Needle Tip Tracking Research Articles

Needle Tip Tracking through Photoluminescence for Minimally Invasive Surgery.

Minimally invasive surgery continues to prioritize patient safety by improving imaging techniques and tumor detection methods. In this work, an all-optical alternative to the current image based techniques for in vitro minimally invasive procedures has been explored. The technique uses a highly fluorescent marker for the surgical needle to be tracked inside simulated tissues. A series of markers were explored including inorganic (Perovskite and PbS) and organic (carbon dots) nanoparticles and organic dye (Rhodamine 6G) to identify layers of different stiffnesses within a tissue. Rhodamine 6G was chosen based on its high fluorescence signal to track 3D position of a surgical needle in a tissue. The needle was tracked inside homogeneous and inhomogeneous gelatin tissues successfully. This exploratory study of tissue characterization and needle tip tracking using fluorescent markers or photoluminescence technique show potential for real-time application of robot-assisted needle insertions during in vivo procedures.

Needle Tip Tracking Based on Optical Imaging and AI

Needle Tip Tracking Based on Optical Imaging and AI

Improving Needle Tip Tracking and Detection in Ultrasound-Based Navigation System Using Deep Learning-Enabled Approach.

Ultrasound-guided percutaneous interventions have numerous advantages over traditional techniques. Accurate needle placement in the target anatomy is crucial for successful intervention, and reliable visual information is essential to achieve this. However, previous studies have revealed several challenges, such as the variability in needle echogenicity and the common misalignment of the ultrasound beam and the needle. Advanced techniques have been developed to optimize needle visualization, including hardware-based and image-processing-based methods. This paper proposes a novel strategy of integrating ultrasound-based deep learning approaches into an optical navigation system to enhance needle visualization and improve tip positioning accuracy. Both the tracking and detection algorithms are optimized utilizing optical tracking information. The information is introduced into the tracking network to define the search patch update strategy and form a trajectory reference to correct tracking results. In the detection network, the original image is processed according to the needle insertion position and current position given by the optical localization system to locate a coarse region, and the depth-score criterion is adopted to optimize detection results. Extensive experiments demonstrate that our approach achieves promising tip tracking and detection performance with tip localization errors of 1.11 ± 0.59 mm and 1.17 ± 0.70 mm, respectively. Moreover, we establish a paired dataset consisting of ultrasound images and their corresponding spatial tip coordinates acquired from the optical tracking system and conduct real puncture experiments to verify the effectiveness of the proposed methods. Our approach significantly improves needle visualization and provides physicians with visual guidance for posture adjustment.

Learning-based needle tip tracking in 2D ultrasound by fusing visual tracking and motion prediction.

Visual trackers are the most commonly adopted approach for needle tip tracking in ultrasound (US)-based procedures. However, they often perform unsatisfactorily in biological tissues due to the significant background noise and anatomical occlusion. This paper presents a learning-based needle tip tracking system, which consists of not only a visual tracking module, but also a motion prediction module. In the visual tracking module, two sets of masks are designed to improve the tracker's discriminability, and a template update submodule is used to keep up to date with the needle tip's current appearance. In the motion prediction module, a Transformer network-based prediction architecture estimates the target's current position according to its historical position data to tackle the problem of target's temporary disappearance. A data fusion module then integrates the results from the visual tracking and motion prediction modules to provide robust and accurate tracking results. Our proposed tracking system showed distinct improvement against other state-of-the-art trackers during the motorized needle insertion experiments in both gelatin phantom and biological tissue environments (e.g. 78% against <60% in terms of the tracking success rate in the most challenging scenario of "In-plane-static" during the tissue experiments). Its robustness was also verified in manual needle insertion experiments under varying needle velocities and directions, and occasional temporary needle tip disappearance, with its tracking success rate being >18% higher than the second best performing tracking system. The proposed tracking system, with its computational efficiency, tracking robustness, and tracking accuracy, will lead to safer targeting during existing clinical practice of US-guided needle operations and potentially be integrated in a tissue biopsy robotic system.

Intraoperative Needle Tip Tracking with an Integrated Fibre-Optic Ultrasound Sensor.

