title: Comparison of Two Electromagnetic Navigation Systems For CT-Guided Punctures: A Phantom Study.
abstract: OBJECTIVE
  We compared the targeting accuracy and reliability of two different electromagnetic navigation systems for manually guided punctures in a phantom.
  
  
  METHODS
  CT data sets of a gelatin filled plexiglass phantom were acquired with 1, 3, and 5 mm slice thickness. After paired-point registration of the phantom, a total of 480 navigated stereotactic needle insertions were performed manually using electromagnetic guidance with two different navigation systems (Medtronic Stealth Station: AxiEM; Philips: PercuNav). A control CT was obtained to measure the target positioning error between the planned and actual needle trajectory.
  
  
  RESULTS
  Using the Philips PercuNav, the accomplished Euclidean distances were 4.42 ± 1.33 mm, 4.26 ± 1.32 mm, and 4.46 ± 1.56 mm at a slice thickness of 1, 3, and 5 mm, respectively. The mean lateral positional errors were 3.84 ± 1.59 mm, 3.84 ± 1.43 mm, and 3.81 ± 1.71 mm, respectively. Using the Medtronic Stealth Station AxiEM, the Euclidean distances were 3.86 ± 2.28 mm, 3.74 ± 2.1 mm, and 4.81 ± 2.07 mm at a slice thickness of 1, 3, and 5 mm, respectively. The mean lateral positional errors were 3.29 ± 1.52 mm, 3.16 ± 1.52 mm, and 3.93 ± 1.68 mm, respectively.
  
  
  CONCLUSIONS
  Both electromagnetic navigation devices showed excellent results regarding puncture accuracy in a phantom model. The Medtronic Stealth Station AxiEM provided more accurate results in comparison to the Philips PercuNav for CT with 3 mm slice thickness. One potential benefit of electromagnetic navigation devices is the absence of visual contact between the instrument and the sensor system. Due to possible interference with metal objects, incorrect position sensing may occur. In contrast to the phantom study, patient movement including respiration has to be compensated for in the clinical setting.
  
  
  CONCLUSIONS
  • Commercially available electromagnetic navigation systems have the potential to improve the therapeutic range for CT guided percutaneous procedures by comparing the needle placement accuracy on the basis of planning CT data sets with different slice thickness. Citation Format: • Putzer D, Arco D, Schamberger B et al. Comparison of Two Electromagnetic Navigation Systems For CT-Guided Punctures: A Phantom Study. Fortschr Röntgenstr 2016; 188: 470 - 478.
authors.affiliation: Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: D
authors.initials: D
authors.lastname: Putzer
authors.affiliation: Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: D
authors.initials: D
authors.lastname: Arco
authors.affiliation: Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Schamberger
authors.affiliation: Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Schanda
authors.affiliation: Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Mahlknecht
authors.affiliation: Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Widmann
authors.affiliation: Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Schullian
authors.affiliation: Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Jaschke
authors.affiliation: Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Bale
mesh_terms: D001707:Biopsy, Needle / Q000295:instrumentation*; D017115:Catheter Ablation / Q000295:instrumentation*; D066264:Datasets as Topic; D061827:Dimensional Measurement Accuracy; D055590:Electromagnetic Phenomena; D004867:Equipment Design; D061705:Image-Guided Biopsy / Q000295:instrumentation*; D019047:Phantoms, Imaging; D011873:Radiology Information Systems / Q000295:instrumentation; D015203:Reproducibility of Results; D012984:Software; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*