A Navigation System for Minimally Invasive CT-Guided Interventions

Nagel, Markus; Schmidt, Gerd; Petzold, Ralf; Kalender, Willi A.

doi:10.1007/11566489_5

Cited by 25 publications

(21 citation statements)

References 8 publications

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“…2,4 To address this issue, several navigation systems have been introduced which can guide the physician towards a preselected target (e.g. [5][6][7][8][9][10][11][12][13] ). The overall insertion error of these systems typically comprises (cf.…”

Section: Purposementioning

confidence: 99%

Human vs. robot operator error in a needle-based navigation system for percutaneous liver interventions

et al. 2009

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Computed tomography (CT) guided percutaneous punctures of the liver for cancer diagnosis and therapy (e.g. tumor biopsy, radiofrequency ablation) are well-established procedures in clinical routine. One of the main challenges related to these interventions is the accurate placement of the needle within the lesion. Several navigation concepts have been introduced to compensate for organ shift and deformation in real-time, yet, the operator error remains an important factor influencing the overall accuracy of the developed systems. The aim of this study was to investigate whether the operator error and, thus, the overall insertion error of an existing navigation system could be further reduced by replacing the user with the medical robot Robopsy. For this purpose, we performed navigated needle insertions in a static abdominal phantom as well as in a respiratory liver motion simulator and compared the human operator error with the targeting error performed by the robot. According to the results, the Robopsy driven needle insertion system is able to more accurately align the needle and insert it along its axis compared to a human operator. Integration of the robot into the current navigation system could thus improve targeting accuracy in clinical use.

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Section: Purposementioning

confidence: 99%

Human vs. robot operator error in a needle-based navigation system for percutaneous liver interventions

et al. 2009

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“…Patient preparation. The patient is positioned, prepared and stabilized by means of a vacuum mattress on the scanner table, as presented in reference [17]. At this point, the lesion and the likely needle entry point positions are coarsely known by the physician, and the patient DR can therefore be placed near the intended target.…”

Section: Instrument Guidancementioning

confidence: 99%

A navigation system for percutaneous needle interventions based on PET/CT images: Design, workflow and error analysis of soft tissue and bone punctures

Oliveira-Santos

Klaeser

Weitzel

et al. 2011

Computer Aided Surgery

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Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention.Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well as highlighting the differences between bone and soft tissue punctures.An overall average error of 4.23 mm and 3.07 mm for bone and soft tissue punctures, respectively, demonstrated the feasibility of using this system for such interventions. The proposed system workflow was shown to be effective in separating the preparation from the sterile phase, as well as in keeping the system manageable by a single operator. Among the distinct sources of error, the user error based on the system accuracy (defined as the distance from the planned target to the actual needle tip) appeared to be the most significant. Bone punctures showed higher user error, whereas soft tissue punctures showed higher tissue deformation error.

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“…VectorVision R from BRAINLAB AG. and Navigation System II from Stryker Inc.) use a stereo camera placed outside the operative field [1,2]. Solutions based on video cameras have also been proposed.…”

Section: Introductionmentioning

confidence: 99%

“…Real-time display of its position is then possible on both video and X-ray images since they are coregistered after calibration of the device. Our proposed solution 1 does not require an augmented C-arm. We exploit a small video camera placed on the surgical instrument, e.g.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Calibration of a Camera-Based Guidance Solution for Orthopedic and Trauma Surgery

Magaraggia

Egli

Kleinszig

et al. 2013

Bildverarbeitung Für Die Medizin 2013

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Abstract. In orthopedic and trauma surgery, fracture reduction usually requires the use of metallic plates and their fixation by means of screws. The employment of guidance solutions during surgical procedures has become of great importance during the last decades. Our guidance solution exploits a small video camera placed directly on the instrument, for example a drill, and a set of small markers placed around the location where the drilling needs to be performed. A calibration step is required in order to determine the relative position of the instrument tip and axis w.r.t the coordinate system of the video camera. In this paper we describe a calibration method for our guidance solution. This calibration method exploits optical markers and a calibration plate whose geometry is known. Moreover, we show how we can exploit directly the image acquired by the video camera during the calibration in order to define an error measure to estimate the accuracy of the calibration. With this method, we achieved respectively an accuracy of 0.23 mm and 3.40• in the estimation of the instrument tip position and of the orientation of the instrument axis.

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A Navigation System for Minimally Invasive CT-Guided Interventions

Cited by 25 publications

References 8 publications

Human vs. robot operator error in a needle-based navigation system for percutaneous liver interventions

Human vs. robot operator error in a needle-based navigation system for percutaneous liver interventions

A navigation system for percutaneous needle interventions based on PET/CT images: Design, workflow and error analysis of soft tissue and bone punctures

Calibration of a Camera-Based Guidance Solution for Orthopedic and Trauma Surgery

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