An ex-vivo study on needle placement accuracy of a pre-clinical robotic guidance system

Abstract

Purpose: Ultrasound (US) use has grown significantly in recent years. Due to technical developments of high-end US systems, this modality is not only used for diagnosis and routine check-ups, but increasingly used for guidance during vascular access or procedures such as biopsies, ablations and drainages. A limitation of these high-end US systems are their large footprint and high cost. Portable US devices may play a role in replacing high-end systems for specific tasks in the interventional room. Here, we have investigated the clinical utility of a novel tablet-based US device for vascular access. Materials: For 18 consecutive patients that underwent an interventional procedure, first attempt to gain arterial access was performed with a linear probe using a portable US machine (Lumify, Philips). For all procedures, a secondary high-end system was available in the room in case image quality on the portable system was perceived as insufficient.Operators were asked to rate image quality of needle and target (insufficient, sufficient, good, excellent) and whether a conversion to high-end US system was required. Results: Successful access was obtained using the tablet system in 94.4% of cases (17/18). Access locations included: left radial artery (n ¼ 7) and right femoral artery (n ¼ 11). One case in a pediatric patient required conversion to a high-end system due to insufficient visibility of the needle. In all cases, the image quality of the target was scored sufficient or higher. Overall, image quality was scored excellent in 77.8% (14/18) of cases. Conclusions: For the majority of the cases, the tablet based US machine provided sufficient image quality to successfully gain arterial access. This tablet-based solution could replace large high-end US machines for a variety of routine procedures and may provide an improved workflow and more flexibility in the interventional suite. Abstract No. 460An ex-vivo study on needle placement accuracy of a pre-clinical robotic guidance system