Percutaneous Lung Tumor Biopsy Under CBCT Guidance with PET-CT Fusion Imaging: Preliminary Experience

Floridi, Chiara; Carnevale, Aldo; Fumarola, Enrico Maria; Schampaert, S Stéphanie; Fontana, Federico; Palma, Diego De; Sole, Angelo Del; Giganti, Melchiore; Carrafiello, Gianpaolo

doi:10.1007/s00270-019-02270-1

Cited by 16 publications

(15 citation statements)

References 18 publications

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“… Automatic vessels analysis, by use of intravascular ultrasound (IVUS): in complex cases of peripheral vascular diseases, it benefits by aiding with analysis of vessel size, lesion characteristic and potential post-treatment effects. Fusion of pre-procedure 3D images onto intraoperative 2D images: synchronizing MRI, CT or Cone Beam CT cross-sectional preoperative imaging with intraoperative real-time fluoroscopic or ultrasound images, allows for more precise guidance for biopsies [ 41 – 45 ] and local image guided therapies [ 46 , 47 ] (Figs. 1 , 2 , 3 ) and improves problem solving during procedures [ 48 – 50 ].…”

Section: Fields Of Applicationmentioning

confidence: 99%

Interventional Radiology ex-machina: impact of Artificial Intelligence on practice

et al. 2021

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Artificial intelligence (AI) is a branch of Informatics that uses algorithms to tirelessly process data, understand its meaning and provide the desired outcome, continuously redefining its logic. AI was mainly introduced via artificial neural networks, developed in the early 1950s, and with its evolution into "computational learning models." Machine Learning analyzes and extracts features in larger data after exposure to examples; Deep Learning uses neural networks in order to extract meaningful patterns from imaging data, even deciphering that which would otherwise be beyond human perception. Thus, AI has the potential to revolutionize the healthcare systems and clinical practice of doctors all over the world. This is especially true for radiologists, who are integral to diagnostic medicine, helping to customize treatments and triage resources with maximum effectiveness. Related in spirit to Artificial intelligence are Augmented Reality, mixed reality, or Virtual Reality, which are able to enhance accuracy of minimally invasive treatments in image guided therapies by Interventional Radiologists. The potential applications of AI in IR go beyond computer vision and diagnosis, to include screening and modeling of patient selection, predictive tools for treatment planning and navigation, and training tools. Although no new technology is widely embraced, AI may provide opportunities to enhance radiology service and improve patient care, if studied, validated, and applied appropriately.

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Section: Fields Of Applicationmentioning

confidence: 99%

Interventional Radiology ex-machina: impact of Artificial Intelligence on practice

et al. 2021

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“…Another technique that has had an increasing role is CBCT that produces CT images with the possibility of real-time fluoroscopy visualization. It offers greater flexibility in the orientation of the detector around the patient compared to the closed CT gantry [ 40 ].…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…FI technique is recently being applied to lung procedures since software algorithms were developed to register the intraprocedural anatomic imaging with preprocedural PET/CT data. Some studies reported the experience of fusion PET/CT-CBCT studying it in guiding percutaneous biopsy of lung lesions compared with CBCT guidance [ 40 , 41 , 42 ]. PET/CT-CBCT-guided is feasible and safe as CBCT-guided biopsy with a lower number of non-diagnostic samples and false-negative cases, with evidence of metabolic information provided by a prior PET/CT and a better quality of the samples obtained with FI guidance [ 40 ].…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…Some studies reported the experience of fusion PET/CT-CBCT studying it in guiding percutaneous biopsy of lung lesions compared with CBCT guidance [ 40 , 41 , 42 ]. PET/CT-CBCT-guided is feasible and safe as CBCT-guided biopsy with a lower number of non-diagnostic samples and false-negative cases, with evidence of metabolic information provided by a prior PET/CT and a better quality of the samples obtained with FI guidance [ 40 ]. Systems that allow to guide a virtual needle on a pre-acquired lung CT have been implemented to reduce the number of CT acquisition required in lung procedures and to improve the non-axial approach in CT guided lung ablations.…”

Section: Clinical Applicationsmentioning

confidence: 99%

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Role of Fusion Imaging in Image-Guided Thermal Ablations

et al. 2021

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Thermal ablation (TA) procedures are effective treatments for several kinds of cancers. In the recent years, several medical imaging advancements have improved the use of image-guided TA. Imaging technique plays a pivotal role in improving the ablation success, maximizing pre-procedure planning efficacy, intraprocedural targeting, post-procedure monitoring and assessing the achieved result. Fusion imaging (FI) techniques allow for information integration of different imaging modalities, improving all the ablation procedure steps. FI concedes exploitation of all imaging modalities’ strengths concurrently, eliminating or minimizing every single modality’s weaknesses. Our work aims to give an overview of FI, explain and analyze FI technical aspects and its clinical applications in ablation therapy and interventional oncology.

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“…EM navigation systems, based on EM field generators and EM sensors, have been applied to perform procedures such as thermal ablations of hepatic tumors [12,13] with a reduction in radiation exposure for patients [12], and for interventions in other surgical fields [14][15][16]. Flat-panel cone beam CT navigation systems based on fusion imaging have also been proposed in the last few years to assist procedures such as percutaneous biopsies on bones [17,18] or lungs [19], and are considered an effective method that simplifies needle path planning and shortens procedure times. Laser tracking systems [20] and navigational robots [21] have also been employed for navigation during image-guided interventions.…”

Section: Introductionmentioning

confidence: 99%

Impact of an Augmented Reality Navigation System (SIRIO) on Bone Percutaneous Procedures: A Comparative Analysis with Standard CT-Guided Technique

et al. 2021

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(1) Background: The purpose of this study is to evaluate the impact of an augmented reality navigation system (SIRIO) for percutaneous biopsies and ablative treatments on bone lesions, compared to a standard CT-guided technique. (2) Methods: Bioptic and ablative procedures on bone lesions were retrospectively analyzed. All procedures were divided into SIRIO and Non-SIRIO groups and in <2 cm and >2 cm groups. Number of CT-scans, procedural time and patient’s radiation dose were reported for each group. Diagnostic accuracy was obtained for bioptic procedures. (3) Results: One-hundred-ninety-three procedures were evaluated: 142 biopsies and 51 ablations. Seventy-four biopsy procedures were performed using SIRIO and 68 under standard CT-guidance; 27 ablative procedures were performed using SIRIO and 24 under standard CT-guidance. A statistically significant reduction in the number of CT-scans, procedural time and radiation dose was observed for percutaneous procedures performed using SIRIO, in both <2 cm and >2 cm groups. The greatest difference in all variables examined was found for procedures performed on lesions <2 cm. Higher diagnostic accuracy was found for all SIRIO-assisted biopsies. No major or minor complications occurred in any procedures. (4) Conclusions: The use of SIRIO significantly reduces the number of CT-scans, procedural time and patient’s radiation dose in CT-guided percutaneous bone procedures, particularly for lesions <2 cm. An improvement in diagnostic accuracy was also achieved in SIRIO-assisted biopsies.

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Percutaneous Lung Tumor Biopsy Under CBCT Guidance with PET-CT Fusion Imaging: Preliminary Experience

Cited by 16 publications

References 18 publications

Interventional Radiology ex-machina: impact of Artificial Intelligence on practice

Interventional Radiology ex-machina: impact of Artificial Intelligence on practice

Role of Fusion Imaging in Image-Guided Thermal Ablations

Impact of an Augmented Reality Navigation System (SIRIO) on Bone Percutaneous Procedures: A Comparative Analysis with Standard CT-Guided Technique

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