Ultrasound is an essential tool for guidance of many minimally-invasive surgical and interventional procedures, where accurate placement of the interventional device is critical to avoid adverse events. Needle insertion procedures for anaesthesia, fetal medicine and tumour biopsy are commonly ultrasound-guided, and misplacement of the needle may lead to complications such as nerve damage, organ injury or pregnancy loss. Clear visibility of the needle tip is therefore critical, but visibility is often precluded by tissue heterogeneities or specular reflections from the needle shaft. This paper presents the in vitro and ex vivo accuracy of a new, real-time, ultrasound needle tip tracking system for guidance of fetal interventions. A fibre-optic, Fabry-Pérot interferometer hydrophone is integrated into an intraoperative needle and used to localise the needle tip within a handheld ultrasound field. While previous, related work has been based on research ultrasound systems with bespoke transmission sequences, the new system-developed under the ISO 13485 Medical Devices quality standard-operates as an adjunct to a commercial ultrasound imaging system and therefore provides the image quality expected in the clinic, superimposing a cross-hair onto the ultrasound image at the needle tip position. Tracking accuracy was determined by translating the needle tip to 356 known positions in the ultrasound field of view in a tank of water, and by comparison to manual labelling of the the position of the needle in B-mode US images during an insertion into an ex vivo phantom. In water, the mean distance between tracked and true positions was 0.7 ± 0.4 mm with a mean repeatability of 0.3 ± 0.2 mm. In the tissue phantom, the mean distance between tracked and labelled positions was 1.1 ± 0.7 mm. Tracking performance was found to be independent of needle angle. The study demonstrates the performance and clinical compatibility of ultrasound needle tracking, an essential step towards a first-in-human study.

Evaluating the Impact of Assessment Metrics for Simulated Central Venous Catheterization Training.

Performance assessment and feedback are critical factors in successful medical simulation-based training. The Dynamic Haptic Robotic Trainer (DHRT) allows residents to practice ultrasound-guided needle insertions during simulated central venous catheterization (CVC) procedures while providing detailed feedback and assessment. A study was performed to examine the effectiveness of the DHRT in training the important skills of needle tip tracking and aspiration and how these skills impact procedural complications in simulated CVC. The DHRT data were collected for 163 residents at 2 hospitals for 6 simulated needle insertions. Users were given automated feedback on 5 performance metrics, which measure aspiration rate, arterial punctures, punctures through and through the vein, loss of access to the vein, and successful access to the vein. Aspiration rates and tip tracking rates were analyzed to determine their significance in preventing CVC complications and improving performance. Tip tracking rates higher than 40% were 2.3 times more likely to result in successful venous access than rates less than 10%. Similarly, aspiration rates higher than 80% were 2.6 times more likely to result in successful venous access than rates less than 10%. Proper tip tracking and aspiration both reduced mechanical complications. Resident performance improved for all metrics except tip tracking. Proper tip tracking and aspiration both reduced complications and increased the likelihood of success. However, the skill of tip tracking was not effectively learned through practice without feedback. Therefore, ultrasound-guided needle-based procedures, including CVC, can be improved by providing specific feedback to users on their ultrasound usage to track needle insertions.

Development of a multisystem point of care ultrasound skills assessment checklist

BackgroundMany institutions are training clinicians in point-of-care ultrasound (POCUS), but few POCUS skills checklists have been developed and validated. We developed a consensus-based multispecialty POCUS skills checklist with anchoring references for basic cardiac, lung, abdominal, and vascular ultrasound, and peripheral intravenous line (PIV) insertion.MethodsA POCUS expert panel of 14 physicians specializing in emergency, critical care, and internal/hospital medicine participated in a modified-Delphi approach to develop a basic POCUS skills checklist by group consensus. Three rounds of voting were conducted, and consensus was defined by ≥ 80% agreement. Items achieving < 80% consensus were discussed and considered for up to two additional rounds of voting.ResultsThirteen POCUS experts (93%) completed all three rounds of voting. Cardiac, lung, abdominal, and vascular ultrasound checklists included probe location and control, basic machine setup, image quality and optimization, and identification of anatomical structures. PIV insertion included additional items for needle tip tracking. During the first round of voting, 136 (82%) items achieved consensus, and after revision and revoting, an additional 21 items achieved consensus. A total of 153 (92%) items were included in the final checklist.ConclusionsWe have developed a consensus-based, multispecialty POCUS checklist to evaluate skills in image acquisition and anatomy identification for basic cardiac, lung, abdominal, and vascular ultrasound, and PIV insertion.

