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Keywords:
Head and neck, Computer applications, Ultrasound, PET-CT, Nuclear medicine conventional, Instrumentation, Diagnostic procedure, Technical aspects, Image registration, Education and training
Authors:
G. Bizzarri, A. Bianchini, D. Valle, L. Velari, S. De Nuntis, A. Dell'Era, L. Di Vito, L. Forzoni, E. Papini; Albano Laziale/IT
DOI:
10.1594/ecr2017/B-0066
Methods and materials
For the present study a MyLabTwice ultrasound scanner equipped with an electromagnetic (EM) tracking system,
2D navigation with BodyMap and 3D Virtual Navigator hardware and software,
was used (ESAOTE,
Italy).
BodyMap is an EM tracked technology for 2D Navigation,
that combines US with pre-acquired 2D DICOM images,
used to show the real-time position of the US probe with respect to any secondary images,
such as scintiscan.
While the probe is moving,
showing the real-time ultrasound frames,
the probe position (indicated by a green circle) is automatically over-imposed on the reference DICOM image (Fig 1).
Virtual Navigator is a technology for 3D fusion imaging procedures allowed by the same hardware of BodyMap.
By moving the transducer,
real-time US scans of the neck is simultaneously matched with the 3D multiplanar reconstruction of the second modality (Fig 2).
The procedure was performed on 20 patients with different findings (abnormal uptake in thyroid nodules,
12; residual uptake after thyroidectomy,
3; lymph nodes pathologic uptake,
5; parathyroid pathologic uptake,
2) at Scintiscan and PETCT.
Each patients was examined by three operators.
Functional images were evaluated by each operator and loaded on the equipment before performing US examination.
With the patient in supine position the support for magnetic generator was placed under the shoulder in order to have the generator on the left side (Fig 3).
Firstly,
a standard US scan was performed with the cognitive approach.
The US scan was then co-registered with scintiscan or PETCT using anatomical landmarks (linear probe LA533,
5-13 MHz with magnetic sensor support) and the 2D navigation with BM (or 3D VN modality) was activated (Fig 4).
US examination was then performed with the aid of navigation software.
Each operator was asked about their confidence in localization with cognitive approach versus 2D navigation with BM or 3D VN.
The number of successful co-registrations and the time necessary for the set-up of cognitive approach and 2D navigation with BM or 3D VN were recorded.