Electromagnetic field-based navigation for percutaneous punctures on C-arm CT: experimental evaluation and clinical application.
The aim of this study was to prospectively evaluate the needle visualization and placement error and use of an electromagnetic field-based tracking navigation device for puncture procedures based on C-arm CT (CACT) images. A commercially available navigation device was mounted on an angiographic X-ray system setup for CACT. After the target was defined, needle placement was performed under real-time visualization of the virtual needle in CACT images. The final, real needle position was assessed by CACT. Punctures were performed in phantoms (n = 76) and in twelve patients (eight biopsies, three drainages, one injection). Procedure times, system error, user error and total error were assessed. In phantoms, mean total error was 2.3 +/- 0.9 mm, user error was 1.4 +/- 0.8 mm and system error was 1.7 +/- 0.8 mm. In the patient study, the targeted puncture was successful in all twelve cases. The mean total error was 5.4 mm +/- 1.9 mm (maximum 8.1 mm), user error was 3.7 +/- 1.7 mm, system error was 3.2 +/- 1.4 mm and mean skin-to-target time was less than 1 min. The navigation device relying on CACT was accurate in terms of needle visualization and useful for needle placement under both experimental and clinical conditions. For more complex procedures, electromagnetic field-based tracking guidance might be of help in facilitating the puncture and reducing both the puncture risk and procedure time.
Department of Radiology and Nuclear Medicine, Charité-University Hospital, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany. Bernhard.Meyer@charite.de
Bernhard C
BC
Meyer
Olaf
O
Peter
Markus
M
Nagel
Martin
M
Hoheisel
Bernd B
BB
Frericks
Karl-Jürgen
KJ
Wolf
Frank K
FK
Wacker
D004574:Electromagnetic Fields; D055590:Electromagnetic Phenomena; D004581:Electronics / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D019047:Phantoms, Imaging; D011677:Punctures / Q000295:instrumentation* / Q000379:methods; D015641:Radiography, Interventional / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods