TY - JOUR
T1 - A concept for electromagnetic navigated targeting of liver tumors using an angiographic approach
AU - Schwalbe, Marius
AU - Williamson, Tom
AU - Paolucci, Iwan
AU - Fuss, Torsten
AU - Baumgartner, Iris
AU - Candinas, Daniel
AU - Weber, Stefan
AU - Tinguely, Pascale
N1 - Funding Information:
This work was partially funded by the Ruth & Arthur Scherbarth Stiftung.
Publisher Copyright:
© 2017 Society of Medical Innovation and Technology.
PY - 2018/1/2
Y1 - 2018/1/2
N2 - Background: The benefits of using navigation technology for percutaneous local ablation of selected hepatocellular carcinoma (HCC) have been shown. Due to additional efforts in the procedural workflow, barriers to introducing navigation systems on a broad clinical level remain high. In this work, initial steps toward a novel concept for simple and precise targeting of HCC are evaluated. Material and methods: The proposed technique is based on an angiographic approach using an intrahepatic electromagnetic (EM) reference, for consecutive percutaneous navigated positioning of ablation probes. We evaluated the environmental influence of the angiography suite on EM tracking accuracy, the measurement of a 3 D offset from two 2 D fluoroscopy images, and the accuracy and efficiency of the proposed approach in a porcine liver model. Results: The C-arm had a major influence on EM tracking accuracy, with an error up to 3.8 mm. The methodology applied for measurement of a 3 D offset from 2 D fluoroscopy images was confirmed to be feasible with a mean error of 0.76 mm. In the porcine liver model experiment, the overall target positioning error (TPE) was 2.0 mm and time for navigated targeting was 17.9 seconds, when using a tracked ablation probe. Conclusions: The initial methodology of the proposed technique was confirmed to be feasible, introducing a novel concept for simple and precise navigated targeting of HCC.
AB - Background: The benefits of using navigation technology for percutaneous local ablation of selected hepatocellular carcinoma (HCC) have been shown. Due to additional efforts in the procedural workflow, barriers to introducing navigation systems on a broad clinical level remain high. In this work, initial steps toward a novel concept for simple and precise targeting of HCC are evaluated. Material and methods: The proposed technique is based on an angiographic approach using an intrahepatic electromagnetic (EM) reference, for consecutive percutaneous navigated positioning of ablation probes. We evaluated the environmental influence of the angiography suite on EM tracking accuracy, the measurement of a 3 D offset from two 2 D fluoroscopy images, and the accuracy and efficiency of the proposed approach in a porcine liver model. Results: The C-arm had a major influence on EM tracking accuracy, with an error up to 3.8 mm. The methodology applied for measurement of a 3 D offset from 2 D fluoroscopy images was confirmed to be feasible with a mean error of 0.76 mm. In the porcine liver model experiment, the overall target positioning error (TPE) was 2.0 mm and time for navigated targeting was 17.9 seconds, when using a tracked ablation probe. Conclusions: The initial methodology of the proposed technique was confirmed to be feasible, introducing a novel concept for simple and precise navigated targeting of HCC.
KW - EM navigation
KW - endovascular reference
KW - fluoroscopy
KW - Liver tumor ablation
KW - minimally invasive
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U2 - 10.1080/13645706.2017.1407798
DO - 10.1080/13645706.2017.1407798
M3 - Article
C2 - 29179633
AN - SCOPUS:85035092529
SN - 1364-5706
VL - 27
SP - 51
EP - 59
JO - Minimally Invasive Therapy and Allied Technologies
JF - Minimally Invasive Therapy and Allied Technologies
IS - 1
ER -