title: Automatic path proposal computation for CT-guided percutaneous liver biopsy.
abstract: OBJECTIVE
  To evaluate feasibility of automatic software-based path proposals for CT-guided percutaneous biopsies.
  
  
  METHODS
  Thirty-three patients (60 [Formula: see text] 12 years) referred for CT-guided biopsy of focal liver lesions were consecutively included. Pre-interventional CT and dedicated software (FraunhoferMeVis Pathfinder) were used for (semi)automatic segmentation of relevant structures. The software subsequently generated three path proposals in downward quality for CT-guided biopsy. Proposed needle paths were compared with consensus proposal of two experts (comparable, less suitable, not feasible). In case of comparable results, equivalent approach to software-based path proposal was used. Quality of segmentation process was evaluated (Likert scale, 1 [Formula: see text] best, 6 [Formula: see text] worst), and time for processing was registered.
  
  
  RESULTS
  All biopsies were performed successfully without complications. In 91 % one of the three automatic path proposals was rated comparable to experts' proposal. None of the first proposals was rated not feasible, and 76 % were rated comparable to the experts' proposal. 7 % automatic path proposals were rated not feasible, all being second choice ([Formula: see text]) or third choice ([Formula: see text]). In 79 %, segmentation at least was good. Average total time for establishing automatic path proposal was 42 [Formula: see text] 9 s.
  
  
  CONCLUSIONS
  Automatic software-based path proposal for CT-guided liver biopsies in the majority provides path proposals that are easy to establish and comparable to experts' insertion trajectories.
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Helck
authors.affiliation: Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Schumann
authors.affiliation: we-do-IT, Melbourne, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Aumann
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Thierfelder
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: F F
authors.initials: FF
authors.lastname: Strobl
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Braunagel
authors.affiliation: Siemens AG Healthcare, Forchheim, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Niethammer
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: D A
authors.initials: DA
authors.lastname: Clevert
authors.affiliation: Institute and Policlinic of Radiology, University Hospital at the Technische Universität Dresden, Dresden, Germany.
authors.forename: R T
authors.initials: RT
authors.lastname: Hoffmann
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Reiser
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Sandner
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany. christoph.trumm@med.uni-muenchen.de.
authors.forename: C
authors.initials: C
authors.lastname: Trumm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012984:Software; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
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