Keywords:
Interventional non-vascular, Computer applications, CT, Percutaneous, Image manipulation / Reconstruction, Ablation procedures, Biopsy, Technology assessment
Authors:
P. Durand, A. Moreau-Gaudry, J. frandon, M. Medici, E. Chipon, C. SENGEL, I. BRICAULT; Grenoble/FR
DOI:
10.1594/ecr2013/B-0429
Purpose
To assess the accuracy and usability of a navigation system dedicated to assist CT guided interventions.
Accuracy of needle placement is critital for the success of percutaneous guided interventions and to avoid adverse events but some cases prove to difficult :
- Double obliquity required to achieve a safe trajectory.
- Patient's movements during the procedure.
Different navigation systems have been developed so far to assist CT quided interventions using mechanical localization,
laser,
optical or electromagnetic tracking with the following limitations :
- They often lack the possibility to do a real-time trajectory planning
- They were not tested on real clinical settings
- Most of the available trials are technical validations on phantoms,
animal studies or non comparative small clinical series that do not embrace a full variety of interventions.
The IMACTIS® CT Navigation system prototype (La Tronche,
France) (Fig.
1) uses an electromagnetic localizer including a fiducial on the patient’s skin and a sensor clipped in a sterile needle holder.
Position and orientation of the needle holder and needle path is displayed in real-time on 2D reconstructed CT-images extracted from the 3D CT volume (Fig 2).
As a result,
the interventional radiologist can explore the patient anatomy in any plane,
and visualize the needle trajectory before its insertion by navigating on the patient in real time(Fig.
3).
Thus,
the purpose of this trial was to compare navigated procedures with standard CT procedures,
in order to assess the accuracy and usability of this navigation system in a routine clinical setting.