Evaluation of a novel, patient-mounted system for CT-guided needle navigation—an ex vivo study

Mokry, Anna; Willmitzer, Florian; Hostettler, Rafael; Richter, Henning; Kircher, Patrick R.; Kneissl, Sibylle; Wetzel, Stephan G.

doi:10.1007/s00234-018-2107-0

Cited by 11 publications

(4 citation statements)

References 14 publications

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“…The “CNS” (Medical Templates AG, Egg, Zurich, Switzerland) was described recently in detail in an ex vivo study [ 3 ]. In short, the PC is a disposable cube-shaped apparatus consisting of an upper- and a lower-grid template, with fields marked both with letters and numbers (e.g., field B2).…”

Section: Methodsmentioning

confidence: 99%

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Navigation Guidance for Percutaneous Splanchnic Nerve Radiofrequency Neurolysis: Preliminary Results

et al. 2022

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Background and Objectives: To describe preliminary results upon the application of the “Cube Navigation System” (CNS) for computed tomography (CT)-guided splanchnic nerve radiofrequency neurolysis. Materials and Methods: CT-guided splanchnic nerve neurolysis was performed in five patients; in all cases, neurolysis was performed under CT guidance using the CNS. The mean patient age was 71.6 years (range 54–81 years; male/female: 5/0). Technical success, parameters of the neurolysis session and complications were evaluated. Technical success was defined as a needle position on the defined target. Session parameters included procedure time and number of scans. The CIRSE reporting system was used for complications’ classification and grading. Results: Technical success was obtained in all cases; in 1/5 patients, a slight correction in needle orientation was necessary. Mean procedure time was 12.4 min (range 8–19 min); an average of four CT scans was recorded in the five neurolysis sessions. There were no complications or material failures reported in the present study. Conclusions: Preliminary results of the present study show that computed tomography (CT)-guided splanchnic nerve radiofrequency neurolysis using the CNS is an accurate and time-efficient percutaneous procedure. More prospective and comparative studies with larger patient samples are necessary for verification of this system as well as for drawing broader conclusions.

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Section: Methodsmentioning

confidence: 99%

“…The physical puncture needle is then inserted into the respective holes on the PC. In an in vitro phantom study, the CNS showed significantly improved accuracy, lower procedure time and an overall lower intervention time compared to punctures performed with the FHM [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Navigation Guidance for Percutaneous Splanchnic Nerve Radiofrequency Neurolysis: Preliminary Results

et al. 2022

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“…Mokry et al [16] came to the result that the PCS improves accuracy and reduces intervention time compared to the free-hand method. Their phantom study showed almost equal results compared with ours (3.4 mm ± 2.3 mm vs. 3.84 mm ± 1.75 mm).…”

Section: Maxiomentioning

confidence: 99%

Comparison of a Robotic and Patient-Mounted Device for CT-Guided Needle Placement: A Phantom Study

Scharll

Mitteregger²,

Laimer³

et al. 2022

JCM

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Background: Robotic-based guidance systems are becoming increasingly capable of assisting in needle placement during interventional procedures. Despite these technical advances, less sophisticated low-cost guidance devices promise to enhance puncture accuracy compared with the traditional freehand technique. Purpose: To compare the in vitro accuracy and feasibility of two different aiming devices for computed-tomography (CT)-guided punctures. Methods: A total of 560 CT-guided punctures were performed by using either a robotic (Perfint Healthcare: Maxio) or a novel low-cost patient-mounted system (Medical Templates AG: Puncture Cube System [PCS]) for the placement of Kirschner wires in a plexiglass phantom with different slice thicknesses. Needle placement accuracy as well as procedural time were assessed. The Euclidean (ED) and normal distances (ND) were calculated at the entry and target point. Results: Using the robotic device, the ND at the target for 1.25 mm, 2.5 mm, 3.75 mm and 5 mm slice thickness were 1.28 mm (SD ± 0.79), 1.25 mm (SD ± 0.81), 1.35 mm (SD ± 1.00) and 1.35 mm (SD ± 1.03). Using the PCS, the ND at the target for 1 mm, 3 mm and 5 mm slices were 3.84 mm (SD ± 1.75), 4.41 mm (SD ± 2.31) and 4.41 mm (SD ± 2.11), respectively. With all comparable slice thicknesses, the robotic device was significantly more accurate compared to the low-cost device (p < 0.001). Needle placement with the PCS resulted in lower intervention time (mean, 158.83 s [SD ± 23.38] vs. 225.67 s [SD ± 17.2]). Conclusion: Although the robotic device provided more accurate results, both guidance systems showed acceptable results and may be helpful for interventions in difficult anatomical regions and for those requiring complex multi-angle trajectories.

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“…A recently introduced navigation tool, the Cube Navigation System, has shown high accuracy in an in vitro study ( 6 ) and promising initial clinical results ( 7 ). Additionally, its relatively small size and ease of use seem to address some of the problems with other CT navigation systems.…”

Section: Introductionmentioning

confidence: 99%

Case report: Experience with the Cube Navigation System in complex access routes during CT-guided lumbosacral infiltration therapy

Diepers

Gruber²,

Remonda³

et al. 2023

Front. Surg.

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PurposeComputed tomography (CT)-guided infiltrations are a mainstay in the treatment of lower back pain. Needle placement is usually performed using the free-hand method, where the translation from the planned needle angle to the actual needle insertion angle is estimated. However, the free-hand method is especially challenging in cases where a double-oblique access route (out-of-plane) rather than an in-plane route is necessary. In this case series, we report our experience with the patient-mounted Cube Navigation System to guide needle placement for complex access routes in lumbar pain therapy.Research design and methodsWe retrospectively analyzed the cases of five patients in whom a double-oblique access route was necessary for CT-guided lumbar infiltration pain treatment. Each of those procedures was done using the Cube Navigation System to provide navigational guidance. The mean patient age was 69 ± 13 years (range 58–82 years; all females). Technical success, procedure time, and number of control scans were determined retrospectively.ResultsTechnical success (i.e., positioning and accuracy) was obtained in all cases. Mean procedure time was 15 ± 7 min (10–22 min); on average, 2 ± 1 CT control scans were performed. There were no complications or material failures reported in the present study.ConclusionDouble-oblique punctures with the Cube Navigation System in this initial case series of complex access routes at the lumbar spine were accurate and the procedure was time efficient. In the authors’ view, the Cube Navigation System has the potential to improve needle guidance for complex access routes, especially considering the ease of use of the device.

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Evaluation of a novel, patient-mounted system for CT-guided needle navigation—an ex vivo study

Cited by 11 publications

References 14 publications

Navigation Guidance for Percutaneous Splanchnic Nerve Radiofrequency Neurolysis: Preliminary Results

Navigation Guidance for Percutaneous Splanchnic Nerve Radiofrequency Neurolysis: Preliminary Results

Comparison of a Robotic and Patient-Mounted Device for CT-Guided Needle Placement: A Phantom Study

Case report: Experience with the Cube Navigation System in complex access routes during CT-guided lumbosacral infiltration therapy

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