Ultrasonic Needle Tracking with Dynamic Electronic Focusing.

Accurate identification of the needle tip is a key challenge with ultrasound-guided percutaneous interventions in regional anaesthesia, foetal surgery and cardiovascular medicine. In this study, we developed an ultrasonic needle tracking system in which the measured needle tip location was used to set the electronic focus of the external ultrasound imaging probe. In this system, needle tip tracking was enabled with a fibre-optic ultrasound sensor that was integrated into a needle stylet, and the A-lines recorded by the sensor were processed to generate tracking images of the needle tip. The needle tip position was estimated from the tracking images. The dependency of the tracking image on the electronic focal depth of the external ultrasound imaging probe was studied in a water bath and with needle insertions into a clinical training phantom. The variability in the estimated tracked position of the needle tip, with the needle tip at fixed depths in the imaging plane across a depth range from 0.5 to 7.5 cm, was studied. When the electronic focus was fixed, the variability of tracked position was found to increase with distance from that focus. The variability with the fixed focus was found to depend on the the relative distance between the needle tip and focal depth. It was found that with dynamic focusing, the maximum variability of tracked position was below 0.31 mm, as compared with 3.97 mm for a fixed focus.

The Development of a Virtual Simulator for a Novel Design Non-Permanent Magnetic Needle Based Eye Anesthesia Training System

Ophthalmic anesthesia plays a crucial role in eye surgery. However, the conventional practice of this process is a blind procedure, in which a needle is inserted blindly into the cadaver. This paper introduces a needle tip tracking system for ophthalmic anesthesia training focusing on the Retrobulbar block procedure. The study presents a development in a prototyped system using Hall effect sensor arrays to track a 5D magnetized needle tip (X, Y, Z, θ, φ ). The orbital structure is fabricated with embedded Hall effect sensors. The extended Kalman filter and least square method are developed to select the observation model from multiple training sets and to estimate the needle tip coordinates. The robotic manipulator (ABB YUMI) is used to model the training set between the distance and the initial angle of the magnetized needle. The developed system provides the needle tip position with an RMS of Euclidean distance error up to 1.7398 ± 0.5288 mm. As a result, the system is capable of providing the needle tip positions with an acceptable error comparing the system’s accuracy with the size of the retrobulbar target space and important anatomies.

Needle Tip Tracking in 2D Ultrasound Based on Improved Compressive Tracking and Adaptive Kalman Filter

Ultrasound (US) is commonly used in percutaneous needle procedures for real-time guidance. Accurate and robust automatic needle tracking is highly desirable to address the influence of noise and artifacts in US images. This letter presents a tracking approach which combines an improved compressive tracking (ICT) algorithm and a modified Sage-Husa adaptive Kalman filter (SHAKF) to achieve real-time needle tip tracking under 2D US. Estimated needle insertion velocity is used to improve the tracking performance while the high US pixel intensity of the needle tip is used to correct drift. A simplified SHAKF is then implemented to adaptively estimate the statistical characteristics of the noise in the compressive tracking results. An innovation threshold is proposed to improve the response speed of the filter while a normalized cross correlation based method is used to improve the tracking robustness. The proposed tracking approach has been evaluated in in-plane and out-of-plane motions under different insertion speeds and angles in both phantom and tissue experiments. Compared with the original compressive tracking, ICT+Kalman filter, and the template matching algorithm, our proposed approach demonstrates highly accurate tracking performance and high robustness in all cases.

Path Replanning for Orientation-Constrained Needle Steering.

