scholarly journals Augmented reality improves procedural efficiency and reduces radiation dose for CT-guided lesion targeting: a phantom study using HoloLens 2

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Brian J. Park ◽  
Stephen J. Hunt ◽  
Gregory J. Nadolski ◽  
Terence P. Gade
Keyword(s):  
Augmented Reality ◽  
Radiation Dose ◽  
Prospective Trial ◽  
Procedure Time ◽  
Ct Guided ◽  
Ct Dose ◽  
Out Of Plane ◽  
Ct Dose Index ◽  
3D Guidance ◽  
The Ideal

Abstract Out-of-plane lesions pose challenges for CT-guided interventions. Augmented reality (AR) headsets are capable to provide holographic 3D guidance to assist CT-guided targeting. A prospective trial was performed assessing CT-guided lesion targeting on an abdominal phantom with and without AR guidance using HoloLens 2. Eight operators performed a cumulative total of 86 needle passes. Total needle redirections, radiation dose, procedure time, and puncture rates of nontargeted lesions were compared with and without AR. Mean number of needle passes to reach the target reduced from 7.4 passes without AR to 3.4 passes with AR (p = 0.011). Mean CT dose index decreased from 28.7 mGy without AR to 16.9 mGy with AR (p = 0.009). Mean procedure time reduced from 8.93 min without AR to 4.42 min with AR (p = 0.027). Puncture rate of a nontargeted lesion decreased from 11.9% without AR (7/59 passes) to 0% with AR (0/27 passes). First needle passes were closer to the ideal target trajectory with AR versus without AR (4.6° vs 8.0° offset, respectively, p = 0.018). AR reduced variability and elevated the performance of all operators to the same level irrespective of prior clinical experience. AR guidance can provide significant improvements in procedural efficiency and radiation dose savings for targeting out-of-plane lesions.

Percutaneous Computed Tomography-Guided Lung Biopsies: Preliminary Results using an Augmented Reality Navigation System

2012 ◽  
Vol 98 (6) ◽  
pp. 775-782 ◽  
Author(s):  
Rosario Francesco Grasso ◽  
Giacomo Luppi ◽  
Roberto Luigi Cazzato ◽  
Eliodoro Faiella ◽  
Francesco D'Agostino ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Augmented Reality ◽  
Radiation Dose ◽  
Navigation System ◽  
Ct Scans ◽  
Ultrasound Images ◽  
Procedure Time ◽  
Ct Guided ◽  
X Ray ◽  
Lung Biopsies

Aims and background “Augmented reality” is a technique to create a composite view by augmenting the real intervention field, visualized by the doctor, with additional information coming from a virtual volume generated using computed tomography (CT), magnetic resonance or ultrasound images previously acquired from the same patient. In the present study we verified the accuracy and validated the clinical use of an augmented reality navigation system produced to perform percutaneous CT-guided lung biopsies. Methods One hundred and eighty consecutive patients with solitary parenchymal lung lesions, enrolled using a nonrandom enrollment system, underwent percutaneous CT-guided aspiration and core biopsy using a traditional technique (group C, 90 patients) and navigation system assistance (group S, 90 patients). For each patient we recorded the largest lesion diameter, procedure time, overall number of CT scans, radiation dose, and complications. The entire experimental project was evaluated and approved by the local institutional review board (ethics committee). Results Each procedure was concluded successfully and a pathological diagnosis was reached in 96% of cases in group S and 90% of cases in group C. Procedure time, overall number of CT scans and incident x-ray radiation dose (CTDIvol) were significantly reduced in navigation system-assisted procedures (P <0.001; z = 5.64) compared with traditional CT-guided procedures. The percentage of procedural complications was 14% in group S and 17% in group C. Conclusion The augmented reality navigation system used in this study was a highly safe, technically reliable and effective support tool in percutaneous CT-guided lung biopsy, allowing to shorten the procedure time and reduce the incident x-ray radiation dose to patients and the rate of insufficient specimens. Furthermore, it has the potential to increase the number of procedures executed in the allocated time without increasing the number of complications.

