title: Application of 3D imaging in the real-time US-CT fusion navigation for minimal invasive tumor therapy.
abstract: OBJECTIVE
  Image-guided minimally invasive treatment (IG-MIT) has been widely used for local therapy of both benign and malignant tumors. However, precise needle targeting is a very important step in the minimally invasive treatment. Nowadays, minimally invasive treatment is usually performed with the guidance of the two-dimensional (2D) image. The tip of the puncture needle is difficult to place with precise positioning into the three-dimensional (3D) space of the tumor. This study was an experimental ex vivo study in porcine liver and heart samples with internal targets, focusing on the accuracy with the guidance of the real-time 3D imaging using a self-developed real-time ultrasonography and preoperative computed tomography (CT) fusion navigation system for minimal invasive tumor (liver tumor and uterine fibroid) therapy.
  
  
  METHODS
  There are thirty porcine liver samples and thirty porcine heart samples used in the experiments. The average weight of the porcine liver samples was 2216.8 g, and the average weight of the porcine heart samples was 510.5 g. We conducted statistical analysis of the experimental results obtained by five medical students and five interventional radiologists.
  
  
  RESULTS
  The puncture precision of the needle placement under the guidance of 3D imaging was significantly higher than that of the other groups, and the assistant function is more obvious for medical students than that for interventional radiologists [Formula: see text]. Assistant function of the US-CT fusion imaging is higher than that of the first group too [Formula: see text]. The precision of the puncture with guidance of the 3D imaging was very satisfied in the fact that it was found that there was a mean discrepancy of [Formula: see text] (medical students) and [Formula: see text] (interventional radiologists) in porcine livers and there was a mean discrepancy of [Formula: see text] (medical students) and [Formula: see text] (interventional radiologists) in porcine hearts.
  
  
  CONCLUSIONS
  Experimental results showed that the accuracy of needle targeting can be improved with the guidance of the real-time 3D imaging than that with the guidance of both 2D US images and US-CT fusion images in IG-MIT. Assistant function of 3D imaging is obviously for medical students.
authors.affiliation: Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.
authors.forename: Wenbo
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Gynaecology, Zoucheng People's Hospital, 59 Qianquan Road, Zoucheng, Shandong, 273500, China.
authors.forename: Yingfeng
authors.identifier: http://orcid.org/0000-0003-4431-7360
authors.initials: Y
authors.lastname: Xue
authors.affiliation: Department of Orthopedic, Zoucheng People's Hospital, Shandong, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Radiology, Zoucheng People's Hospital, Shandong, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China. xjcradiology@163.com.|Department of Gynaecology, Zoucheng People's Hospital, 59 Qianquan Road, Zoucheng, Shandong, 273500, China. xjcradiology@163.com.
authors.forename: Jin
authors.initials: J
authors.lastname: Xue
authors.affiliation: Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.
authors.forename: Shaobo
authors.initials: S
authors.lastname: Duan
authors.affiliation: Department of Neurology, Zoucheng People's Hospital, Shandong, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
mesh_terms: D000818:Animals; D005260:Female; D006338:Heart Neoplasms / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D023421:Models, Animal; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013552:Swine; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: 3D image guidance; Minimally invasive treatment; Precise needle targeting; US–CT fusion navigation; Ultrasound guidance