Korean J Radiol.  2015 Aug;16(4):729-735. 10.3348/kjr.2015.16.4.729.

Intervention Planning Using a Laser Navigation System for CT-Guided Interventions: A Phantom and Patient Study

• Gruber-Rouh T
• Lee C
• Bolck J
• Naguib NN
• Schulz B
• Eichler K
• Aschenbach R
• Wichmann J
• Vogl TJ
• Zangos S

• KMID: 2155545
• DOI: http://doi.org/10.3348/kjr.2015.16.4.729

Abstract

OBJECTIVE
To investigate the accuracy, efficiency and radiation dose of a novel laser navigation system (LNS) compared to those of free-handed punctures on computed tomography (CT).
MATERIALS AND METHODS
Sixty punctures were performed using a phantom body to compare accuracy, timely effort, and radiation dose of the conventional free-handed procedure to those of the LNS-guided method. An additional 20 LNS-guided interventions were performed on another phantom to confirm accuracy. Ten patients subsequently underwent LNS-guided punctures.
RESULTS
The phantom 1-LNS group showed a target point accuracy of 4.0 +/- 2.7 mm (freehand, 6.3 +/- 3.6 mm; p = 0.008), entrance point accuracy of 0.8 +/- 0.6 mm (freehand, 6.1 +/- 4.7 mm), needle angulation accuracy of 1.3 +/- 0.9degrees (freehand, 3.4 +/- 3.1degrees; p < 0.001), intervention time of 7.03 +/- 5.18 minutes (freehand, 8.38 +/- 4.09 minutes; p = 0.006), and 4.2 +/- 3.6 CT images (freehand, 7.9 +/- 5.1; p < 0.001). These results show significant improvement in 60 punctures compared to freehand. The phantom 2-LNS group showed a target point accuracy of 3.6 +/- 2.5 mm, entrance point accuracy of 1.4 +/- 2.0 mm, needle angulation accuracy of 1.0 +/- 1.2degrees, intervention time of 1.44 +/- 0.22 minutes, and 3.4 +/- 1.7 CT images. The LNS group achieved target point accuracy of 5.0 +/- 1.2 mm, entrance point accuracy of 2.0 +/- 1.5 mm, needle angulation accuracy of 1.5 +/- 0.3degrees, intervention time of 12.08 +/- 3.07 minutes, and used 5.7 +/- 1.6 CT-images for the first experience with patients.
CONCLUSION
Laser navigation system improved accuracy, duration of intervention, and radiation dose of CT-guided interventions.

Keyword

Laser navigation system; LNS; CT-guided interventions; Phantom study; First experience with patients

MeSH Terms

Adult
Female
Humans
Image-Guided Biopsy/methods
*Lasers
Male
Middle Aged
Needles
Phantoms, Imaging
Punctures/*methods
Tomography, X-Ray Computed/*instrumentation/*methods

Figure

• 

  Fig. 1 Laser navigation system (LNS) is fixed to carrying arm attached to computed tomography (CT) room ceiling. C-arm of LNS is positioned in front of gantry (arrow). System does not impair regular use of CT room.

• 

  Fig. 2 Marking needle entry point with laser navigation system (LNS). A. Image illustrates placing needle tip on surface of Phantom 2 with laser spot marked by LNS during intervention. B. Needle is adjusted in direction of laser beam denoted by projecting laser beam as point on centre of upper end of puncture needle during lesion targeting in Phantom 1.

• 

  Fig. 3 Phantom 1 computed tomography (CT) image. Axial CT image of Phantom 1 using laser navigation system showing needle reaching its target position (arrow).

• 

  Fig. 4 Computed tomography image of patient with pleural effusion left. Confirmation of needle position in comparison to planned needle path for intervention using laser navigation system in patient with pleural effusion left.

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