title: A respiratory correlated image guided surgery method: quantitative accuracy results in swine and human cadaver environments.
abstract: BACKGROUND
  Intervention on small targets in the lung is difficult, leading our team to develop a highly accurate respiratory correlated image guided surgery (RCIGS) system.
  
  
  METHODS
  Simulated point source targets were implanted into ex vivo porcine and human cadaver lungs attached to a ventilator. The RCIGS system was utilized to guide intervention in the presence of respiratory motion using a commercially available electromagnetic tracking solution. After intervention, the lungs were imaged to determine the target registration error between the target and needle.
  
  
  RESULTS
  The system tumor position modeling had sub-mm accuracy. The mean intervention error for 12 porcine targets was 3.8 mm. The mean target registration error on four targets in a human cadaver was 4.0 mm at a mean depth of 9 cm.
  
  
  CONCLUSIONS
  The system provides an accuracy for intervention on targets of less than 1 cm in diameter at depths of up to 10 cm. A system of this accuracy outperforms current clinical standards.
authors.affiliation: Amgen, Inc., Thousand Oaks, CA, 91320, USA.
authors.forename: Ryan L
authors.initials: RL
authors.lastname: Smith
authors.forename: Jie
authors.initials: J
authors.lastname: Wen
authors.forename: Camille
authors.initials: C
authors.lastname: Noel
authors.forename: Martin L
authors.initials: ML
authors.lastname: Mayse
authors.forename: Parag J
authors.initials: PJ
authors.lastname: Parikh
mesh_terms: D000818:Animals; D001706:Biopsy; D002102:Cadaver; D002138:Calibration; D056973:Four-Dimensional Computed Tomography; D006801:Humans; D009068:Movement; D009339:Needles; D015203:Reproducibility of Results; D012119:Respiration; D012371:Robotics; D012984:Software; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D013552:Swine; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*
keywords: biopsy; image guided surgery; lung; radio frequency ablation; respiratory correlation; respiratory gating