An electromagnetic navigation system for transbronchial interventions with a novel approach to respiratory motion compensation

Gergel, Ingmar; Hering, Jan; Tetzlaff, Ralf; Meinzer, Hans Peter; Wegner, Ingmar

doi:10.1118/1.3662871

Cited by 21 publications

(14 citation statements)

References 30 publications

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“…Drawbacks are the extended costs of this technique, and the fact that no improvement of diagnostic yield compared to the conventional method has yet been demonstrated [94]. Motion compensation is an important issue, because the lung is affected by breathing motion [44]. In spite of the number of studies in this area, there still is a lack of high level evidence such as comparative studies [94].…”

Section: Clinical Evidencementioning

confidence: 99%

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Franz

Haidegger

Birkfellner

et al. 2014

IEEE Trans. Med. Imaging

387

273

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Abstract-Object tracking is a key enabling technology in the context of computer-assisted medical interventions. Allowing the continuous localization of medical instruments and patient anatomy, it is a prerequisite for providing instrument guidance to subsurface anatomical structures. The only widely used technique that enables real-time tracking of small objects without lineof-sight restrictions is electromagnetic (EM) tracking. While EM tracking has been the subject of many research efforts, clinical applications have been slow to emerge. The aim of this review paper is therefore to provide insight into the future potential and limitations of EM tracking for medical use. We describe the basic working principles of EM tracking systems, list the main sources of error, and summarize the published studies on tracking accuracy, precision and robustness along with the corresponding validation protocols proposed. State-of-the-art approaches to error compensation are also reviewed in depth. Finally, an overview of the clinical applications addressed with EM tracking is given. Throughout the paper, we report not only on scientific progress, but also provide a review on commercial systems. Given the continuous debate on the applicability of EM tracking in medicine, this paper provides a timely overview of the state-of-the-art in the field.

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Section: Clinical Evidencementioning

confidence: 99%

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Franz

Haidegger

Birkfellner

et al. 2014

IEEE Trans. Med. Imaging

387

273

View full text Add to dashboard Cite

show abstract

“…These systems localize small EM sensors in an EM field of known geometry and permit the tracking of flexible instruments, such as catheters or flexible endoscopes. Meanwhile, EMbased navigation has been applied in various interventions, e.g., for deployment of stent grafts, 3 creation of a transjugular intrahepatic portosystemic shunt (TIPS), 4 catheter-based ablation therapies for treatment of atrial fibrillation, 5 navigated bronchoscopies, 6 radiofrequency ablation (RFA) of liver tumors, 7 and guidance of flexible laparoscopic ultrasound (US) probes. 8 In addition, the technique is now used in several commercial products, such as the StealthStation V R S7 V R surgical navigation system (Medtronic Navigation, Louisville, KY), the PercuNav system for needle-based procedures (Philips Healthcare, DA Best, The Netherlands), and the i-Logic TM system for navigated bronchoscopies (SuperDimension Gmbh, MN).…”

Section: Introductionmentioning

confidence: 99%

Standardized assessment of new electromagnetic field generators in an interventional radiology setting

et al. 2012

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“…Holding a deep breath may manage the respiratory motion problem, but the duration of bronchoscopy procedures which involve BALF, biopsy, brushing et al, may take some longer time. The navigation system with the proposed respiratory motion compensation method and EBUS allow for real time guidance during bronchoscopic interventions, and thus could increase the diagnostic yield [21]. Therefore, combing with other diagnostic techniques may improve diagnostic yields.…”

Section: Discussionmentioning

confidence: 99%

Small lung lesions invisible under fluoroscopy are located accurately by three-dimensional localization technique on chest wall surface and performed bronchoscopy procedures to increase diagnostic yields

Deng

Cao²,

et al. 2016

BMC Pulm Med

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BackgroundNowadays, small peripheral pulmonary lesions (PPLs) are frequently detected and the prognosis of lung cancer depends on the early diagnosis. Because of the high fee and requiring specialized training, many advanced techniques are not available in many developing countries and rural districts.MethodsThree sets of opaque soft copper wires visible under the fluoroscopy (Flu) in the Flu-flexible bronchoscopy (FB) group (n = 24), which determined the three planes of the lesion, were respectively placed firmly on the surface of the chest wall with adhesive tape on the chest wall. The FB tip was advanced into the bronchus toward the crosspoint of the three perpendicular planes under Flu with careful rotation of a C-arm unit. Then the specimen were harvested focusing around the crosspoint for pathologic diagnosis. The rapid on-site evaluation (ROSE) procedure was also performed. The average Flu time during FB procedures were recorded and diagnostic accuracy rates in the Flu-FB group were compared with the other group guided by radial endobronchial ultrasound (R-EBUS) (n = 23).ResultsThe location of the core point of the lesion, whether it was visible or not under the fluoroscopy could be recognized by three-dimensional localization technique. The accuracy rates of diagnostic yields were 62.5% in the Flu-FB group, and was similar as 65.2% in the R-EBUS group (P > 0.05). However, in the Flu-FB group, there was a decreasing tendency on accurate diagnosis rates of lower lobe (LL) lesions when comparing with non-LL lesions (3/8 = 37.5% vs 12/16 = 75%, P = 0.091) while in the R-EBUS group it was similar (9/12 = 75% vs 6/11 = 54.6%, P = 0.278). In the Flu-FB group, fluoroscopy time was negatively correlated with the lesion length (r = −0.613, P = 0.001), however, there was no significant difference between the lesions invisible or not (5.83 ± 1.45 min vs 7.67 ± 2.02 min, P = 0.116) under the fluoroscopy, as well as no significant difference among SPN, mGGO and GGO (6.12 ± 2.05 min, 7.25 ± 1.33 min and 7.80 ± 2.02 min, P > 0.05).ConclusionsSmall PPL whether it is visible or not under fluoroscopy can be located accurately by our three-dimensional localization technique on chest wall surface and performed bronchoscopy procedures to increase diagnostic yields. It is more convenient, economical and reliable with the similar diagnostic yields than R-EBUS guided method.Trial registrationCurrent Controlled Trials ChiCTR-DDD-16009715. The date of registration: 3rd Nov, 2016. Retrospectively registered.

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An electromagnetic navigation system for transbronchial interventions with a novel approach to respiratory motion compensation

Abstract: The navigation system with the proposed respiratory motion compensation method allows for real time guidance during bronchoscopic interventions, and thus could increase the diagnostic yield of transbronchial biopsy.

Cited by 21 publications

References 30 publications

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Standardized assessment of new electromagnetic field generators in an interventional radiology setting

Small lung lesions invisible under fluoroscopy are located accurately by three-dimensional localization technique on chest wall surface and performed bronchoscopy procedures to increase diagnostic yields

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