Freehand Biopsy Guided by Electromagnetic Needle Tracking: A Phantom Study

Zusammenfassung

Ziel: Bewertung der Genauigkeit und des Zeitaufwands bei einer Biopsie mittels elektromagnetischen Nadeltrackings an einem Phantom im Vergleich zur Standardtechnik der ultraschallgestützten Biopsie mit angeschlossener Lenkeinrichtung. Darüber hinaus die Bewertung der Biopsie außerhalb der Ebene gestützt duch Nadeltracking.

Material und Methoden: An einem Phantom wurden drei verschiedene Biopsieserien durchgeführt: eine, bei der die Lenkeinrichtung an den Meßwandler ohne Nadeltracking angeschlossen ist und somit der Standardtechnik der ultraschallgestützten Biopsie ähnelt (Serie 1), eine Freihand innerhalb der Scan-Ebene mittels elektromagnetischen Nadeltrackings (Serie 2) und eine Freihand außerhalb der Scan-Ebene mittels elektromagnetischen Nadeltrackings (Serie 3). Das Phantom enthielt Kugeln von 1 cm Durchmesser, die mit roter Farbe gefüllt waren. Jede Perforation der Phantomoberfläche wurde als eine Biopsie gewertet.

Ergebnisse: 180 Biopsien wurden durchgeführt. Die mittlere Zeitdauer pro Biopsie betrug in Serie eins 19,9 s (SD: 9,1), in Serie zwei 34,1 s (SD 17,9) und in Serie drei 34,4 s (SD: 14,0). Die Erfolgsrate betrug insgesamt: 88 % für die nadelgeführte Biopsie in der Ebene, 87 % für das Nadeltracking in der Ebene und 92 % für das Nadeltracking außerhalb der Ebene. Zwischen den Methoden konnte kein statistisch signifikanter Unterschied ausgemacht werden.

Schlussfolgerung: Die Nadelnavigation ist ein möglicherweise wertvolles Hilfsmittel der bildgestützten Biopsie mit einer ähnlichen Erfolgsquote im Vergleich zur konventionellen bildgestützten Biopsie. Darüber hinaus ermöglicht sie die bildgestützte Biopsie außerhalb der Ebene.

Abstract

Purpose: To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking.

Materials and Methods: Three different series of biopsy were performed in a phantom: one with a steering device attached to the transducer without needle tracking, simulating the standard ultrasound-guided biopsy procedure (series 1), one freehand in the scan plane using electromagnetic needle tracking (series 2), and one freehand off-the-scan plane using electromagnetic needle tracking (series 3). The phantom contained spheres of 1 cm in diameter filled with red dye. Each time of the phantom surface was perforated counted as an attempt.

Results: 180 biopsies were performed. The mean time spent on each biopsy in series one was 19.9 seconds (SD: 9.1), in series two 34.1 seconds (SD: 17.9) and in series three 34.4 seconds (SD: 14.0). The overall rate of success was: 88 % for in-plane needle-guided biopsy, 87 % for in-plane needle tracking, and 92 % for off-plane needle tracking. No statistically significant difference between the methods was shown.

Conclusion: Needle navigation is a potentially valuable tool for image-guided biopsy with an equal rate of success compared with conventional image-guided biopsy. Furthermore, it enables off-plane image-guided biopsy.

Key words

technology assessment - biopsy - ultrasound - interventional procedures

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