Abstract
PurposeAccurate and precise needle placement is of utmost importance in interventional radiology. However, targeting can be challenging due to, eg, tissue motion and deformation. Steerable needles are a possible solution to overcome these challenges. The present work studied the clinical need for steerable needles. We aimed to answer three subquestions: 1) What are the current challenges in needle placement? 2) What are allowable needle placement errors? and 3) Do current needles need improvement and would steerable needles add clinical value?MethodsA questionnaire was administered at the Annual Meeting of Cardiovascular and Interventional Radiology Society of Europe in 2016. In total, 153 respondents volunteered to fill out the survey, among them 125 (interventional) radiologists with experience in needle placement.Results1) Current challenges in needle placement include patient-specific and technical factors. Movement of the target due to breathing makes it most difficult to place a needle (90%). 2) The mean maximal allowable needle placement error in targeted lesions is 2.7 mm. A majority of the respondents (85%) encounter unwanted needle bending upon insertion. The mean maximal encountered unwanted needle bending is 5.3 mm. 3) Needles in interventional radiology need improvement, eg, improved needle visibility and manipulability, according to 95% of the respondents. Added value for steerable needles in current interventions is seen by 93% of the respondents.ConclusionSteerable needles have the potential to add clinical value to radiologic interventions. The current data can be used as input for defining clinical design requirements for technical tools, such as steerable needles and navigation models, with the aim to improve needle placement in interventional radiology.
Highlights
In interventional radiology, needles are placed under image guidance into organs to treat or diagnose patients, eg, in thermal ablation and biopsy procedures, respectively
The answers to the questions stated in the “Introduction” section are as follows: 1. Challenges in needle placement in interventional radiology concern patient-specific and technical factors
For people involved in the development of new medical tools for interventional radiology, the take-home message is to focus on improving imaging quality and needle visibility, and on finding solutions for patient-specific challenges
Summary
Needles are placed under image guidance into organs to treat or diagnose patients, eg, in thermal ablation and biopsy procedures, respectively. One proposed technical innovation to overcome some of the challenges in needle placement, and decreasing the needle placement error in interventional radiology, is a steerable needle Such a needle would help in decreasing the placement error, and in reducing the number of punctures and lowering the overall procedure time. Several medical engineering research groups are working on the development of steerable needles. According to research, these needles can be used to correct unwanted needle bending and lesion motion,[2,3] actively steer around anatomical obstacles,[2] or even reach anatomical targets that are not accessible using conventional needles.[4,5]. An overview of needle-like instruments for steering through solid organs is given by Scali et al.[6]
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