Augmented Reality Visualization for CT-guided Interventions: System Description, Feasibility, and Initial Evaluation in an Abdominal Phantom

Das, Marco; Sauer, Frank; Schoepf, U. Joseph; Khamene, Ali; Vogt, Sebastian; Schaller, Stefan; Kikinis, Ron; vanSonnenberg, Eric; Silverman, Stuart G.

doi:10.1148/radiol.2401040018

Cited by 53 publications

(29 citation statements)

References 18 publications

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“…2,4 To address this issue, several navigation systems have been introduced which can guide the physician towards a preselected target (e.g. [5][6][7][8][9][10][11][12][13] ). The overall insertion error of these systems typically comprises (cf.…”

Section: Purposementioning

confidence: 99%

Human vs. robot operator error in a needle-based navigation system for percutaneous liver interventions

et al. 2009

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Computed tomography (CT) guided percutaneous punctures of the liver for cancer diagnosis and therapy (e.g. tumor biopsy, radiofrequency ablation) are well-established procedures in clinical routine. One of the main challenges related to these interventions is the accurate placement of the needle within the lesion. Several navigation concepts have been introduced to compensate for organ shift and deformation in real-time, yet, the operator error remains an important factor influencing the overall accuracy of the developed systems. The aim of this study was to investigate whether the operator error and, thus, the overall insertion error of an existing navigation system could be further reduced by replacing the user with the medical robot Robopsy. For this purpose, we performed navigated needle insertions in a static abdominal phantom as well as in a respiratory liver motion simulator and compared the human operator error with the targeting error performed by the robot. According to the results, the Robopsy driven needle insertion system is able to more accurately align the needle and insert it along its axis compared to a human operator. Integration of the robot into the current navigation system could thus improve targeting accuracy in clinical use.

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Section: Purposementioning

confidence: 99%

Human vs. robot operator error in a needle-based navigation system for percutaneous liver interventions

et al. 2009

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“…11.6 mm) for in vivo targeting of artificial liver lesions in a ping model based on invasive registration needles. Das et al [27] showed total targeting errors of 3.5 mm (range: 2.7-4.2 mm) with an optical navigation system based on CT-guided, frame-attached marker paired-point registration in a phantom, and achieved 100% success in initial attempts to target simulated liver lesions ranging in size from 5 to 15 mm. Levy et al [28] showed total errors of 4 mm in an abdominal phantom and Zhang et al [25] reported errors of 8.3 AE 3.7 mm in a pig model, both with electromagnetic tracking systems.…”

Section: Improving Ct-guided Interventionsmentioning

confidence: 99%

Accuracy and diagnostic yield of CT-guided stereotactic liver biopsy of primary and secondary liver tumors

Schullian

Widmann

Lang

et al. 2011

Computer Aided Surgery

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Objective: CT-guided biopsy still plays a decisive role in the management of liver tumors, especially if the lesions are not visible or accessible by ultrasound. As CT-guided stereotaxy appears to be a very accurate targeting technique, the aim of this study was to evaluate the targeting accuracy, diagnostic yield, and complications of CT-guided stereotactic liver biopsy of primary and secondary liver tumors. Methods and Materials: Prior to stereotactic liver biopsy, patients under general anesthesia were immobilized using a vacuum cushion. Respiratory motion was controlled by temporary disconnections of the endotracheal tube. An opticalbased navigation system was used for 3D trajectory planning and placement of a 15-G coaxial needle via a stereotactic aiming device. The histological samples were obtained using a 16-G Tru-Cut TM biopsy needle system. For evaluation of targeting accuracy the control CT image with the needles in place was fused with the planning CT image. The lateral error at the tip and skin entry point and the angular error were calculated. In addition, the skin-to-liver-surface (SL) distance, the needle-to-liver-surface (NL) angle, and the presence of liver cirrhosis were evaluated. The diagnostic yield was evaluated by histological reports from the institutional pathologists. Results: The median lateral error was 2.5 mm (range: 0-6.5 mm) at the needle entry point and 3.2 mm (range: 0.01-9.4 mm) at the needle tip. The median angular error was 1.06(range: 0-6.64 ). Liver cirrhosis, NL angle and SL distance showed no significant impact on the targeting accuracy. Forty-five of the 46 liver biopsies (97.8%) were diagnostic according to the histological reports. No puncture-related complications such as bleeding or perforation of intestinal organs or lung tissue were recorded.

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“…Only few have therefore ever left their laboratories, and most appear in latency or stereo perception measurements, phantom, cadaver or animal studies [4][5][6][7][8].…”

Section: Augmented Reality and Applications In Surgerymentioning

confidence: 99%

Image guidance for robotic minimally invasive coronary artery bypass

Figl

Rueckert

Hawkes

et al. 2010

Computerized Medical Imaging and Graphics

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Augmented Reality Visualization for CT-guided Interventions: System Description, Feasibility, and Initial Evaluation in an Abdominal Phantom

Abstract: radiology.rsnajnls.org/cgi/content/full/2401040018/DC1

Cited by 53 publications

References 18 publications

Human vs. robot operator error in a needle-based navigation system for percutaneous liver interventions

Human vs. robot operator error in a needle-based navigation system for percutaneous liver interventions

Accuracy and diagnostic yield of CT-guided stereotactic liver biopsy of primary and secondary liver tumors

Image guidance for robotic minimally invasive coronary artery bypass

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