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首页> 外文期刊>Academic radiology >Evaluation of an Electromagnetic Image-Fusion Navigation System for Biopsy of Small Lesions. Assessment of Accuracy in an In Vivo Swine Model.
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Evaluation of an Electromagnetic Image-Fusion Navigation System for Biopsy of Small Lesions. Assessment of Accuracy in an In Vivo Swine Model.

机译：对小病变活检的电磁图像融合导航系统的评估。体内猪模型的准确性评估。

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Purpose: To evaluate the accuracy of a novel combined electromagnetic (EM) navigation/image fusion system for biopsy of small lesions. Materials and Methods: Using ultrasound (US) guidance, metallic (2 ?? 1 mm) targets were imbedded in the paraspinal muscle ( n = 28), kidney ( n = 18), and liver ( n = 4) of four 55- to 65-kg pigs. Baseline helical computed tomography (CT) imaging (Brilliance; Philips) identified these biopsy targets and six and nine cutaneous fiducial markers. CT data were imported into a MyLab Twice system (Esaote, Genoa, Italy) for CT/US image fusion. After verification of successful image fusion, baseline registration error and respiratory motion error were assessed by documenting deviation of the US and CT position of the targets in real time. Biopsy targeting was subsequently performed under conditions of normal respiratory using 15-cm 16G eTrax needles (Civco). To mimic the conditions of poor US visualization, only reconstructed CT information was displayed during biopsy. Accuracy of targeting was measured by repeat CT scanning as the distance of the needle tip to the target center. Targeting accuracy of free-hand vs. guided technique, and electromagnetic (EM) sensor positioning (ie, on the hub or within the needle stylus tip) were evaluated. Results: In muscle, needle registration error was 0.9 ?? 1.2 mm and respiratory motion error 4.0 ?? 1.0 mm. Target accuracy was 4.0 ?? 3.2 mm when an EM sensor was imbedded in the needle tip. Yet, with the EM sensor back on the needle hub, greater targeting accuracy was achieved using an US guide (3.2 ?? 1.6 mm) vs. freehand (5.7 ?? 3.2 mm, P = .04). For kidney, registration error was 1.8 ?? 1.7 mm and respiratory motion error 4.9 ?? 1.0 mm. For the deeper kidney targets, target accuracy was 4.4 ?? 3.2 mm with a tip EM sensor, which was an improvement over the hub EM sensor positioning (9.3 ?? 4.6 mm; P < .01). An additional source of fusion error was noted for liver. Beyond 17 ?? 1 mm of respiratory motion, targets were observed to move >3 cm with US transducereedle compression resulting in 14 ?? 1.4 mm targeting accuracy. Conclusions: A combined image-fusion/EM tracking platform can provide a high degree of needle placement accuracy (<5 mm) when targeting small lesions. Results fall within accuracy of respiratory error; with best results obtained by incorporating an EM sensor into the tip of the biopsy system. ? 2013 .
机译：目的：评估新型组合电磁（EM）导航/图像融合系统对小病变活检的准确性。材料和方法：在超声（US）引导下，将金属（2 ?? 1 mm）靶标埋在四个55-的椎旁肌（n = 28），肾脏（n = 18）和肝脏（n = 4）中。达到65公斤的猪。基线螺旋计算机断层扫描（CT）成像（华晨;飞利浦）确定了这些活检目标以及六个和九个皮肤基准标记。将CT数据导入MyLab Twice系统（意大利热那亚Esaote）进行CT / US图像融合。验证成功的图像融合后，通过实时记录目标的US和CT位置偏差来评估基线配准误差和呼吸运动误差。随后在正常呼吸条件下使用15厘米16G eTrax针（Civco）进行活检靶向。为了模拟美国可视化效果较差的情况，活检过程中仅显示重建的CT信息。通过重复CT扫描测量针头到目标中心的距离，从而确定瞄准的准确性。评估了徒手技术与导向技术的瞄准精度以及电磁（EM）传感器的位置（即，在针座上或在针笔尖端内）。结果：在肌肉中，针的套准误差为0.9？ 1.2毫米，呼吸运动误差4.0 ?? 1.0毫米目标精度为4.0 ??将EM传感器嵌入针尖中时为3.2毫米。然而，将EM传感器放回针座后，使用US导向器（3.2 ?? 1.6 mm）相对于徒手（5.7 ?? 3.2 mm，P = .04）可以获得更高的瞄准精度。对于肾脏，配准误差为1.8 ??。 1.7毫米，呼吸运动误差4.9英寸1.0毫米对于较深的肾脏目标，目标准确性为4.4 ??尖端EM传感器为3.2 mm，比轮毂EM传感器的定位有所改进（9.3≤4.6 mm; P <.01）。注意到肝脏发生融合错误的另一个原因。超越17 ??呼吸运动为1​​毫米，在US换能器/针头压缩的情况下，观察到目标移动> 3厘米，结果为14英寸。定位精度为1.4毫米。结论：结合图像融合/ EM跟踪平台可在靶向小病变时提供高度的针头定位精度（<5 mm）。结果在呼吸错误的准确性之内;将EM传感器并入活检系统尖端可获得最佳结果。 ？ 2013年。

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