Qian Dong

By Chengzhan Zhu, Bingzi Dong and Qian Dong

Imaging plays crucial roles in the management of pediatric patients with suspected liver malignant tumors. Three-dimensional (3D) imaging could significantly improve the resection rate of pediatric tumors and increase the safety of the surgery. With the development of medical imaging, 3D reconstruction technology, the innovation of liver surgery and the proposal of precise hepatectomy, the intrahepatic vascular anatomy of the liver and liver segmentectomy based on that vascular anatomy have become well developed. With the analysis of 3D digital liver, we proposed a new type of liver classification system: Dong’s digital liver classification system. And we measured the normal total liver volume from neonate to aging making a reference for surgeons all around the world. And the Human Digital Liver Database was established by the Affiliated Hospital of Qingdao University and Hisense Company, aiming to collect digital liver from neonates, children, adults, and the elderly, from normal livers, livers with cancer, and simulated livers resected using Hisense CAS. Then we showed one case report of patient with giant liver tumor. With the application of Hisense CAS and our data, we successfully removed the tumor. We believe that the new techniques in imaging will help surgeons to accomplish better operations.

Part of the book: Liver Research and Clinical Management

By Wenli Xiu, Xiwei Hao, Nan Xia, Yongjian Chen, Haitao Niu and Qian Dong

Pediatric oncological surgery is difficult and challenging, especially in children with malignant solid tumors. Compared with adults, children have immature organs, thin blood vessels, and poor surgical tolerance. Moreover, pediatric malignant solid tumors are often huge, complex in location, fast-growing, and highly malignant. With artificial intelligence and machine learning breaking through many bottlenecks, computer-assisted precision medicine has also taken a quantum leap forward. Ten years ago, Professor Dong’s group invented the Computer-assisted Surgery System (Hisense CAS). Now, this three-dimensional (3D) visualization technology based on artificial intelligence has been used for pediatric precise oncological surgery and has been upgraded to version 5.0. Hisense CAS was developed based on enhanced pediatric CT data, so it has advantages in displaying pediatric solid tumors. CAS can display the adjacent relationships of the tumor with the surrounding tissues (especially the compressed blood vessels) in a 3D, dynamic, and complete manner through rapid and accurate 3D reconstruction of organs, tumors, and blood vessels. Then, precise preoperative evaluations and surgical planning can be carried out. This chapter focuses on individualized computer-assisted surgical planning and progress in common and complex pediatric tumors (such as malignant liver tumors, retroperitoneal tumors, and mediastinal tumors) and introduces experience in improving the resectability of tumors and reducing surgical complications.

Part of the book: Artificial Intelligence in Medicine and Surgery

By Xianjun Zhou, Chengzhan Zhu, Bin Wei, Nan Xia, Yongjian Chen and Qian Dong

A good understanding of liver anatomy is required for performing precise liver resection. However, the currently described methods of liver segmentation based on portal and hepatic veins are inconclusive. We proposed a system of liver segmentation based on previous reports and our data. Three-dimensional computed tomography software based on artificial intelligence was used to analyze the portal vein branching pattern in 759 patients. We analyzed four different types of liver segmentation and measured their respective segmental liver volumes. We classified four types of liver segmentation based on the right portal vein. Median segmental liver volumes were variable for the different types of segmentation. Our system of liver segmentation enables a better classification of individual patients into one of the different types, thus assisting in preoperative surgical planning. Segmental liver volume is useful for the preoperative evaluation of remnant liver volume.

Part of the book: Artificial Intelligence in Medicine and Surgery