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Intervention Planning Using a Laser Navigation System for CT-Guided Interventions: A Phantom and Patient Study.

Gruber-Rouh T, Lee C, Bolck J, Naguib NN, Schulz B, Eichler K, Aschenbach R, Wichmann JL, Vogl TJ, Zangos S - Korean J Radiol (2015)

Bottom Line: An additional 20 LNS-guided interventions were performed on another phantom to confirm accuracy.The LNS group achieved target point accuracy of 5.0 ± 1.2 mm, entrance point accuracy of 2.0 ± 1.5 mm, needle angulation accuracy of 1.5 ± 0.3°, intervention time of 12.08 ± 3.07 minutes, and used 5.7 ± 1.6 CT-images for the first experience with patients.Laser navigation system improved accuracy, duration of intervention, and radiation dose of CT-guided interventions.

View Article: PubMed Central - PubMed

Affiliation: Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany.

ABSTRACT

Objective: To investigate the accuracy, efficiency and radiation dose of a novel laser navigation system (LNS) compared to those of free-handed punctures on computed tomography (CT).

Materials and methods: Sixty punctures were performed using a phantom body to compare accuracy, timely effort, and radiation dose of the conventional free-handed procedure to those of the LNS-guided method. An additional 20 LNS-guided interventions were performed on another phantom to confirm accuracy. Ten patients subsequently underwent LNS-guided punctures.

Results: The phantom 1-LNS group showed a target point accuracy of 4.0 ± 2.7 mm (freehand, 6.3 ± 3.6 mm; p = 0.008), entrance point accuracy of 0.8 ± 0.6 mm (freehand, 6.1 ± 4.7 mm), needle angulation accuracy of 1.3 ± 0.9° (freehand, 3.4 ± 3.1°; p < 0.001), intervention time of 7.03 ± 5.18 minutes (freehand, 8.38 ± 4.09 minutes; p = 0.006), and 4.2 ± 3.6 CT images (freehand, 7.9 ± 5.1; p < 0.001). These results show significant improvement in 60 punctures compared to freehand. The phantom 2-LNS group showed a target point accuracy of 3.6 ± 2.5 mm, entrance point accuracy of 1.4 ± 2.0 mm, needle angulation accuracy of 1.0 ± 1.2°, intervention time of 1.44 ± 0.22 minutes, and 3.4 ± 1.7 CT images. The LNS group achieved target point accuracy of 5.0 ± 1.2 mm, entrance point accuracy of 2.0 ± 1.5 mm, needle angulation accuracy of 1.5 ± 0.3°, intervention time of 12.08 ± 3.07 minutes, and used 5.7 ± 1.6 CT-images for the first experience with patients.

Conclusion: Laser navigation system improved accuracy, duration of intervention, and radiation dose of CT-guided interventions.

No MeSH data available.


Related in: MedlinePlus

Marking needle entry point with laser navigation system (LNS).A. Image illustrates placing needle tip on surface of Phantom 2 with laser spot marked by LNS during intervention. B. Needle is adjusted in direction of laser beam denoted by projecting laser beam as point on centre of upper end of puncture needle during lesion targeting in Phantom 1.
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Figure 2: Marking needle entry point with laser navigation system (LNS).A. Image illustrates placing needle tip on surface of Phantom 2 with laser spot marked by LNS during intervention. B. Needle is adjusted in direction of laser beam denoted by projecting laser beam as point on centre of upper end of puncture needle during lesion targeting in Phantom 1.

Mentions: A complete CT scan of Phantom 1 was acquired on the CT table with a slice thickness of 5 mm, and the image file (DICOM format) was transferred via a local network to the LNS workstation. The appropriate image plane and needle path for the puncture was selected by drawing a marker line selecting the needle entry point on the surface (representing the skin) of the phantom body and the target point using the LNS navigation software. The system automatically calculated puncture depth and table position. Once the corresponding table position was reached, the LNS automatically marked the needle entry point (Fig. 2A) and needle direction via the laser beam. The physician introduced the needle at the highlighted needle entry point and advanced the needle, ensuring that the laser spot was always visible on the distal end of the needle (Fig. 2B). The correct length of the intervention for needles without depth control was estimated from the residual part of the needle. Once the needle tip reached the target point, needle advancement was stopped, and the intervention was completed. As soon as the series of punctures were finished, another CT-scan of the whole phantom was performed, and the data were transferred to the LNS computer for the accuracy analysis (Fig. 3). The procedure was the same for Phantom 2, and the intervention was terminated when the needle reached the target. The first patients were punctured using the same technique.


