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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
Conclusion
3D VN and 2D Navigation with BM using an EM tracking system are reliable techniques.
When compared with the cognitive approach,
they resulted in an increased operator confidence in US localization of abnormal or pathologic functional findings on scintiscan and PETCT.
Operators’ confidence further increased in the cases with challenging small lesions.
Inter-observer agreement resulted to be substantial for all cases,
or nearly perfect for cases with small target lesion,
making the techniques robust.
As regard the time required for the set-up of the navigation modality,
it can appear incredibly short if compared with the cognitive approach.
However,
using the fusion environment,
functional images could be evaluated in virtual real-time while performing US.
Time was saved because the operator had no necessity of consulting the multimodality reporting PACS console.
On the other hand,
during the cognitive approach the operator sometimes needed repeated access to the reporting console in order to check the correct spatial alignment of US and functional images. Image fusion and virtual navigation by EM tracking are very promising tools for radiological daily practice with very-low or no impact on the standard examination setting and protocol.
During neck US,
Virtual Navigator should be implemented each time a precise correlation with other imaging modalities is needed,
both for diagnostic and interventional purposes (Fig 8).
The solely limitation to be considered is the cost of the necessary hardware and software.
However,
it must be highlighted that an EM tracking system can have countless applications in a radiological environment which goes towards making its cost affordable [7].
In order to induce wider clinical use,
navigation systems need to be more user-friendly and easily available.
Large scale production will make further technical improvements possible such as wireless sensors,
US probe and medical tools with integrated magnetic sensors and miniaturized generators [8].