title: Needle-based interventions with the image-guided surgery toolkit (IGSTK): from phantoms to clinical trials.
abstract: We present three image-guided navigation systems developed for needle-based interventional radiology procedures, using the open source image-guided surgery toolkit (IGSTK). The clinical procedures we address are vertebroplasty, RF ablation of large lung tumors, and lung biopsy. In vertebroplasty, our system replaces the use of fluoroscopy, reducing radiation exposure to patient and physician. We evaluate this system using a custom phantom and compare the results obtained by a medical student, an interventional radiology fellow, and an attending physician. In RF ablation of large lung tumors, our system provides an automated interventional plan that minimizes damage to healthy tissue and avoids critical structures, in addition to accurate guidance of multiple electrode insertions. We evaluate the system's performance using an animal model. Finally, in the lung biopsy procedure, our system replaces the use of computed tomographic (CT) fluoroscopy, reducing radiation exposure to patient and physician, while at the same time enabling oblique trajectories which are considered challenging under CT fluoroscopy. This system is currently being used in an ongoing clinical trial at Georgetown University Hospital and was used in three cases.
authors.affiliation: Imaging Science and Information Systems Center, Department of Radiology, Georgetown University Medical Center, Washington, DC 20007, USA. zivy@isis.georgetown.edu
authors.forename: Ziv
authors.initials: Z
authors.lastname: Yaniv
authors.forename: Patrick
authors.initials: P
authors.lastname: Cheng
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Wilson
authors.forename: Teo
authors.initials: T
authors.lastname: Popa
authors.forename: David
authors.initials: D
authors.lastname: Lindisch
authors.forename: Enrique
authors.initials: E
authors.lastname: Campos-Nanez
authors.forename: Hernan
authors.initials: H
authors.lastname: Abeledo
authors.forename: Vance
authors.initials: V
authors.lastname: Watson
authors.forename: Kevin
authors.initials: K
authors.lastname: Cleary
authors.forename: Filip
authors.initials: F
authors.lastname: Banovac
mesh_terms: D000818:Animals; D001707:Biopsy, Needle; D017115:Catheter Ablation / Q000379:methods; D002986:Clinical Trials as Topic; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005471:Fluoroscopy; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007431:Intraoperative Complications / Q000517:prevention & control; D008175:Lung Neoplasms / Q000601:surgery; D008953:Models, Anatomic; D009339:Needles; D019047:Phantoms, Imaging; D015642:Radiology, Interventional / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013552:Swine; D054854:Vertebroplasty / Q000379:methods