title: Electromagnetic navigation to aid radiofrequency ablation and biopsy of lung tumors.
abstract: OBJECTIVE
  We evaluated an electromagnetic (EM) navigation system (Veran Medical Technologies Inc, St. Louis, MO) to determine its potential to reduce the number of skin punctures and instrument adjustments during computed tomographic-guided percutaneous ablation and biopsy of lung nodules.
  
  
  METHODS
  Ten patients undergoing lung percutaneous ablation were prospectively enrolled. The mean age was 70 years. Positioning of the needle device was verified with computed tomographic fluoroscopy prior to the execution of any biopsy or ablation. Each EM navigation-guided procedure was defined as an EM-intervention.
  
  
  RESULTS
  Nineteen EM interventions were performed. When an EM-guided biopsy was performed, the intervention was done immediately prior to ablation. For all 19 EM interventions, only one skin-puncture was required. The mean number of instrument adjustments required was 1.2 (range, 0 to 2). The mean time for each EM intervention was 5.2 minutes (range, 1 to 20 minutes). Pneumothorax occurred in 5 patients (50%). Only the number of instrument adjustments was significantly related to the pneumothorax rate (p = 0.005).
  
  
  CONCLUSIONS
  The EM navigation is feasible and seems to be a useful aid for image-guided procedures. Early experience suggests a low number of skin-puncture and instrument adjustments using the EM navigation system. Instrument adjustments were a key factor in pneumothorax development.
authors.affiliation: Department of Cardiothoracic Surgery, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Ricardo S
authors.initials: RS
authors.lastname: Santos
authors.forename: Avneesh
authors.initials: A
authors.lastname: Gupta
authors.forename: Michael I
authors.initials: MI
authors.lastname: Ebright
authors.forename: Michael
authors.initials: M
authors.lastname: DeSimone
authors.forename: Gregory
authors.initials: G
authors.lastname: Steiner
authors.forename: Mary-Jane
authors.initials: MJ
authors.lastname: Estrada
authors.forename: Benedict
authors.initials: B
authors.lastname: Daly
authors.forename: Hiran C
authors.initials: HC
authors.lastname: Fernando
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D004574:Electromagnetic Fields; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed