Top

International Journal of Computer Assisted Radiology and Surgery

Published in:

01-09-2013 | Original Article

Percutaneous lung biopsy: comparison between an augmented reality CT navigation system and standard CT-guided technique

Authors: R. F. Grasso, E. Faiella, G. Luppi, E. Schena, F. Giurazza, R. Del Vescovo, F. D’Agostino, R. L. Cazzato, B. Beomonte Zobel

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 5/2013

Abstract

Purpose

Percutaneous lung biopsies (PLBs) performed for the evaluation of pulmonary masses require image guidance to avoid critical structures. A new CT navigation system (SIRIO, “Sistema robotizzato assistito per il puntamento intraoperatorio”) for PLBs was validated.

Methods

The local Institutional Review Board approved this retrospective study. Image-guided PLBs in 197 patients were performed with a CT navigation system (SIRIO). The procedures were reviewed based on the number of CT scans, patients’ radiation exposure and procedural time recorded. Comparison was performed with a group of 72 patients undergoing standard CT-guided PLBs. Sensitivity, specificity and overall diagnostic accuracy were assessed in both groups.

Results

SIRIO-guided PLBs showed a significant reduction in procedure time, number of required CT scans and the radiation dose administered to patients (\(p<0.001\)). In terms of diagnostic accuracy, SIRIO proved to be more accurate for small-sized lesions (\(<\)20 mm) than standard CT-guidance.

Conclusion

SIRIO proved to be a reliable and effective tool when performing CT-guided PLBs and was especially useful for sampling small (\(<\)20 mm) lesions.

Jin KN, Park CM, Goo JM, Lee HJ, Lee Y, Kim JI, Choi SY, Kim HC (2010) Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems. Eur Radiol 20(9):2108–2115

Yaniv Z, Cheng P, Wilson E et al (2010) Needle-based interventions with the image-guided surgery toolkit (IGSTK): from phantoms to clinical trials. IEEE Trans Biomed Eng 57(4):922–933PubMedCrossRef

Wood BJ, Zhang H, Durrani A, Glossop N, Ranjan S, Lindisch D et al (2005) Navigation with electromagnetic tracking for interventional radiology procedures: a feasibility study. J Vasc Interv Radiol 16(4):493–505PubMedCrossRef

Hoheisel M, Skalej M, Beuing O, Bill U, Klingenbeck-Regn K, Petzold R et al (2009) Kyphoplasty interventions using a navigation system and C-arm CT data: first clinical results. In: Medical imaging 2009: physics of medical imaging. Proceedings of SPIE, vol 7258, 72580E

Appelbaum L, Sosna J, Nissenbaum Y, Benshtein A, Goldberg SN (2011) Electromagnetic navigation system for CT-guided biopsy of small lesions. AJR Am J Roentgenol 196(5):1194–1200PubMedCrossRef

Bruners P, Penzkofer T, Nagel M, Elfring R, Gronloh N, Schmitz-Rode T et al (2009) Electromagnetic tracking for CT-guided spine interventions: phantom, ex-vivo and in-vivo results. Eur Radiol 19(4):990–994PubMedCrossRef

Meier-Meitinger M, Nagel M, Kalender W, Bautz WA, Baum U (2008) Computer-assisted navigation system for interventional CT-guided procedures: results of phantom and clinical studies. Rofo 180(4):310–317

Aghayev E, Ebert LC, Christe A, Jackowski C, Rudolph T, Kowal J et al (2008) CT data-based navigation for post-mortem biopsy-a feasibility study. J Forensic Leg Med 15(6):382–387PubMedCrossRef

Khan MF, Dogan S, Maataoui A, Gurung J, Schiemann M, Ackermann H et al (2005) Accuracy of biopsy needle navigation using the Medarpa system-computed tomography reality superimposed on the site of intervention. Eur Radiol 5(11):2366–2374CrossRef

10.

Khan MF, Dogan S, Maataoui A, Wesarg S, Gurung J, Ackermann H et al (2006) Navigation-based needle puncture of a cadaver using a hybrid tracking navigational system. Invest Radiol 41(10):713–720PubMedCrossRef

11.

Wallace MJ, Gupta S, Hicks ME (2009) Out-of-plane computed-tomography-guided biopsy using a magnetic-field-based navigation system. Cardiovasc Intervent Radiol 29(1):108–113CrossRef

12.

Grand DJ, Atalay MA, Cronan JJ, Mayo-Smith WW, Dupuy DE (2011) CT-guided percutaneous lung biopsy: comparison of conventional CT fluoroscopy to CT fluoroscopy with electromagnetic navigation system in 60 consecutive patients. Eur J Radiol 79(2):e133–e136

13.

Brunetti G (2010) SIRIO users’s manual. Masmec S.p.A, Modugno

14.

Council Directive 93/42/EEC concerning medical devices (1993). Official Journal of the European Communities No L 169/1

15.

Office for Official Publications of the European Communities (1999) European guidelines on quality criteria for computed tomography, Luxembourg

16.

Yamagami T, Iida S, Kato T, Tanaka O, Nishimura T (2003) Combining fine-needle aspiration and core biopsy under CT fluoroscopy guidance: a better way to treat patients with lung nodules? AJR Am J Roentgenol 181(4):1011–1015PubMedCrossRef

17.

Sconfienza LM, Mauri G, Grossi F, Truini M, Serafini G, Sardanelli F et al (2012) Pleural and peripheral lung lesions: comparison of US- and CT-guided Biopsy. Radiology (epub ahead of print)

18.

Lal H, Neyaz Z, Nath A, Borah S (2012) CT-guided percutaneous biopsy of intrathoracic lesions. Korean J Radiol 13(2):210–226PubMedCrossRef

19.

Kim GR, Hur J, Lee SM, Lee HJ, Hong YJ, Nam JE et al (2010) CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: a prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol 21(2):232–239PubMedCrossRef

20.

Braak SJ, Herder GJ, van Heesewijk JP, van Strijen MJ (2011) Pulmonary masses: initial results of cone-beam C guidance with needle planning software for percutaneous lung biopsy. Cardiovasc Intervent Radiol (epub ahead of print)

21.

Bolger C, Wigfield C (2000) Image guided surgery: applications to the cervical and thoracic spine and a review of the first 120 procedures. J Neurosurg Spine 92:175–180CrossRef

22.

Laine T, Lund T, Ylikoski M, Lohikoski J, Schlenzka D (2000) Accuracy of pedicle screw insertion with and without computer assistance: a randomised controlled clinical study in 100 consecutive patients. Eur Spine J 9:235–240 (discussion 241)

23.

Schwarz Y, Mehta AC, Ernst A, Herth F, Engel A, Besser D et al (2003) Electromagnetic navigation during flexible bronchoscopy. Respiration 70:516–522PubMedCrossRef

24.

Coenen VA, Krings T, Axer H et al (2003) Intraoperative three-dimensional visualization of the pyramidal tract in neuronavigation system (PTV) reliability predicts true position of principal motor pathways. Surg Neurol 60(5):381–390

25.

Klein JS, Salomon G, Stewart EA (1996) Transthoracic needle biopsy with a coaxially placed 20-gauge automated cutting needle: results in 122 patients. Radiology 198(3):715–720PubMed

26.

Tsukada H, Satou T, Iwashima A, Souma T (2000) Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules. AJR Am J Roentgenol 175(1):239–243PubMedCrossRef

27.

Laurent F, Latrabe V, Vergier B, Montaudon M, Vernejoux JM, Dubrez J (2000) CT-guided transthoracic needle biopsy of pulmonary nodules smaller than 20 mm: results with an automated 20-gauge coaxial cutting needle. Clin Radiol 55(4):281–287PubMedCrossRef

28.

Lucidarme O, Howarth N, Finet JF, Grenier P (1998) Intrapulmonary lesions: percutaneous automated biopsy with a detachable, 18-gauge, coaxial cutting needle. Radiology 207(3):759–765PubMed

29.

Krücker J, Xu S, Glossop N, Viswanathan A, Borgert J, Schulz H et al (2007) Electromagnetic tracking for thermal ablation and biopsy guidance: clinical evaluation of spatial accuracy. J Vasc Interv Radiol 18(9):1141–1150PubMedCrossRef

Title: Percutaneous lung biopsy: comparison between an augmented reality CT navigation system and standard CT-guided technique
Authors: R. F. Grasso
E. Faiella
G. Luppi
E. Schena
F. Giurazza
R. Del Vescovo
F. D’Agostino
R. L. Cazzato
B. Beomonte Zobel
Publication date: 01-09-2013
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Computer Assisted Radiology and Surgery / Issue 5/2013
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-013-0816-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Percutaneous lung biopsy: comparison between an augmented reality CT navigation system and standard CT-guided technique

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2013

The impact of missing sensor information on surgical workflow management

An error analysis perspective for patient alignment systems

An in vivo subject-specific 3D functional knee joint model using combined MR imaging

Reality based modeling and simulation of gallbladder shape deformation using variational methods

The LiverSurgeryTrainer: training of computer-based planning in liver resection surgery

A method for segmentation of dental implants and crestal bone