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Erschienen in: International Journal of Computer Assisted Radiology and Surgery 1/2016

01.01.2016 | Original Article

Towards markerless navigation for percutaneous needle insertions

verfasst von: Alexander Seitel, Nadine Bellemann, Mohammadreza Hafezi, Alfred M. Franz, Mark Servatius, Arash Saffari, Thomas Kilgus, Heinz-Peter Schlemmer, Arianeb Mehrabi, Boris A. Radeleff, Lena Maier-Hein

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 1/2016

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Abstract

Purpose

Percutaneous needle insertions are increasingly used for diagnosis and treatment of abdominal lesions. The challenging part of computed tomography (CT)-guided punctures is the transfer of the insertion trajectory planned in the CT image to the patient. Conventionally, this often results in several needle repositionings and control CT scans. To address this issue, several navigation systems for percutaneous needle insertions have been presented; however, none of them has thus far become widely accepted in clinical routine. Their benefit for the patient could not exceed the additional higher costs and the increased complexity in terms of bulky tracking systems and specialized markers for registration and tracking.

Methods

We present the first markerless and trackerless navigation concept for real-time patient localization and instrument guidance. It has specifically been designed to be integrated smoothly into the clinical workflow and does not require markers or an external tracking system. The main idea is the utilization of a range imaging device that allows for contactless and radiation-free acquisition of both range and color information used for patient localization and instrument guidance.

Results

A first feasibility study in phantom and porcine models yielded a median targeting accuracy of 6.9 and 19.4 mm, respectively.

Conclusions

Although system performance remains to be improved for clinical use, expected advances in camera technology as well as consideration of respiratory motion and automation of the individual steps will make this approach an interesting alternative for guiding percutaneous needle insertions.

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Fußnoten
1
Note that the range data could as well be used to generate tracking information when post-processed with an instrument/object tracking algorithm (e.g., [39]). With the term tracking system, we refer to the widely applied definition where specialized hardware (cameras and tracking markers) are used for generating tracking information.
 
2
This porcine trial was approved by the Committee for Animal Care and Research of the Karlsruhe regional council (G-83/12).
 
3
The statistical power of these calculations (\(n = 10\)) may still not be sufficient to reliably detect significant differences.
 
4
Note that one trial was not considered in the error calculation due to an erroneous visualization of the implemented prototype which can easily be fixed in future versions.
 
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Metadaten
Titel
Towards markerless navigation for percutaneous needle insertions
verfasst von
Alexander Seitel
Nadine Bellemann
Mohammadreza Hafezi
Alfred M. Franz
Mark Servatius
Arash Saffari
Thomas Kilgus
Heinz-Peter Schlemmer
Arianeb Mehrabi
Boris A. Radeleff
Lena Maier-Hein
Publikationsdatum
01.01.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Computer Assisted Radiology and Surgery / Ausgabe 1/2016
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-015-1156-7

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