Navigation with three-dimensional rotational radiographic data for transpedicular percutaneous needle introduction: feasibility and comparison with fluoroscopic guidance.
OBJECTIVE
To investigate the feasibility of navigation with three-dimensional (3D) rotational radiographic data for transpedicular percutaneous needle introduction and to compare navigation with 3D rotational radiographic data with conventional fluoroscopic guidance.


METHODS
A navigation system was coupled to a 3D rotational radiographic imaging system. In a cadaver study, 60 biopsy needles were introduced into vertebral bodies with fluoroscopic guidance or navigation with 3D rotational radiographic data by two interventionalists with different levels of experience in percutaneous procedures. Radiation exposure, fluoroscopy and introduction times, and needle position were evaluated and compared.


RESULTS
For 3D rotational radiographic navigation, the needle position was equivalent for both interventionalists (7 mm). For fluoroscopic guidance, the interventionalist with less experience in percutaneous procedures had significantly more pedicle cortex violations than the other interventionalist (eight vs one). Radiation exposure measured at the operators' hand was lower for 3D rotational radiography-guided needle introductions. Radiation exposure measured at the body wall of the cadaver was equivalent between modalities (9 mGy).


CONCLUSIONS
Navigation with 3D rotational radiographic image data is feasible for transpedicular percutaneous needle introduction and has two advantages compared with fluoroscopic guidance: it poses less strict requirements on the expertise of the interventionalist, and it reduces radiation exposure to the interventionalist.
van Walsum
Theo
T
Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands. t.vanwalsum@erasmusmc.nl
van de Kraats
Everine B
EB
Voormolen
Maurits H J
MH
Verlaan
Jorrit-Jan
JJ
Mali
Willem P Th M
WP
Niessen
Wiro J
WJ
D001707:Biopsy, Needle / Q000379:methods*; D002102:Cadaver; D005240:Feasibility Studies; D005471:Fluoroscopy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008159:Lumbar Vertebrae / Q000473:pathology; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods*; D012399:Rotation; D013819:Thermoluminescent Dosimetry; D013904:Thoracic Vertebrae / Q000473:pathology