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

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.

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Needle placement accuracy in CT-guided robotic post mortem biopsy

Current Directions in Biomedical Engineering ◽

10.1515/cdbme-2020-0031 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Martin Gromniak ◽

Maximilian Neidhardt ◽

Axel Heinemann ◽

Klaus Püschel ◽

Alexander Schlaefer

Keyword(s):

Needle Biopsy ◽

Minimal Invasive ◽

Robotic Arm ◽

Limited Time ◽

Time Since Death ◽

Time Cost ◽

Needle Placement ◽

Manner Of Death ◽

Ct Guided ◽

Placement Accuracy

AbstractForensic autopsies include a thorough examination of the corpse to detect the source or alleged manner of death as well as to estimate the time since death. However, a full autopsy may be not feasible due to limited time, cost or ethical objections by relatives. Hence, we propose an automated minimal invasive needle biopsy system with a robotic arm, which does not require any online calibrations during a procedure. The proposed system can be easily integrated into the workflow of a forensic biopsy since the robot can be flexibly positioned relative to the corpse. With our proposed system, we performed needle insertions into wax phantoms and livers of two corpses and achieved an accuracy of 4.34 ± 1.27 mm and 10.81 ± 4.44 mm respectively.

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Development of a robotic FD-CT-guided navigation system for needle placement-preliminary accuracy tests

International Journal of Medical Robotics and Computer Assisted Surgery ◽

10.1002/rcs.393 ◽

2011 ◽

Vol 7 (2) ◽

pp. 225-236 ◽

Cited By ~ 32

Author(s):

Saúl Tovar-Arriaga ◽

Ralf Tita ◽

Jesús Carlos Pedraza-Ortega ◽

Efren Gorrostieta ◽

Willi A. Kalender

Keyword(s):

Navigation System ◽

Needle Placement ◽

Ct Guided

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A NEW DEVICE FOR STEREOTACTIC CT-GUIDED BIOPSY OF THE CANINE BRAIN: DESIGN, CONSTRUCTION, AND NEEDLE PLACEMENT ACCURACY

Veterinary Radiology & Ultrasound ◽

10.1111/j.1740-8261.2002.tb00995.x ◽

2002 ◽

Vol 43 (3) ◽

pp. 229-236 ◽

Cited By ~ 21

Author(s):

Alain Giroux ◽

Jeryl C. Jones ◽

Jan Helge Bohn ◽

Robert B. Duncan ◽

Don R. Waldron ◽

...

Keyword(s):

Needle Placement ◽

Ct Guided ◽

New Device ◽

Guided Biopsy ◽

Canine Brain ◽

Ct Guided Biopsy ◽

Placement Accuracy ◽

Design Construction

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A miniature patient-mount navigation system for assisting needle placement in CT-guided intervention

International Journal of Medical Robotics and Computer Assisted Surgery ◽

10.1002/rcs.412 ◽

2011 ◽

Vol 7 (4) ◽

pp. 423-430 ◽

Cited By ~ 5

Author(s):

Mu-Lien Lin ◽

Been-Der Yang ◽

Yao-Hung Wang ◽

Chi-Lin Yang ◽

Jaw-Lin Wang

Keyword(s):

Navigation System ◽

Needle Placement ◽

Ct Guided

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

10.26226/morressier.615e2a8f7c09fc044a973975 ◽

2021 ◽

Author(s):

Rosario Francesco Grasso ◽

Flavio Andresciani ◽

Carlo Altomare ◽

Giuseppina Pacella ◽

Gennaro Castiello ◽

...

Keyword(s):

Computed Tomography ◽

Augmented Reality ◽

Navigation System ◽

Thermal Ablation ◽

3D Navigation ◽

Ct Guided

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

Biology ◽

10.3390/biology10070646 ◽

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.

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Application of Intraoperative CT-Guided Navigation in Simultaneous Minimally Invasive Anterior and Posterior Surgery for Infectious Spondylitis

BioMed Research International ◽

10.1155/2017/2302395 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Meng-Huang Wu ◽

Navneet Kumar Dubey ◽

Ching-Yu Lee ◽

Yen-Yao Li ◽

Chin-Chang Cheng ◽

...

