Needle-based interventions with the image-guided surgery toolkit (IGSTK): from phantoms to clinical trials.
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.
Yaniv
Ziv
Z
Imaging Science and Information Systems Center, Department of Radiology, Georgetown University Medical Center, Washington, DC 20007, USA. zivy@isis.georgetown.edu
Cheng
Patrick
P
Wilson
Emmanuel
E
Popa
Teo
T
Lindisch
David
D
Campos-Nanez
Enrique
E
Abeledo
Hernan
H
Watson
Vance
V
Cleary
Kevin
K
Banovac
Filip
F
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