Accuracy and Feasibility of Frameless Stereotactic and Robot-Assisted CT-Based Puncture in Interventional Radiology: a Comparative Phantom Study

Cardiovasc Intervent Radiol

Haidu

et al. 2011

Section: Planning Ctmentioning

confidence: 99%

Stereotactic Radiofrequency Ablation (SRFA) of Liver Lesions: Technique Effectiveness, Safety, and Interoperator Performance

Cardiovasc Intervent Radiol

Haidu

et al. 2011

“…Stoffner et al [6] reported a similar targeting accuracy (using 1-and 3-mm slice thicknesses) for a robot-assisted system to that obtained with stereotaxy using an aiming device. However, most current robotic systems are cumbersome and not yet ready for clinical implementation.…”

Section: Improving Ct-guided Interventionsmentioning

confidence: 78%

“…This technology may improve the technical options for and accuracy of percutaneous CT-guided liver targeting through 3D imaging, computerized trajectory planning in arbitrarily oriented tracks, and navigated or stereotactic aiming device-guided needle placement [2][3]. Previous studies have confirmed high targeting accuracy with such systems in phantoms and animal experiments [6]; however, stereotactic image guided biopsy has so far only been reported for diagnosis of brain or breast tumors [7,8]. The aim of the present work was to clinically assess the targeting accuracy, diagnostic yield, and complications of CT-guided stereotactic liver biopsy.…”

Section: Introductionmentioning

confidence: 87%

“…Measurements from the aiming device to the planned target are automatically calculated, and can be easily marked on the biopsy needle. In a phantom study, optically navigated stereotactic CT-guided (3-mm slice thickness), surface marker paired-point registration-based and aiming device-supported punctures showed total targeting errors of 2.2 AE 1.1 mm (range: 0.6-5.5 mm) and lateral errors of 1.8 AE 1.2 mm (range: 0.1-5.0 mm) [6].…”

Section: Improving Ct-guided Interventionsmentioning

confidence: 99%

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Accuracy and diagnostic yield of CT-guided stereotactic liver biopsy of primary and secondary liver tumors

Lang

et al. 2011

Computer Aided Surgery

Objective: CT-guided biopsy still plays a decisive role in the management of liver tumors, especially if the lesions are not visible or accessible by ultrasound. As CT-guided stereotaxy appears to be a very accurate targeting technique, the aim of this study was to evaluate the targeting accuracy, diagnostic yield, and complications of CT-guided stereotactic liver biopsy of primary and secondary liver tumors. Methods and Materials: Prior to stereotactic liver biopsy, patients under general anesthesia were immobilized using a vacuum cushion. Respiratory motion was controlled by temporary disconnections of the endotracheal tube. An opticalbased navigation system was used for 3D trajectory planning and placement of a 15-G coaxial needle via a stereotactic aiming device. The histological samples were obtained using a 16-G Tru-Cut TM biopsy needle system. For evaluation of targeting accuracy the control CT image with the needles in place was fused with the planning CT image. The lateral error at the tip and skin entry point and the angular error were calculated. In addition, the skin-to-liver-surface (SL) distance, the needle-to-liver-surface (NL) angle, and the presence of liver cirrhosis were evaluated. The diagnostic yield was evaluated by histological reports from the institutional pathologists. Results: The median lateral error was 2.5 mm (range: 0-6.5 mm) at the needle entry point and 3.2 mm (range: 0.01-9.4 mm) at the needle tip. The median angular error was 1.06(range: 0-6.64 ). Liver cirrhosis, NL angle and SL distance showed no significant impact on the targeting accuracy. Forty-five of the 46 liver biopsies (97.8%) were diagnostic according to the histological reports. No puncture-related complications such as bleeding or perforation of intestinal organs or lung tissue were recorded.

“…The new technology may improve the technical options of percutaneous radiofrequency ablation of liver tumours through 3D imaging, computerized trajectory planning in arbitrary orientated tracks and navigated or stereotactic aiming device-guided electrode placement (3)(4). Previous studies have confirmed high targeting accuracy in phantoms and animal experiments; however, accuracy data in a clinical series are missing (7). Thus the goal of our study was to evaluate the clinical accuracy of stereotactic targeting of the liver for local ablative tumour therapy.…”

Section: Introductionmentioning

confidence: 96%

Targeting accuracy of CT-guided stereotaxy for radiofrequency ablation of liver tumours

Minimally Invasive Therapy & Allied Technologies

Haidu

et al. 2011

The targeting accuracy during CT-guided stereotactic radiofrequency ablation (SRFA) of liver tumours was evaluated in a clinical study. Patients under general anaesthesia were immobilized using a vacuum cushion and respiratory motion control was based on temporary disconnections of the endotracheal tube. An optical-based navigation system was used for 3D trajectory planning and needle placement via a stereotactic aiming device. A control CT with the needles in place was fused with the planning CT for accuracy evaluation. Sub-analysis was performed for "location" (liver segments II-VIII), "approach" (intercostal or transabdominal), "properties" (clear parenchymal, subcapsular, subphrenic, fat, and subphrenic plus fat), and "path length". In 20 patients with 35 liver lesions, a total of 145 needles were placed with mean (±SD) lateral errors of 3.6 ± 2.5 mm at the needle tip, angular errors of 1.3° ± 1.2°, and longitudinal errors at the needle tip of -7.4 ± 6.2 mm. No puncture-related complications were noted. No significant differences of angular errors between segments, approach and properties were recorded. Long paths correlated with smaller angular errors. CT-guided stereotaxy can be considered safe and provided precise multiple needle placement for SRFA of liver lesions at arbitrary trajectories in various segments and locations.