Needle-based neurosurgical procedures require high accuracy in catheter positioning to achieve high clinical efficacy. Significant challenges for achieving accurate targeting are (i) tissue deformation (ii)clinical obstacles along the insertion path (iii) catheter control. We propose a novel path-replanner able to generate an obstacle-free and curvature bounded three-dimensional (3D) path at each time step during insertion, accounting for a constrained target pose and intraoperative anatomical deformation. Additionally, our solution is sufficiently fast to be used in a closed-loop system: needle tip tracking via electromagnetic sensors is used by the path-replanner to automatically guide the programmable bevel-tip needle (PBN) while surgical constraints on sensitive structures avoidance are met. The generated path is achieved by combining the "Bubble Bending" method for online path deformation and a 3D extension of a convex optimisation method for path smoothing. Simulation results performed on a realistic dataset show that our replanning method can guide a PBN with bounded curvature to a predefined target pose with an average targeting error of 0.65 ±0.46mm in position and 3.25 ±5.23 degrees in orientation under a deformable simulated environment. The proposed algorithm was also assessed in-vitro on a brain-like gelatin phantom, achieving a target error of 1.81 ±0.51mm in position and 5.9 ±1.42 degrees in orientation. The presented work assessed the performance of a new online steerable needle path-planner able to avoid anatomical obstacles while optimizing surgical criteria. This method is particularly suited for surgical procedures demanding high accuracy on the desired goal pose under tissue deformations and real-world inaccuracies.

A Mannequin-Based Training System With Integrated Sensors for Ophthalmic Sub-Tenon Anesthesia

Sub-tenon ophthalmic blocks are gaining popularity for ophthalmic anesthesia but have no suitable systems available for training. In this article, the design and development of the first mannequin-based system to train and evaluate an ophthalmic anesthesiologist to perform the sub-tenon block correctly is presented. The system has integrated sensors with new sensing schemes for needle tip tracking and detection of errors incurred by the trainee. An integrated, conductive silicone-based eye model sensor is presented in this article. The model replicates the human ocular anatomy, and the embedded sensors within the eye model help to classify, assess, and evaluate the performed procedure. The developed system was also validated in a pilot clinical study for naturality and usage in a clinical setting with 37 ophthalmic anesthetists. The system recorded 98.3 % accuracy assessing the performed procedure during the clinical study, and the participants rated the naturality of the system with a score of 8.0 ± 0.63 (on a scale of 10) ( p <; 0.01). 89 % of the participants and experienced sub tenon block instructors who previously used provisional animal eye-based models for training preferred the training system for its usage of anatomically accurate models and effective warning systems that evaluate the performed procedure.

Ultrasonographic needle tip tracking for in-plane infraclavicular brachialis plexus blocks: a randomized controlled volunteer study

BackgroundOnvision is a new technology for needle tip detection and tracking in ultrasound-guided regional anesthesia. The system consists of a piezoelectric sensor close to the needle tip and an electronic...

Comparison of the learning curves of novice anaesthetists using needle tip tracking during simulated ultrasound-guided sciatic regional nerve block on the soft embalmed Thiel cadaver

Comparison of the learning curves of novice anaesthetists using needle tip tracking during simulated ultrasound-guided sciatic regional nerve block on the soft embalmed Thiel cadaver

The effect of needle tip tracking on procedural time of ultrasound-guided lumbar plexus block: a randomised controlled trial.

Technology that facilitates performance of deep peripheral nerve blocks is of clinical interest. The Onvision™ is a new device for ultrasonographic needle tip tracking that incorporates an ultrasound sensor on the needle tip that is then represented by a green circle on the ultrasound screen. The primary aim of this study was to investigate the effect of needle tip tracking on procedural time in the first human volunteer study. Secondary outcome measures included: number of hand movements; hand movement path length; block success rate; block onset time; block duration; discomfort experienced by the volunteers; and the anaesthetists' confidence as to whether their block would be successful. Two anaesthetists performed ultrasound-guided lumbar plexus blocks with an out-of-plane technique, with and without the use of needle tip tracking. In total, data from 25 volunteers were studied. Mean (SD) procedural time was 163 (103) s with needle tip tracking and 216 (117) s without (p=0.10). Hand motion analysis showed that needle tip tracking was associated with a significant decrease in the mean (SD) number of intended needling hand movements (39 (29) vs. 59 (36); p=0.03) and path lengths (3.2 (3.1)m vs. 5.5 (4.5)m; p=0.03). No differences were found for any other secondary outcomes. The use of Onvision needle tip tracking did not reduce procedural time for out-of-plane ultrasound-guided lumbar plexus block but did reduce the number of hand movements and path lengths. This may indicate improved needle control but further studies are needed to confirm this finding.

Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine.

Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine.

Needle tip tracking for ultrasound-guided peripheral nerve block procedures-An observer blinded, randomised, controlled, crossover study on a phantom model.