Intervention Planning Using a Laser Navigation System for CT-Guided Interventions: A Phantom and Patient Study.

Gruber-Rouh T, Lee C, Bolck J, Naguib NN, Schulz B, Eichler K, Aschenbach R, Wichmann JL, Vogl TJ, Zangos S - Korean J Radiol (2015)

Marking needle entry point with laser navigation system (LNS).A. Image illustrates placing needle tip on surface of Phantom 2 with laser spot marked by LNS during intervention. B. Needle is adjusted in direction of laser beam denoted by projecting laser beam as point on centre of upper end of puncture needle during lesion targeting in Phantom 1.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499536&req=5

Figure 2: Marking needle entry point with laser navigation system (LNS).A. Image illustrates placing needle tip on surface of Phantom 2 with laser spot marked by LNS during intervention. B. Needle is adjusted in direction of laser beam denoted by projecting laser beam as point on centre of upper end of puncture needle during lesion targeting in Phantom 1.
Mentions: A complete CT scan of Phantom 1 was acquired on the CT table with a slice thickness of 5 mm, and the image file (DICOM format) was transferred via a local network to the LNS workstation. The appropriate image plane and needle path for the puncture was selected by drawing a marker line selecting the needle entry point on the surface (representing the skin) of the phantom body and the target point using the LNS navigation software. The system automatically calculated puncture depth and table position. Once the corresponding table position was reached, the LNS automatically marked the needle entry point (Fig. 2A) and needle direction via the laser beam. The physician introduced the needle at the highlighted needle entry point and advanced the needle, ensuring that the laser spot was always visible on the distal end of the needle (Fig. 2B). The correct length of the intervention for needles without depth control was estimated from the residual part of the needle. Once the needle tip reached the target point, needle advancement was stopped, and the intervention was completed. As soon as the series of punctures were finished, another CT-scan of the whole phantom was performed, and the data were transferred to the LNS computer for the accuracy analysis (Fig. 3). The procedure was the same for Phantom 2, and the intervention was terminated when the needle reached the target. The first patients were punctured using the same technique.

Bottom Line: An additional 20 LNS-guided interventions were performed on another phantom to confirm accuracy.The LNS group achieved target point accuracy of 5.0 ± 1.2 mm, entrance point accuracy of 2.0 ± 1.5 mm, needle angulation accuracy of 1.5 ± 0.3°, intervention time of 12.08 ± 3.07 minutes, and used 5.7 ± 1.6 CT-images for the first experience with patients.Laser navigation system improved accuracy, duration of intervention, and radiation dose of CT-guided interventions.

View Article: PubMed Central - PubMed

Affiliation: Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany.

ABSTRACT

Objective: To investigate the accuracy, efficiency and radiation dose of a novel laser navigation system (LNS) compared to those of free-handed punctures on computed tomography (CT).

Materials and methods: Sixty punctures were performed using a phantom body to compare accuracy, timely effort, and radiation dose of the conventional free-handed procedure to those of the LNS-guided method. An additional 20 LNS-guided interventions were performed on another phantom to confirm accuracy. Ten patients subsequently underwent LNS-guided punctures.

Results: The phantom 1-LNS group showed a target point accuracy of 4.0 ± 2.7 mm (freehand, 6.3 ± 3.6 mm; p = 0.008), entrance point accuracy of 0.8 ± 0.6 mm (freehand, 6.1 ± 4.7 mm), needle angulation accuracy of 1.3 ± 0.9° (freehand, 3.4 ± 3.1°; p < 0.001), intervention time of 7.03 ± 5.18 minutes (freehand, 8.38 ± 4.09 minutes; p = 0.006), and 4.2 ± 3.6 CT images (freehand, 7.9 ± 5.1; p < 0.001). These results show significant improvement in 60 punctures compared to freehand. The phantom 2-LNS group showed a target point accuracy of 3.6 ± 2.5 mm, entrance point accuracy of 1.4 ± 2.0 mm, needle angulation accuracy of 1.0 ± 1.2°, intervention time of 1.44 ± 0.22 minutes, and 3.4 ± 1.7 CT images. The LNS group achieved target point accuracy of 5.0 ± 1.2 mm, entrance point accuracy of 2.0 ± 1.5 mm, needle angulation accuracy of 1.5 ± 0.3°, intervention time of 12.08 ± 3.07 minutes, and used 5.7 ± 1.6 CT-images for the first experience with patients.

Conclusion: Laser navigation system improved accuracy, duration of intervention, and radiation dose of CT-guided interventions.

No MeSH data available.


Related in: MedlinePlus