Value-assessment of computer-assisted navigation strategies during percutaneous needle placement

Value-assessment of computer-assisted navigation strategies during percutaneous needle placement

Boekestijn, Imke (Leiden University Medical Center)
Azargoshasb, Samaneh (Leiden University Medical Center; Antoni van Leeuwenhoek Hospital)
van Oosterom, Matthias N. (Leiden University Medical Center; Antoni van Leeuwenhoek Hospital)
Slof, Leon J. (Leiden University Medical Center)
Dibbets-Schneider, Petra (Leiden University Medical Center)
Dankelman, J. (TU Delft Medical Instruments & Bio-Inspired Technology)
van Erkel, Arian R. (Leiden University Medical Center)
Rietbergen, Daphne D.D. (Leiden University Medical Center)
van Leeuwen, Fijs W.B. (Leiden University Medical Center; Antoni van Leeuwenhoek Hospital)

2022

Purpose: Navigational strategies create a scenario whereby percutaneous needle-based interventions of the liver can be guided using both pre-interventional 3D imaging datasets and dynamic interventional ultrasound (US). To score how such technologies impact the needle placement process, we performed kinematic analysis on different user groups. Methods: Using a custom biopsy phantom, three consecutive exercises were performed by both novices and experts (n = 26). The exercise came in three options: (1) US-guidance, (2) US-guidance with pre-interventional image-registration (US + Reg) and (3) US-guidance with pre-interventional image-registration and needle-navigation (US + Reg + Nav). The traveled paths of the needle were digitized in 3D. Using custom software algorithms, kinematic metrics were extracted and related to dexterity, decision making indices to obtain overall performance scores (PS). Results: Kinematic analysis helped quantifying the visual assessment of the needle trajectories. Compared to US-guidance, novices yielded most improvements using Reg (PS_avg(US) = 0.43 vs. PS_avg(US+Reg) = 0.57 vs. PS_{avg(US+Reg+Nav)} = 0.51). Interestingly, the expert group yielded a reversed trend (PS_avg(US) = 0.71 vs PS_avg(US+Reg) = 0.58 vs PS_{avg(US+Reg+Nav)} = 0.59). Conclusion: Digitizing the movement trajectory allowed us to objectively assess the impact of needle-navigation strategies on percutaneous procedures. In particular, our findings suggest that these advanced technologies have a positive impact on the kinematics derived performance of novices.

Computer-assisted surgery
Image fusion
Navigation
Needle guidance
Performance assessment

http://resolver.tudelft.nl/uuid:2cf0eafc-878c-4f1e-903c-577ff84ed3fc

https://doi.org/10.1007/s11548-022-02719-8

1861-6410

International Journal of Computer Assisted Radiology and Surgery, 17 (10), 1775-1785

Institutional Repository

journal article

© 2022 Imke Boekestijn, Samaneh Azargoshasb, Matthias N. van Oosterom, Leon J. Slof, Petra Dibbets-Schneider, J. Dankelman, Arian R. van Erkel, Daphne D.D. Rietbergen, Fijs W.B. van Leeuwen