BackgroundThe Onvision needle tip tracking (NTT) is a new technology consisting of a needle with an ultrasound sensor close to the needle tip and a console for computerised signal processing. The aim of the study was to evaluate NTT technology during ultrasound‐guided simulated peripheral nerve block procedures in a porcine phantom model.MethodsForty anaesthesiologists performed in‐plane and out‐of‐plane simulated nerve blocks with and without NTT guidance. The primary outcome measure was procedure time. Secondary outcomes were hand movements and the path length travelled by the hands measured by motion analysis, precision of the needle tip related to the target structure, success rates and violations of the target structure, and the participants confidence whether their procedure would be successful or not.ResultsProcedure time was reduced from 66.7 (SD = 47.5) seconds to 43.8 (SD = 29.2) seconds when NTT was used for out‐of‐plane procedures (P = 0.002). The number of hand movements of the probe hand was 13.9 (SD = 30.2) with NTT and 22.8 (SD = 30.0) without NTT (P = 0.019). No significant differences were registered during the performance of in‐plane procedures. The participants confidence in a presumed block success was increased with both in‐plane procedures (8.50 (SD = 1.18) with NTT vs 7.65 (SD = 1.96), P = 0.004) and out‐of‐plane procedures (8.50 (SD = 1.09) vs 7.10 (SD = 1.89), P = 0.0001).ConclusionsThe new NTT technology significantly reduced the procedure time and the number of hand movements for ultrasound‐guided out‐of‐plane PNB procedures. No significant differences were found for the in‐plane procedures.

Within-subjects analysis of operator performance with and without needle tip tracking during ultrasound-guided sciatic regional nerve block on the soft embalmed Thiel cadaver

Within-subjects analysis of operator performance with and without needle tip tracking during ultrasound-guided sciatic regional nerve block on the soft embalmed Thiel cadaver

Visual needle tip tracking in 2D US guided robotic interventions

Percutaneous needle procedures are among the most frequently performed minimally invasive surgical procedure. For tracking the needle tip in the tissue, 2D ultrasound (US) imaging is commonly used; however, the low resolution of the images creates a challenge for tracking. This paper describes a robotic system that can perform US image guided biopsies by tracking the needle and the target simultaneously. It uses a template-based visual tracking method for small and deformable targets. During the experiments, a needle was inserted into realistic phantoms using a 5-DOF robot. The 2D US probe was held by a robotic arm that was servoed along the needle path. The 3D shape of the needle was estimated using the 2D transverse US images, which was used to align the needle axis with the 2D imaging plane. The accuracy of the visual needle tip tracking was evaluated using an optical tracking system, and a computed tomography scanner was used to determine the accuracy of the 3D needle shape estimation method. Target reaching accuracies were measured using an electromagnetic tracking system. The results of the experiments showed that the proposed system can track the needle tip in 2D US guided needle procedures in real-time with a sub-millimeter positional error.

Three-Dimensional Ultrasonic Needle Tip Tracking with a Fiber-Optic Ultrasound Receiver.

Ultrasound is frequently used for guiding minimally invasive procedures, but visualizing medical devices is often challenging with this imaging modality. When visualization is lost, the medical device can cause trauma to critical tissue structures. Here, a method to track the needle tip during ultrasound image-guided procedures is presented. This method involves the use of a fiber-optic ultrasound receiver that is affixed within the cannula of a medical needle to communicate ultrasonically with the external ultrasound probe. This custom probe comprises a central transducer element array and side element arrays. In addition to conventional two-dimensional (2D) B-mode ultrasound imaging provided by the central array, three-dimensional (3D) needle tip tracking is provided by the side arrays. For B-mode ultrasound imaging, a standard transmit-receive sequence with electronic beamforming is performed. For ultrasonic tracking, Golay-coded ultrasound transmissions from the 4 side arrays are received by the hydrophone sensor, and subsequently the received signals are decoded to identify the needle tip's spatial location with respect to the ultrasound imaging probe. As a preliminary validation of this method, insertions of the needle/hydrophone pair were performed in clinically realistic contexts. This novel ultrasound imaging/tracking method is compatible with current clinical workflow, and it provides reliable device tracking during in-plane and out-of-plane needle insertions.