title: A low-cost, durable, combined ultrasound and fluoroscopic phantom for cervical transforaminal injections.
abstract: BACKGROUND
  This technical report describes a durable, low-cost, anatomically accurate, and easy-to-prepare combined ultrasound (US) and fluoroscopic phantom of the cervical spine. This phantom is meant to augment training in US- and fluoroscopic-guided pain medicine procedures.
  
  
  METHODS
  The combined US and fluoroscopic phantom (CUF-P) is prepared from commercially available liquid plastic that is ordinarily used to prepare synthetic fishing lures. The liquid plastic is heated and then poured into a metal canister that houses an anatomical cervical spine model. Drops of dark purple dye are added to make the phantom opaque. After cooling, tubing is attached to the CUF-P to simulate blood vessels.
  
  
  RESULTS
  The CUF-P accurately simulates human tissue by imitating both the tactile texture of skin and the haptic resistance of human tissue as the needle is advanced. This phantom contains simulated fluid-filled vertebral arteries that exhibit pulsed flow under color Doppler US. Under fluoroscopic examination, the CUF-P-simulated vertebral arteries also exhibit uptake of contrast dye if mistakenly injected.
  
  
  CONCLUSIONS
  The creation of a training phantom allows the pain physician to practice needle positioning technique while simultaneously visualizing both targeted and avoidable vascular structures under US and fluoroscopic guidance. This low-cost CUF-P is easy to prepare and is reusable, making it an attractive alternative to current homemade and commercially available phantom simulators.
authors.affiliation: Department of Anesthesiology Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St., Boston, MA, USA. irlerman@partners.org
authors.forename: Imanuel R
authors.initials: IR
authors.lastname: Lerman
authors.forename: Dmitri
authors.initials: D
authors.lastname: Souzdalnitski
authors.forename: Samer
authors.initials: S
authors.lastname: Narouze
mesh_terms: D002574:Cervical Vertebrae / Q000098:blood supply / Q000000981:diagnostic imaging*; D002983:Clinical Competence; D003365:Costs and Cost Analysis; D004867:Equipment Design; D005471:Fluoroscopy / Q000191:economics / Q000295:instrumentation; D006801:Humans; D007267:Injections; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D009048:Motor Skills; D019047:Phantoms, Imaging / Q000191:economics; D011673:Pulsatile Flow; D015641:Radiography, Interventional / Q000191:economics / Q000295:instrumentation*; D018615:Ultrasonography, Doppler, Color / Q000191:economics* / Q000295:instrumentation*; D018084:Ultrasonography, Interventional / Q000191:economics / Q000295:instrumentation*; D014711:Vertebral Artery / Q000000981:diagnostic imaging