scholarly journals Comparison study of image quality at various radiation doses for CT venography using advanced modeled iterative reconstruction

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256564
Author(s):  
Jung Han Hwang ◽  
Jin Mo Kang ◽  
So Hyun Park ◽  
Suyoung Park ◽  
Jeong Ho Kim ◽  
...  
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Iterative Reconstruction ◽  
Ct Venography ◽  
Ultralow Dose ◽  
Ct Dose ◽  
Dual Source ◽  
Ct Dose Index ◽  
Deep Vein

Objective We compared the image quality according to the radiation dose on computed tomography (CT) venography at 80 kVp using advanced modeled iterative reconstruction for deep vein thrombus and other specific clinical conditions considering standard-, low-, and ultralow-dose CT. Methods In this retrospective study, 105 consecutive CT venography examinations were included using a third-generation dual-source scanner in the dual-source mode in tubes A (reference mAs, 210 mAs at 70%) and B (reference mAs, 90 mAs at 30%) at a fixed 80 kVp. Two radiologists independently reviewed each observation of standard- (100% radiation dose), low- (70%), and ultralow-dose (30%) CT. The objective quality of large veins and subjective image quality regarding lower-extremity veins and deep vein thrombus were compared between images according to the dose. In addition, the CT dose index volumes were displayed from the images. Results From the patients, 24 presented deep vein thrombus in 69 venous segments of CT examinations. Standard-dose CT provided the lowest image noise at the inferior vena cava and femoral vein compared with low- and ultralow-dose CT (p < 0.001). There were no differences regarding subjective image quality between the images of popliteal and calf veins at the three doses (e.g., 3.8 ± 0.7, right popliteal vein, p = 0.977). The image quality of the 69 deep vein thrombus segments showed equally slightly higher scores in standard- and low-dose CT (4.0 ± 0.2) than in ultralow-dose CT (3.9 ± 0.4). The CT dose index volumes were 4.4 ± 0.6, 3.1 ± 0.4, and 1.3 ± 0.2 mGy for standard-, low-, and ultralow-dose CT, respectively. Conclusions Low- and ultralow-dose CT venography at 80 kVp using an advanced model based iterative reconstruction algorithm allows to evaluate deep vein thrombus and perform follow-up examinations while showing an acceptable image quality and reducing the radiation dose.

CT-guided liver biopsy: correlation of procedure time and radiation dose with patient size, weight, and lesion volume and depth

2010 ◽  
Vol 34 (4) ◽  
pp. 263-268 ◽  
Author(s):  
Jianhai Li ◽  
Unni K. Udayasankar ◽  
John Carew ◽  
William C. Small
Keyword(s):  
Radiation Dose ◽  
Liver Biopsy ◽  
Lesion Volume ◽  
Procedure Time ◽  
Ct Guided ◽  
Patient Size

scholarly journals Lung Thermal Ablation: Comparison between an Augmented Reality Computed Tomography (CT) 3D Navigation System (SIRIO) and Standard CT-Guided Technique

Biology ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 646
Author(s):  
Rosario Francesco Grasso ◽  
Flavio Andresciani ◽  
Carlo Altomare ◽  
Giuseppina Pacella ◽  
Gennaro Castiello ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Augmented Reality ◽  
Radiation Exposure ◽  
Navigation System ◽  
Target Lesion ◽  
Ct Scans ◽  
Procedure Time ◽  
Technical Success ◽  
3D Navigation ◽  
Ct Guided

(1) Background: The aim of this retrospective study is to assess safety and efficacy of lung radiofrequency (RFA) and microwave ablation (MWA) using an augmented reality computed tomography (CT) navigation system (SIRIO) and to compare it with the standard CT-guided technique. (2) Methods: Lung RFA and MWA were performed with an augmented reality CT 3D navigation system (SIRIO) in 52 patients. A comparison was then performed with a group of 49 patients undergoing the standard CT-guided technique. All the procedures were divided into four groups based on the lesion diameter (>2 cm or ≤2 cm), and procedural time, the number of CT scans, radiation dose administered, and complications rate were evaluated. Technical success was defined as the presence of a “ground glass” area completely covering the target lesion at the immediate post-procedural CT. (3) Results: Full technical success was achieved in all treated malignant lesions for all the considered groups. SIRIO-guided lung thermo-ablations (LTA) displayed a significant decrease in the number of CT scans, procedure time, and patients’ radiation exposure (p < 0.001). This also resulted in a dosage reduction in hypnotics and opioids administrated for sedation during LTA. No significant differences were observed between the SIRIO and non-SIRIO group in terms of complications incidence. (4) Conclusions: SIRIO is an efficient tool to perform CT-guided LTA, displaying a significant reduction (p < 0.001) in the number of required CT scans, procedure time, and patients’ radiation exposure.

Use of Multiphase CT Protocols in 18 Countries: Appropriateness and Radiation Doses

2020 ◽  
pp. 084653711988839 ◽  
Author(s):  
Shivam Rastogi ◽  
Ramandeep Singh ◽  
Riddhi Borse ◽  
Petra Valkovic Zujic ◽  
Doris Segota ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Chest Ct ◽  
Radiation Doses ◽  
Energy Agency ◽  
Dose Length Product ◽  
Ct Dose ◽  
Clinical Indications ◽  
Ct Dose Index ◽  
Multiphase Ct ◽  
Routine Chest

Purpose: To assess the frequency, appropriateness, and radiation doses associated with multiphase computed tomography (CT) protocols for routine chest and abdomen–pelvis examinations in 18 countries. Materials and Methods: In collaboration with the International Atomic Energy Agency, multi-institutional data on clinical indications, number of scan phases, scan parameters, and radiation dose descriptors (CT dose–index volume; dose–length product [DLP]) were collected for routine chest (n = 1706 patients) and abdomen–pelvis (n = 426 patients) CT from 18 institutions in Asia, Africa, and Europe. Two radiologists scored the need for each phase based on clinical indications (1 = not indicated, 2 = probably indicated, 3 = indicated). We surveyed 11 institutions for their practice regarding single-phase and multiphase CT examinations. Data were analyzed with the Student t test. Results: Most institutions use multiphase protocols for routine chest (10/18 institutions) and routine abdomen–pelvis (10/11 institutions that supplied data for abdomen–pelvis) CT examinations. Most institutions (10/11) do not modify scan parameters between different scan phases. Respective total DLP for 1-, 2-, and 3-phase routine chest CT was 272, 518, and 820 mGy·cm, respectively. Corresponding values for 1- to 5-phase routine abdomen–pelvis CT were 400, 726, 1218, 1214, and 1458 mGy cm, respectively. For multiphase CT protocols, there were no differences in scan parameters and radiation doses between different phases for either chest or abdomen–pelvis CT ( P = 0.40-0.99). Multiphase CT examinations were unnecessary in 100% of routine chest CT and in 63% of routine abdomen–pelvis CT examinations. Conclusions: Multiphase scan protocols for the routine chest and abdomen–pelvis CT examinations are unnecessary, and their use increases radiation dose.

scholarly journals Impact of an Augmented Reality Navigation System (SIRIO) on Bone Percutaneous Procedures: A Comparative Analysis with Standard CT-Guided Technique

2021 ◽  
Vol 28 (3) ◽  
pp. 1751-1760
Author(s):  
Eliodoro Faiella ◽  
Gennaro Castiello ◽  
Caterina Bernetti ◽  
Giuseppina Pacella ◽  
Carlo Altomare ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Radiation Dose ◽  
Diagnostic Accuracy ◽  
Navigation System ◽  
Ct Scans ◽  
Bone Lesions ◽  
Ct Guided ◽  
Percutaneous Procedures ◽  
Procedural Time ◽  
Ablative Procedures

