The transjugular intrahepatic portosystemic shunt (TIPS) procedure is one of the most technically challenging procedures in interventional radiology [1]. During the TIPS procedure, a shunt is created in the liver to decrease the high blood pressure for patients with portal hypertension [2]. Especially the intrahepatic puncture is a challenging part of the procedure [3]. During this critical step, the interventional radiologists (IRs) desire to gain access to the portal vein and intend to puncture from the hepatic vein, through the liver, into the portal vein....

From an acquired 3D US dataset, a 3D US based UI was designed (figure 1): 1) on the right, the 3D view of the segmented hepatic and portal vein images are visualized; 2) on the left, a 2D axial section plane is visualized. The mouse allows IRs to scroll through the dataset in the axial direction and to zoom or rotate the segmented images. The mouse also allows IRs to select the preferred target point/area in the portal vein (figure 1) and the preferred hepatic...

All participating IRs said they were seriously interested in the planning-UI. Three participants already expressed their desire to clinically test the UI: “I would also like to, at the proper time, to put it into practice”. IRs mainly appreciated: 1. The possibility to view and interact with 3D digital information. IRs said it made it easier to understand the anatomy, distances, possibilities and constraints and to select the proper trajectory and stent. 2. The UI’s potential to generate 2D planes which could make the current...

The test showed that the UI provides valuable 3D visualization support to plan the intrahepatic TIPS puncture. Although a prototype, all IRs were seriously interested in the UI. The possibility to view and interact with 3D digital information which is currently mentally constructed based on CT was highly appreciated. In addition, the presented 2D US images which can be used during the procedure were greatly valued as well. Design improvements based on the feedback and elaborate testing are needed to further improve the UI.

CF Cuijpers, Department of Design Engineering, Delft University of Technology, Industrial Design Engineering, Delft, the Netherlands, [email protected]; C Klink, Department of Interventional Radiology, Erasmus Medical Centre, Rotterdam, the Netherlands; E Varga, Department of Biomedical Imaging Group, Erasmus Medical Centre, Rotterdam, the Netherlands; PJ Stappers, Department of Industrial Design, Delft University of Technology, Industrial Design Engineering, Delft, the Netherlands, Y Song, Department of Design Engineering, Delft University of Technology, Industrial Design Engineering, Delft, the Netherlands.

[1] Funaki B (2008) Transjugular Intrahepatic Portosystemic Shunt. Seminars in interventional radiology, 1:168–174. [2] Goykhman Y, Ben-Haim M, Rosen G, et al. (2010) Transjugular intrahepatic portosystemic shunt: current indications, patient selection and results. IMAJ 12:687–91. [3] Owen A., Stanley A., Vijayananthan A, Moss J. (2009) The transjugular intrahepatic portosystemic shunt (TIPS). Clinical radiology 64:664–74. [4] Cuijpers CF, Moelker A, Varga E, Stappers PJ, Freudenthal A(2012) Improving image guidance in interventional radiology: the lack of information during a transjugular intrahepatic shunt procedure, EAM, Germany. [5] Krajina...