Phantom evaluation of a navigation system for out-of-plane CT-guided puncture.
OBJECTIVE
The purpose of this phantom study was to assess a new real time electromagnetically-guided navigation system and compare it to standard computed tomography (CT) guidance.


METHODS
A prospective, randomized, comparative study was carried out over a two-day period. Operators without prior experience on the new navigation system sequentially attempted to puncture two 6 mm-diameter targets (one attempt for each target) with out-of-plane trajectories using both the standard CT-guided method and the new navigation station (NAV method).


RESULTS
Intention-to-treat analysis was performed for 54 operators. Twenty-two operators out of 54 (40.7%) reached the target on first attempt with the NAV method versus none (0%) using CT-guidance (P<0.001). The median distance of the puncture from the center of the target was 3.7mm [Q1-Q3=2-6.7] using NAV versus 15 mm [10-20] using CT-guidance (P<0.001). Overall planning and puncture time were shorter using NAV: 76s [50-118] versus 214s [181-264] using CT-guidance (P<0.001).


CONCLUSIONS
Novice operators consistently performed faster and more accurate phantom punctures with out-of-plane trajectories using the electromagnetically-guided navigation system than with the standard CT-guided method.
Service de radiologie et d'imagerie médicale, hôpital Nord, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 9, France. Electronic address: lmoncharmont@chu-grenoble.fr.
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Moncharmont
Unité innovation technologique, centre d'investigation clinique, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 9, France. Electronic address: Alexandre.Moreau-gaudry@imag.fr.
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Moreau-Gaudry
Unité innovation technologique, centre d'investigation clinique, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 9, France. Electronic address: maud.medici@imag.fr.
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Medici
Service de radiologie et d'imagerie médicale, hôpital Nord, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 9, France; TIMC-IMAG, université Grenoble-Alpes, 38000 Grenoble, France. Electronic address: IBricault@chu-grenoble.fr.
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Bricault
D001707:Biopsy, Needle / Q000379:methods*; D055590:Electromagnetic Phenomena; D019047:Phantoms, Imaging; D011446:Prospective Studies; D011677:Punctures / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods
Computed tomography; Electromagnetic navigation; Interventional radiology; Phantom study