title: Design and evaluation of a computed tomography (CT)-compatible needle insertion device using an electromagnetic tracking system and CT images.
abstract: OBJECTIVE
  Percutaneous needle insertion procedures are commonly used for diagnostic and therapeutic purposes. Although current technology allows accurate localization of lesions, they cannot yet be precisely targeted. Lung cancer is the most common cause of cancer-related death, and early detection reduces the mortality rate. Therefore, suspicious lesions are tested for diagnosis by performing needle biopsy.
  
  
  METHODS
  In this paper, we have presented a novel computed tomography (CT)-compatible needle insertion device (NID). The NID is used to steer a flexible needle (φ0.55 mm) with a bevel at the tip in biological tissue. CT images and an electromagnetic (EM) tracking system are used in two separate scenarios to track the needle tip in three-dimensional space during the procedure. Our system uses a control algorithm to steer the needle through a combination of insertion and minimal number of rotations.
  
  
  RESULTS
  Noise analysis of CT images has demonstrated the compatibility of the device. The results for three experimental cases (case 1: open-loop control, case 2: closed-loop control using EM tracking system and case 3: closed-loop control using CT images) are presented. Each experimental case is performed five times, and average targeting errors are 2.86 ± 1.14, 1.11 ± 0.14 and 1.94 ± 0.63 mm for case 1, case 2 and case 3, respectively.
  
  
  CONCLUSIONS
  The achieved results show that our device is CT-compatible and it is able to steer a bevel-tipped needle toward a target. We are able to use intermittent CT images and EM tracking data to control the needle path in a closed-loop manner. These results are promising and suggest that it is possible to accurately target the lesions in real clinical procedures in the future.
authors.affiliation: Center for Medical Imaging - North East Netherlands, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GB, Groningen, The Netherlands. n.shahriari@utwente.nl.|Department of Biomechanical Engineering (MIRA-Institute for Biomedical Technology and Technical Medicine), University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands. n.shahriari@utwente.nl.
authors.forename: Navid
authors.initials: N
authors.lastname: Shahriari
authors.affiliation: Department of Biomechanical Engineering (MIRA-Institute for Biomedical Technology and Technical Medicine), University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands. e.e.g.hekman@utwente.nl.
authors.forename: Edsko
authors.initials: E
authors.lastname: Hekman
authors.affiliation: Center for Medical Imaging - North East Netherlands, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GB, Groningen, The Netherlands. m.oudkerk@umcg.nl.
authors.forename: Matthijs
authors.initials: M
authors.lastname: Oudkerk
authors.affiliation: Department of Biomechanical Engineering (MIRA-Institute for Biomedical Technology and Technical Medicine), University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands. s.misra@utwente.nl.|Department of Biomedical Engineering and Center for Medical Imaging - North East Netherlands, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GB, Groningen, The Netherlands. s.misra@utwente.nl.
authors.forename: Sarthak
authors.initials: S
authors.lastname: Misra
mesh_terms: D000465:Algorithms; D001707:Biopsy, Needle / Q000295:instrumentation*; D055590:Electromagnetic Phenomena; D004867:Equipment Design; D006801:Humans; D061705:Image-Guided Biopsy / Q000295:instrumentation*; D008175:Lung Neoplasms / Q000175:diagnosis; D009339:Needles; D011677:Punctures / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: CT-guided procedures; Computer-assisted surgery; Electromagnetic tracking; Image-guided control; Medical robots and systems; Minimally invasive surgery
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