Keyword(s):

Minimally Invasive ◽

Pedicle Screws ◽

Ct Guided ◽

Posterior Surgery ◽

Intraoperative Computed Tomography ◽

Reactive Protein ◽

Angle Correction ◽

Average Operative Time ◽

Placement Accuracy ◽

Infectious Spondylitis

This study was aimed at evaluating the safety and efficacy of using intraoperative computed tomography- (iCT-) guided navigation in simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. Nine patients with infectious spondylitis were enrolled in this study. The average operative time was 327.6 min (range, 210–490) and intraoperative blood loss was 407 cc (range, 50–1,200). The average duration of hospital stay was 48.9 days (range, 11–76). Out of a total of 54 pedicle screws employed, 53 screws (98.1%) were placed accurately. A reduced visual analog scale on back pain (from 8.2 to 2.2) and Oswestry disability index (from 67.1% to 25.6%) were found at the 2-year follow-up. All patients had achieved resolution of spinal infection with reduced average erythrocyte sedimentation rate (from 83.9 to 14.1 mm/hr) and average C-reactive protein (from 54.4 to 4.8 mg/dL). Average kyphotic angle correction was 10.5° (range, 8.4°–12.6°) postoperatively and 8.5° (range, 6.9°–10.1°) after 2 years. In conclusion, the current iCT-guided navigation approach has been demonstrated to be an alternative method during simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. It can provide a good intraoperative orientation and visualization of anatomic structures and also a high pedicle screw placement accuracy in patient’s lateral decubitus position.

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Author Correction: Feasibility, safety and accuracy of a CT-guided robotic assistance for percutaneous needle placement in a swine liver model

Scientific Reports ◽

10.1038/s41598-021-87093-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Boris Guiu ◽

Thierry De Baère ◽

Guillaume Noel ◽

Maxime Ronot

Keyword(s):

Robotic Assistance ◽

Needle Placement ◽

Ct Guided ◽

Liver Model ◽

Swine Liver

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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Intraoperative computed tomography registration and electromagnetic neuronavigation for transsphenoidal pituitary surgery: accuracy and time effectiveness

Journal of Neurosurgery ◽

10.3171/2010.5.jns091821 ◽

2011 ◽

Vol 114 (2) ◽

pp. 329-335 ◽

Cited By ~ 22

Author(s):

Paula Eboli ◽

Bob Shafa ◽

Marc Mayberg

Keyword(s):

Mr Imaging ◽

Operating Room ◽

Navigation System ◽

Surgical Techniques ◽

Imaging Data ◽

3D Navigation ◽

Closure Time ◽

Bony Landmarks ◽

Room Time ◽

Operating Room Time

Object The authors assessed the feasibility, anatomical accuracy, and cost effectiveness of frameless electromagnetic (EM) neuronavigation in conjunction with portable intraoperative CT (iCT) registration for transsphenoidal adenomectomy (TSA). Methods A prospective database was established for data obtained in 208 consecutive patients who underwent TSA in which the iCT/EM navigation technique was used. Data were compared with those acquired in a retrospective cohort of 65 consecutive patients in whom fluoroscope-assisted TSA had been performed by the same surgeon. All patients in both groups underwent transnasal removal of pituitary adenomas or neuroepithelial cysts, using identical surgical techniques with an operating microscope. In the iCT/EM technique–treated cases, a portable iCT scan was obtained immediately prior to surgery for registration to the EM navigation system, which did not require rigid head fixation. Preexisting (nonnavigation protocol) MR imaging studies were fused with the iCT scans to enable 3D navigation based on MR imaging data. The accuracy of the navigation system was determined in the first 50 iCT/EM cases by visual concordance of the navigation probe location to 5 preselected bony landmarks. For all patients in both cohorts, total operating room time, incision-to-closure time, and relative costs of imaging and surgical procedures were determined from hospital records. Results In every case, iCT registration was successful and preoperative MR images were fused to iCT scans without affecting navigation accuracy. There was 100% concordance between probe tip location and predetermined bony loci in the first 50 cases involving the iCT/EM technique. Total operating room time was significantly less in the iCT/EM cases (mean 108.9 ± 24.3 minutes [208 patients]) compared with the fluoroscopy group (mean 121.1 ± 30.7 minutes [65 patients]; p < 0.001). Similarly, incision-to-closure time was significantly less for the iCT/EM cases (mean 61.3 ± 18.2 minutes) than for the fluoroscopy cases (mean 71.75 ± 19.0 minutes; p < 0.001). Relative overall costs for iCT/EM technique and intraoperative C-arm fluoroscopy were comparable; increased costs for navigation equipment were offset by savings in operating room costs for shorter procedures. Conclusions The use of iCT/MR imaging–guided neuronavigation for transsphenoidal surgery is a time-effective, cost-efficient, safe, and technically beneficial technique.

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