Towards markerless navigation for percutaneous needle insertions

Purpose Percutaneous needle insertions are increasingly used for diagnosis and treatment of abdominal lesions. The challenging part of computed tomography (CT)-guided punctures is the transfer of the insertion trajectory planned in the CT image to the patient. Conventionally, this often results in s...

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Bibliographic Details
Published in:International journal for computer assisted radiology and surgery 2016-01, Vol.11 (1), p.107-117
Main Authors: Seitel, Alexander, Bellemann, Nadine, Hafezi, Mohammadreza, Franz, Alfred M., Servatius, Mark, Saffari, Arash, Kilgus, Thomas, Schlemmer, Heinz-Peter, Mehrabi, Arianeb, Radeleff, Boris A., Maier-Hein, Lena
Format: Article
Language:English
Subjects:
Computer Imaging
Computer Science
Health Informatics
Humans
Imaging
Medicine
Medicine & Public Health
Needles
Original Article
Pattern Recognition and Graphics
Phantoms, Imaging
Punctures - methods
Radiology
Surgery
Tomography, X-Ray Computed - methods
Vision
Workflow
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Summary:Purpose Percutaneous needle insertions are increasingly used for diagnosis and treatment of abdominal lesions. The challenging part of computed tomography (CT)-guided punctures is the transfer of the insertion trajectory planned in the CT image to the patient. Conventionally, this often results in several needle repositionings and control CT scans. To address this issue, several navigation systems for percutaneous needle insertions have been presented; however, none of them has thus far become widely accepted in clinical routine. Their benefit for the patient could not exceed the additional higher costs and the increased complexity in terms of bulky tracking systems and specialized markers for registration and tracking. Methods We present the first markerless and trackerless navigation concept for real-time patient localization and instrument guidance. It has specifically been designed to be integrated smoothly into the clinical workflow and does not require markers or an external tracking system. The main idea is the utilization of a range imaging device that allows for contactless and radiation-free acquisition of both range and color information used for patient localization and instrument guidance. Results A first feasibility study in phantom and porcine models yielded a median targeting accuracy of 6.9 and 19.4 mm, respectively. Conclusions Although system performance remains to be improved for clinical use, expected advances in camera technology as well as consideration of respiratory motion and automation of the individual steps will make this approach an interesting alternative for guiding percutaneous needle insertions.
ISSN:1861-6410
1861-6429
DOI:10.1007/s11548-015-1156-7