Application of Real-Time 3D Navigation System in CT-Guided Percutaneous Interventional Procedures: A Feasibility Study.

Priya Bhattacharji,William Moore

doi:10.1155/2017/3151694

Priya Bhattacharji, William Moore

Open Access

https://doi.org/10.1155/2017/3151694

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Abstract

Introduction To evaluate the accuracy of a quantitative 3D navigation system for CT-guided interventional procedures in a two-part study. Materials and Methods Twenty-two procedures were performed in abdominal and thoracic phantoms. Accuracies of the 3D anatomy map registration and navigation were evaluated. Time used for the navigated procedures was recorded. In the IRB approved clinical evaluation, 21 patients scheduled for CT-guided thoracic and hepatic biopsy and ablations were recruited. CT-guided procedures were performed without following the 3D navigation display. Accuracy of navigation as well as workflow fitness of the system was evaluated. Results In phantoms, the average 3D anatomy map registration error was 1.79 mm. The average navigated needle placement accuracy for one-pass and two-pass procedures, respectively, was 2.0 ± 0.7 mm and 2.8 ± 1.1 mm in the liver and 2.7 ± 1.7 mm and 3.0 ± 1.4 mm in the lung. The average accuracy of the 3D navigation system in human subjects was 4.6 mm ± 3.1 for all procedures. The system fits the existing workflow of CT-guided interventions with minimum impact. Conclusion A 3D navigation system can be performed along the existing workflow and has the potential to navigate precision needle placement in CT-guided interventional procedures.

Highlights

To evaluate the accuracy of a quantitative 3D navigation system for Computed tomography (CT)-guided interventional procedures in a twopart study
Despite having high accuracy rates [6,7,8], CT is limited by the lack of real-time imaging which is often necessary for procedural guidance
The quantitative 3D navigation system (IQQA-Guide, EDDA Technology, Inc.) contains an electromagnetic tracking software package and tracks instrument position and orientation in a fully quantified 3D patient-specific anatomy map generated from one preprocedural CT (Figures 1(a)–1(d)) or MRI and its spatial relation to target

Summary

Introduction

To evaluate the accuracy of a quantitative 3D navigation system for CT-guided interventional procedures in a twopart study. The average navigated needle placement accuracy for one-pass and two-pass procedures, respectively, was 2.0 ± 0.7 mm and 2.8 ± 1.1 mm in the liver and 2.7±1.7 mm and 3.0±1.4 mm in the lung. A 3D navigation system can be performed along the existing workflow and has the potential to navigate precision needle placement in CT-guided interventional procedures. Precision placement of intervention instruments is critical for all procedures especially in percutaneous procedures such as biopsies and ablations in order to achieve diagnostic accuracy as well as accurate tumor targeting. Lesions in soft tissue organs, such as the liver and lung, present a unique challenge for radiologists to target in image guided interventions because of motion and deformation. CT fluoroscopy is still a subject of debate for Radiology Research and Practice (a)

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Conclusion