In-vitro evaluation of a novel needle-based soft tissue navigation system with a respiratory liver motion simulator

Maier-Hein, Lena; Müller, Sascha; Pianka, Frank; Seitel, Alexander; Müller‐Stich, Beat P.; Gutt, Carsten N.; Rietdorf, Urte; Richter, G. M.; Meinzer, Hans-Peter; Schmied, Bruno M.; Wolf, Ivo

doi:10.1117/12.707896

Cited by 10 publications

(13 citation statements)

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“…This was for instance proposed by Zhang et al [130], who utilized magnetically tracked needles along with biomechanical models to compensate for respiratory motion of liver. Similar to this, Maier-Hein et al applied various spline based methods in conjunction with optical tracking data [71] for percutaneous liver RFA. Another limiting factor of all modeling methods is the real time constraint of navigated surgery.…”

Section: Organ Shift and Tissue Deformationmentioning

confidence: 99%

Navigation in Endoscopic Soft Tissue Surgery: Perspectives and Limitations

Baumhauer

Feuerstein

Meinzer

et al. 2008

Journal of Endourology

163

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Abstract-Despite rapid developments in the research areas medical imaging, medical image processing and robotics, the use of computer assistance in surgical routine is still limited to diagnostics, surgical planning, and interventions on mostly rigid structures. In order to establish a computer aided workflow from diagnosis to surgical treatment and follow-up, several proposals for computer assisted soft tissue interventions have been made in recent years. By means of different pre-and intraoperative information sources, like surgical plannings, intraoperative imaging, and tracking devices, surgical navigation systems aim at supporting surgeons in localizing anatomical targets, observing critical structures, and sparing healthy tissue. Current research in particular addresses the problem of organ shift and tissue deformation, and obstacles in communication between navigation system and surgeon.In this article, we review computer assisted navigation systems for soft tissue surgery. We concentrate on approaches which can be applied in endoscopic thoracic and abdominal surgery, as endoscopic surgery has special needs for image guidance due to limitations in perception. Furthermore, this article provides the reader with new trends and technologies in the area of computer assisted surgery. Finally, a balancing of key challenges and possible benefits of endoscopic navigation refines the perspectives of this increasingly important discipline of computer aided medical procedures.

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Section: Organ Shift and Tissue Deformationmentioning

confidence: 99%

Navigation in Endoscopic Soft Tissue Surgery: Perspectives and Limitations

Baumhauer

Feuerstein

Meinzer

et al. 2008

Journal of Endourology

163

View full text Add to dashboard Cite

show abstract

“…In case of a spherical lesion, a volume of 2 ml corresponds to a diameter of approximately 1.5 cm. (c) The liver was sewn to the diaphragm model (i.e., the Plexiglas R plate) of the motion simulator introduced in [9] (Fig. 3).…”

Section: Workflowmentioning

confidence: 99%

“…(e) A planning CT scan of the motion simulator with the integrated porcine liver was acquired (Somatom Sensation 16 multidetector row scanner; Siemens, Erlangen, Germany). A fine resolution (0.75 mm slices) was necessary because our evaluation relies on accurate computation of the center of gravity of the agar nodule in both the planning CT and the control CT. (f) The motion simulator was used to simulate several breathing cycles (cranio-caudal displacement of the liver ≈ 15 mm [9]) reflecting the fact that the patients cannot hold their breaths between acquisition of the planning CT and registration. (a) The navigation aid models were registered with the planning CT image by the semi-automatic algorithm described in [9].…”

Section: Workflowmentioning

confidence: 99%

“…The targeting procedure was conducted at end-expiration because it represents the natural state of the motion simulator (with the artificial lungs relaxed). As we performed gated experiments and only two navigation aids were utilized for motion compensation we chose a rigid deformation model [9]. A navigation monitor provided the visualization for the targeting process: (a) A two-dimensional projection view and a tool tip camera guided the user through the three steps tip positioning, needle alignment, and needle insertion as described in [10].…”

Section: Workflowmentioning

confidence: 99%

“…1). The accuracy of tracking, CT registration, and target position estimation throughout the breathing cycle have already been evaluated [7,9]. We have also investigated suitable visualization schemes to support soft tissue targeting procedures in cooperation with clinicians [10].…”

Section: Introductionmentioning

confidence: 99%

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Precision Targeting of Liver Lesions with a Needle-Based Soft Tissue Navigation System

Maier-Hein

Pianka

Seitel

et al.

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2007

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Abstract. In this study, we assessed the targeting precision of a previously reported needle-based soft tissue navigation system. For this purpose, we implanted 10 2-ml agar nodules into three pig livers as tumor models, and two of the authors used the navigation system to target the center of gravity of each nodule. In order to obtain a realistic setting, we mounted the livers onto a respiratory liver motion simulator that models the human body. For each targeting procedure, we simulated the liver biopsy workflow, consisting of four steps: preparation, trajectory planning, registration, and navigation. The lesions were successfully hit in all 20 trials. The final distance between the applicator tip and the center of gravity of the lesion was determined from control computed tomography (CT) scans and was 3.5 ± 1.1 mm on average. Robust targeting precision of this order of magnitude would significantly improve the clinical treatment standard for various CT-guided minimally invasive interventions in the liver.

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