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

(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.

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

Tumori Journal ◽

10.1177/030089161209800616 ◽

2012 ◽

Vol 98 (6) ◽

pp. 775-782 ◽

Cited By ~ 5

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.

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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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Diagnostic Accuracy of CT-Guided Core Needle Biopsy for Solitary Bone Lesions in Pediatric Patients

10.1055/s-0040-1722507 ◽

2020 ◽

Author(s):

A. Vidoni ◽

A. Saifuddin

Keyword(s):

Diagnostic Accuracy ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Pediatric Patients ◽

Bone Lesions ◽

Ct Guided ◽

Core Needle

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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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Impact of interventionalist’s experience and gender on radiation dose and procedural time in CT-guided interventions—a retrospective analysis of 4380 cases over 10 years

European Radiology ◽

10.1007/s00330-020-07185-x ◽

2020 ◽

Author(s):

Dorothea Theilig ◽

Anna Mayerhofer ◽

David Petschelt ◽

Aboelyazid Elkilany ◽

Bernd Hamm ◽

...

Keyword(s):

Radiation Dose ◽

Retrospective Analysis ◽

Ct Guided ◽

Procedural Time ◽

And Gender

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Percutaneous low-dose CT-guided lung biopsy with an augmented reality navigation system: validation of the technique on 496 suspected lesions

Clinical Imaging ◽

10.1016/j.clinimag.2017.11.013 ◽

2018 ◽

Vol 49 ◽

pp. 101-105 ◽

Cited By ~ 6

Author(s):

Eliodoro Faiella ◽

Giulia Frauenfelder ◽

Domiziana Santucci ◽

Giacomo Luppi ◽

Emiliano Schena ◽

...

Keyword(s):

Augmented Reality ◽

Navigation System ◽

Lung Biopsy ◽

Low Dose ◽

Ct Guided ◽

Low Dose Ct ◽

System Validation

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

Scientific Reports ◽

10.1038/s41598-020-75676-4 ◽

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.

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