(1) Background: The purpose of this study is to evaluate the impact of an augmented reality navigation system (SIRIO) for percutaneous biopsies and ablative treatments on bone lesions, compared to a standard CT-guided technique. (2) Methods: Bioptic and ablative procedures on bone lesions were retrospectively analyzed. All procedures were divided into SIRIO and Non-SIRIO groups and in <2 cm and >2 cm groups. Number of CT-scans, procedural time and patient’s radiation dose were reported for each group. Diagnostic accuracy was obtained for bioptic procedures. (3) Results: One-hundred-ninety-three procedures were evaluated: 142 biopsies and 51 ablations. Seventy-four biopsy procedures were performed using SIRIO and 68 under standard CT-guidance; 27 ablative procedures were performed using SIRIO and 24 under standard CT-guidance. A statistically significant reduction in the number of CT-scans, procedural time and radiation dose was observed for percutaneous procedures performed using SIRIO, in both <2 cm and >2 cm groups. The greatest difference in all variables examined was found for procedures performed on lesions <2 cm. Higher diagnostic accuracy was found for all SIRIO-assisted biopsies. No major or minor complications occurred in any procedures. (4) Conclusions: The use of SIRIO significantly reduces the number of CT-scans, procedural time and patient’s radiation dose in CT-guided percutaneous bone procedures, particularly for lesions <2 cm. An improvement in diagnostic accuracy was also achieved in SIRIO-assisted biopsies.

Reduced Kilovoltage in Computed Tomography–Guided Intervention in a Community Hospital: Effect on the Radiation Dose

2014 ◽  
Vol 65 (4) ◽  
pp. 345-351 ◽  
Author(s):  
Saman Rezazadeh ◽  
Steven J. Co ◽  
Simon Bicknell
Keyword(s):  
Low Dose ◽  
Effective Diameter ◽  
Tube Voltage ◽  
Dose Length Product ◽  
Ct Guided ◽  
Ct Dose ◽  
Patient Size ◽  
Ct Dose Index ◽  
Volume Ct ◽  
Dose Index

Purpose The purpose of this study was to determine whether low-kilovoltage (80 or 100 kV) computed tomography (CT)-guided interventions performed in a community-based hospital are feasible and to compare radiation exposure incurred with conventional 120 kV potential. Materials and Methods Effective doses (ED) received by patients who underwent CT-guided intervention were analysed before and after a low-dose kilovoltage protocol was instituted in our department. We performed CT-guided procedures of 93 consecutive patients by using conventional 120-kV tube voltage (50 patients) and a low voltage of 80 or 100 kV for the remainder of this cohort. Automatic tube current modulation was enabled to obtain the best image quality. Procedure details were prospectively recorded and included examination site and type, slice width, tube voltage and current, dose length product, volume CT dose index, and size-specific dose estimate. Dose length product was converted to ED to account for radiosensitivity of specific organs. Statistical comparisons with test differences in the ED, volume CT dose index, size-specific dose estimate, and effective diameter (patient size) were made by using the Student t test. Results All but 6 of the procedures performed at 80 kV were successful, for a success rate of 86%. At lower voltages, the ED was significantly ( P < .01) reduced, on average, by 57%, 73%, and 65% for the pelvic, chest, and abdomen procedures, respectively. Conclusion A low-dose radiation technique by using 80 or 100 kV results in a high technical success rate for pelvic, chest, and abdomen CT-guided interventional procedures, although dramatically decreasing radiation exposure. There was no significant difference in effective diameter (patient size) between the conventional and the low-dose groups, which would suggest that dose reduction was indeed a result of kVp change and not patient size.

Sign in / Sign up

Export Citation Format

Share Document