Development of a precision system for image-guided needle placement:from scratch to clinic

Advances in medical technology enable an ongoing transition from invasive, open surgery to minimally invasive diagnostics and intervention. In the field of oncology, percutaneous techniques have emerged in which biopsy and ablation of tumours are performed via a needle through the skin using image-guidance. The objective of this research is the development of a precision system for image-guided percutaneous needle placement in the thorax and abdomen to improve upon the convenstional freehand method. It covers the entire strategic, architectural and detail design and realization of a complete system from first idea to prototype, its technical verification, its integration in the intervention suite and its pre-clinical validation, up to its first deployment in clinical practice

A precision system for computed tomography-guided needle placement in the thorax and abdomen-technical design and performance analysis

A system was developed for computed tomography (CT)-guided needle placement in the thorax and abdomen, providing precise aiming of a needle guide (NG) to reach a userspecified target in a single manual insertion. The objective of this work is to present its technical design and analyze its performance in terms of placement error in air. The individual contributions to the placement error of a fiducial marker based system-to-CT registration system, a two degrees-of-freedom (2DOFs) drive system to aim the NG, and a structural link between NG and CT table were experimentally determined, in addition to the placement error of the overall system. An error contribution of 0.81 ± 0.34mm was determined for the registration system, < 1.2mm and < 3.3mm for the drive system, and 0.35mm and 0.43mm for two load cases of the structural link. The overall unloaded system achieved 1.0 ± 0.25mm and 2.6±0.7mm at 100mm and 250mm depth, respectively. The overall placement errors in air do not exceed the ≤5mm error specified as a clinical user requirement for needle placement in tissue

An overview of systems for CT- and MRI-guided percutaneous needle placement in the thorax and abdomen

Minimally invasive biopsies, drainages and therapies in the soft tissue organs of the thorax and abdomen are typically performed through a needle, which is inserted percutaneously to reach the target area. The conventional workflow for needle placement employs an iterative freehand technique. This article provides an overview of needle-placement systems developed to improve this method.\ud An overview of systems for needle placement was assembled, including those found in scientific publications and patents, as well as those that are commercially available. The systems are categorized by function and tabulated. Over 40 systems were identified, ranging from simple passive aids to fully actuated robots. The overview shows a wide variety of developed systems with growing complexity. However, given that only a few systems have reached commercial availability, it is clear that the technical community is struggling to develop solutions that are adopted clinically

An overview of systems for CT- and MRI-guided percutaneous needle placement in the thorax and abdomen

Background Minimally invasive biopsies, drainages and therapies in the soft tissue organs of the thorax and abdomen are typically performed through a needle, which is inserted percutaneously to reach the target area. The conventional workflow for needle placement employs an iterative freehand technique. This article provides an overview of needle-placement systems developed to improve this method. Methods An overview of systems for needle placement was assembled, including those found in scientific publications and patents, as well as those that are commercially available. The systems are categorized by function and tabulated. Results Over 40 systems were identified, ranging from simple passive aids to fully actuated robots. Conclusions The overview shows a wide variety of developed systems with growing complexity. However, given that only a few systems have reached commercial availability, it is clear that the technical community is struggling to develop solutions that are adopted clinically

A Precision System for Computed Tomography-Guided Needle Placement in the Thorax and Abdomen—Technical Design and Performance Analysis

A system was developed for computed tomography (CT)-guided needle placement in the thorax and abdomen, providing precise aiming of a needle guide (NG) to reach a userspecified target in a single manual insertion. The objective of this work is to present its technical design and analyze its performance in terms of placement error in air. The individual contributions to the placement error of a fiducial marker based system-to-CT registration system, a two degrees-of-freedom (2DOFs) drive system to aim the NG, and a structural link between NG and CT table were experimentally determined, in addition to the placement error of the overall system. An error contribution of 0.81 ± 0.34mm was determined for the registration system, < 1.2mm and < 3.3mm for the drive system, and 0.35mm and 0.43mm for two load cases of the structural link. The overall unloaded system achieved 1.0 ± 0.25mm and 2.6±0.7mm at 100mm and 250mm depth, respectively. The overall placement errors in air do not exceed the ≤5mm error specified as a clinical user requirement for needle placement in tissue