Literature DB >> 17804777

Electromagnetic tracking for thermal ablation and biopsy guidance: clinical evaluation of spatial accuracy.

Jochen Krücker1, Sheng Xu, Neil Glossop, Anand Viswanathan, Jörn Borgert, Heinrich Schulz, Bradford J Wood.   

Abstract

PURPOSE: To evaluate the spatial accuracy of electromagnetic needle tracking and demonstrate the feasibility of ultrasonography (US)-computed tomography (CT) fusion during CT- and US-guided biopsy and radiofrequency ablation procedures.
MATERIALS AND METHODS: The authors performed a 20-patient clinical trial to investigate electromagnetic needle tracking during interventional procedures. The study was approved by the institutional investigational review board, and written informed consent was obtained from all patients. Needles were positioned by using CT and US guidance. A commercial electromagnetic tracking device was used in combination with prototype internally tracked needles and custom software to record needle positions relative to previously obtained CT scans. Position tracking data were acquired to evaluate the tracking error, defined as the difference between tracked needle position and reference standard needle position on verification CT scans. Registration between tracking space and image space was obtained by using reference markers attached to the skin ("fiducials"), and different registration methods were compared. The US transducer was tracked to demonstrate the potential use of real-time US-CT fusion for imaging guidance.
RESULTS: One patient was excluded from analysis because he was unable to follow breathing instructions during the acquisition of CT scans. Nineteen of the 20 patients were evaluable, demonstrating a basic tracking error of 5.8 mm +/- 2.6, which improved to 3.5 mm +/- 1.9 with use of nonrigid registrations that used previous internal needle positions as additional fiducials. Fusion of tracked US with CT was successful. Patient motion and distortion of the tracking system by the CT table and gantry were identified as sources of error.
CONCLUSIONS: The demonstrated spatial tracking accuracy is sufficient to display clinically relevant preprocedural imaging information during needle-based procedures. Virtual needles displayed within preprocedural images may be helpful for clandestine targets such as arterial phase enhancing liver lesions or during thermal ablations when obscuring gas is released. Electromagnetic tracking may help improve imaging guidance for interventional procedures and warrants further investigation, especially for procedures in which the outcomes are dependent on accuracy.

Entities:  

Mesh:

Year:  2007        PMID: 17804777      PMCID: PMC2555977          DOI: 10.1016/j.jvir.2007.06.014

Source DB:  PubMed          Journal:  J Vasc Interv Radiol        ISSN: 1051-0443            Impact factor:   3.464


  26 in total

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