A new guidance system for freehand, obstetric ultrasound‐guided procedures

Paltieli, Y.; Degani, S.; Zrayek, A.; Gonen, Ron; Lewiński, Michał; Zamberg, Y.; Ohel, Gonen

doi:10.1046/j.1469-0705.2002.00607.x

Cited by 21 publications

(5 citation statements)

References 17 publications

(21 reference statements)

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“…Needle guidance systems are commercially available. Guidance systems may be suitable for teaching new procedures, because they improve needle visibility and reduce the incidence of common complications [ 11 ]. However, in cases involving small target regions, such as in oligohydramnios, conventional 2DUS imaging may not be adequate for correct positioning of the needle.…”

Section: Advancements In Ultrasound For Image-guided Percutaneous Fetmentioning

confidence: 99%

Advanced ultrasound for prenatal interventions

et al. 2018

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Ultrasound is an integral part of prenatal interventions. Doppler studies and 3-dimensional ultrasound (3DUS) are frequently used to determine whether fetal surgery is required. The operator’s experience remains crucial for reducing procedure-related morbidity. Real-time 3DUS (or 4DUS) can simultaneously display the needle tip in three orthogonal planes, providing reassurance that no fetal parts are in the path. In experienced hands, 4DUS guidance may not be more effective than B-mode, but its value for less-experienced operators remains to be determined. Recent developments in needle, shunt, and video endoscopic technologies may compliment the use of image-guided in utero procedures. Future developments of higher-dimensional transducers and image software may improve the utility of ultrasound for invasive obstetric interventions.

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Section: Advancements In Ultrasound For Image-guided Percutaneous Fetmentioning

confidence: 99%

Advanced ultrasound for prenatal interventions

et al. 2018

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“…A rotary wheel needle–guide on a bracket which is attached to an ultrasound transducer [ 19 ] has been developed to move the needle without fixing the angle, but the position of the needle during movement is still a problem. A two planar linkage with 2D guidance system has been developed with the magnetic rotary sensors to detect the angular displacement [ 20 ]. This system is tested and compared between an experienced and inexperienced radiologist group [ 21 ], which shows high accuracy and lower procedure time.…”

Section: Introductionmentioning

confidence: 99%

Breast biopsy navigation system with an assisted needle holder tool and 2D graphical user interface

Suthakorn

Tanaiutchawoot

Wiratkapan

et al. 2018

European Journal of Radiology Open

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ObjectiveThis paper proposes the development of a breast biopsy navigation system with an assisted needle holder tool for a coaxial needle and a graphical user interface, which utilizes an optical tracking device to localize the needle position relative to the ultrasound image with the aim to improve performance especially for a new radiologist or an inexperienced group.Materials and methodsThe system consists of an assisted needle holder tool, which as an attachment for the 2D ultrasound transducer and the graphical user interface (GUI) that shows the needle pathway, needle line and warning signs. An optical tracking system is used to track the needle motion, ultrasound image and transform all information to with respect to the technique. The system is evaluated using a phantom made from gel candle. There were nine experienced and eight inexperienced participants who performed the breast biopsy intervention, using three methods: the freehand method, only the needle holder tool guidance, and the whole navigation guidance (GUI + assisted needle holder).ResultsThe results demonstrate a success rate of over 90% using only assisted needle holder and the whole system to perform breast biopsy for the experienced and inexperienced groups, whereas for the inexperienced group a success rate of 57.5% was achieved using the freehand method. The use of only assisted needle holder for breast biopsy reduces the time for a procedure in the inexperienced group by 6 s when compared to the freehand method.ConclusionThe authors believe that this navigation system can be applied in a clinical setting and give an advantage to inexperienced radiologists who must successfully perform clinical breast biopsy.

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“…Procedures in which needle visualization is of particular importance include nerve blocks for regional anesthesia and interventional pain management, 1-3 and minimally invasive interventions within the uterus for amniotic fluid sampling, chorionic villus sampling, and fetal surgery. 4,5 With nerve blocks, loss of visibility of the needle tip can result in mechanical trauma to nerve fascicles, 6 local anesthetic toxicity following inadvertent intravascular injections, 7 and pneumothorax. 8 Ultrasound-guided uterine access can be particularly challenging in cases with oligohydramnios, when the practitioner is inexperienced, and when the mother is obese.…”

Section: Introductionmentioning

confidence: 99%

Coded excitation ultrasonic needle tracking: An in vivo study

et al. 2016

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Purpose-Accurate and efficient guidance of medical devices to procedural targets lies at the heart of interventional procedures. Ultrasound imaging is commonly used for device guidance, but determining the location of the device tip can be challenging. Various methods have been proposed to track medical devices during ultrasound-guided procedures, but widespread clinical adoption has remained elusive. With ultrasonic tracking, the location of a medical device is determined by ultrasonic communication between the ultrasound imaging probe and a transducer integrated into the medical device. The signal-to-noise ratio (SNR) of the transducer data is an important determinant of the depth in tissue at which tracking can be performed. In this paper, the authors present a new generation of ultrasonic tracking in which coded excitation is used to improve the SNR without spatial averaging. a)Author to whom correspondence should be addressed. wenfeng.xia@ucl.ac.uk. Conflict of Interest DisclosureThe authors have no COI to report. Methods-A fiber optic hydrophone was integrated into the cannula of a 20 gauge insertion needle. This transducer received transmissions from the ultrasound imaging probe, and the data were processed to obtain a tracking image of the needle tip. Excitation using Barker or Golay codes was performed to improve the SNR, and conventional bipolar excitation was performed for comparison. The performance of the coded excitation ultrasonic tracking system was evaluated in an in vivo ovine model with insertions to the brachial plexus and the uterine cavity. Europe PMC Funders GroupResults-Coded excitation significantly increased the SNRs of the tracking images, as compared with bipolar excitation. During an insertion to the brachial plexus, the SNR was increased by factors of 3.5 for Barker coding and 7.1 for Golay coding. During insertions into the uterine cavity, these factors ranged from 2.9 to 4.2 for Barker coding and 5.4 to 8.5 for Golay coding. The maximum SNR was 670, which was obtained with Golay coding during needle withdrawal from the brachial plexus. Range sidelobe artifacts were observed in tracking images obtained with Barker coded excitation, and they were visually absent with Golay coded excitation. The spatial tracking accuracy was unaffected by coded excitation.Conclusions-Coded excitation is a viable method for improving the SNR in ultrasonic tracking without compromising spatial accuracy. This method provided SNR increases that are consistent with theoretical expectations, even in the presence of physiological motion. With the ultrasonic tracking system in this study, the SNR increases will have direct clinical implications in a broad range of interventional procedures by improving visibility of medical devices at large depths.

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A new guidance system for freehand, obstetric ultrasound‐guided procedures

Abstract: The new guidance system combines the benefits of an attached guide with the flexibility of the 'freehand' technique. Use of the new guidance system for mid-trimester genetic amniocentesis increases needle visibility and lowers the incidence of common complications.

Cited by 21 publications

References 17 publications

Advanced ultrasound for prenatal interventions

Advanced ultrasound for prenatal interventions

Breast biopsy navigation system with an assisted needle holder tool and 2D graphical user interface

Coded excitation ultrasonic needle tracking: An in vivo study

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