Magnetic resonance and ultrasound image‐guided navigation system using a needle manipulator

Abstract

Purpose Image guidance is crucial for percutaneous tumor ablations, enabling accurate needle‐like applicator placement into target tumors while avoiding tissues that are sensitive to injury and/or correcting needle deflection. Although ultrasound (US) is widely used for image guidance, magnetic resonance (MR) is preferable due to its superior soft tissue contrast. The objective of this study was to develop and evaluate an MR and US multi‐modal image‐guided navigation system with a needle manipulator to enable US‐guided applicator placement during MR imaging (MRI)‐guided percutaneous tumor ablation. Methods The MRI‐compatible needle manipulator with US probe was installed adjacent to a 3 Tesla MRI scanner patient table. Coordinate systems for the MR image, patient table, manipulator, and US probe were all registered using an optical tracking sensor. The patient was initially scanned in the MRI scanner bore for planning and then moved outside the bore for treatment. Needle insertion was guided by real‐time US imaging fused with the reformatted static MR image to enhance soft tissue contrast. Feasibility, targeting accuracy, and MR compatibility of the system were evaluated using a bovine liver and agar phantoms. Results Targeting error for 50 needle insertions was 1.6 ± 0.6 mm (mean ± standard deviation). The experiment confirmed that fused MR and US images provided real‐time needle localization against static MR images with soft tissue contrast. Conclusions The proposed MR and US multi‐modal image‐guided navigation system using a needle manipulator enabled accurate needle insertion by taking advantage of static MR and real‐time US images simultaneously. Real‐time visualization helped determine needle depth, tissue monitoring surrounding the needle path, target organ shifts, and needle deviation from the path.

Artifact characterization of Nitinol needles in magnetic resonance imaging-guided musculoskeletal interventions at 3.0 tesla: a phantom study

“…Therefore, further studies with coordinate registration are needed to ensure more accurate verification of the exact needle position and, in particular, the position of the needle tip. In a previous study, Yamada et al 35 applied real-time ultrasound imaging fused with reformatted static MR images and coordinate registration for needle guidance during MR-guided percutaneous tumor ablations and revealed targeting errors of 1.6 ± 0.6 mm. Last, the investigated sequence parameter settings need to be analyzed and adapted to clinical use cases.…”

Artifact reduction of coaxial needles in magnetic resonance imaging-guided abdominal interventions at 1.5 T: a phantom study

“…However, several issues remain to be resolved here, such as integration of, e.g., a coordinate system into the agar phantom and minimizing errors of measurement using the 2D T1 GRE sequence, taking into consideration that the distance between the grid and the needle will never be zero. Yamada et al recently made an attempt in this direction, as they applied real-time US imaging fused with reformatted static MR images and coordinate registration for needle guidance during MR-guided percutaneous tumor ablations, with a mean targeting error of 1.6 ± 0.6 mm 33 . However, to date there is a lack of similar studies using real-time MR sequences.…”