatment depends heavily on the accuracy of needle placement and requires a high degree of skill from the operator. In this paper, we describe an Augmented Reality (AR) system designed to overcome the challenges associated with planning and guiding the needle insertion process. Our solution, based on the HoloLens (Microsoft, USA) platform, tracks the position of the headset, needle electrodes and ultrasound (US) probe in space. The proof of concept implementation of the system uses this tracking data to render real-time holographic guides on the HoloLens, giving the user insight into the current progress of needle insertion and an indication of the target needle trajectory. The operator's field of view is augmented using visual guides and real-time US feed rendered on a holographic plane, eliminating the need to consult external monitors. Based on these early prototypes, we are aiming to develop a system that will lower the skill level required for IRE while increasing overall accuracy of needle insertion and, hence, the likelihood of successful treatment.Comment: 6 pages, 5 figures. Proc. SPIE 10576 (2018) Copyright 2018 Society of Photo Optical Instrumentation Engineers (SPIE). One print or electronic copy may be made for personal use only. Systematic reproduction and distribution, duplication of any material in this publication for a fee or for commercial purposes, or modification of the contents of the publication are prohibite

Germline loss of PKM2 promotes metabolic distress and hepatocellular carcinoma

Alternative splicing of the Pkm gene product generates the PKM1 and PKM2 isoforms of pyruvate kinase (PK), and PKM2 expression is closely linked to embryogenesis, tissue regeneration, and cancer. To interrogate the functional requirement for PKM2 during development and tissue homeostasis, we generated germline PKM2-null mice (Pkm2[superscript −/−]). Unexpectedly, despite being the primary isoform expressed in most wild-type adult tissues, we found that Pkm2[superscript −/−] mice are viable and fertile. Thus, PKM2 is not required for embryonic or postnatal development. Loss of PKM2 leads to compensatory expression of PKM1 in the tissues that normally express PKM2. Strikingly, PKM2 loss leads to spontaneous development of hepatocellular carcinoma (HCC) with high penetrance that is accompanied by progressive changes in systemic metabolism characterized by altered systemic glucose homeostasis, inflammation, and hepatic steatosis. Therefore, in addition to its role in cancer metabolism, PKM2 plays a role in controlling systemic metabolic homeostasis and inflammation, thereby preventing HCC by a non-cell-autonomous mechanism.National Cancer Institute (U.S.) (Cancer Center Support Grant P30CA14051)Howard Hughes Medical InstituteBurroughs Wellcome FundSmith Family FoundationUnited States. Dept. of Health and Human Services (P01CA117969)United States. Dept. of Health and Human Services (R01CA168653)American Society for Engineering Education. National Defense Science and Engineering Graduate FellowshipJane Coffin Childs Memorial Fund for Medical Research (Postdoctoral Fellowship