Integration of free-hand 3D ultrasound and mobile C-arm cone-beam CT: Feasibility and characterization for real-time guidance of needle insertione

This work presents development of an integrated ultrasound (US)-cone-beam CT (CBCT) system for image-guided needle interventions, combining a low-cost ultrasound system (Interson VC 7.5 MHz, Pleasanton, CA) with a mobile C-arm for fluoroscopy and CBCT via use of a surgical tracker. Imaging performance of the ultrasound system was characterized in terms of depth-dependent contrast-to-noise ratio (CNR) and spatial resolution. US-CBCT system was evaluated in phantom studies simulating three needle-based procedures: drug delivery, tumor ablation, and lumbar puncture. Low-cost ultrasound provided flexibility but exhibited modest CNR and spatial resolution that is likely limited to fairly superficial applications within a 10 cm depth of view. Needle tip localization demonstrated target registration error 2.1-3.0 mm using fiducial-based registration.This work was funded by NIH grant R01-EB-017226, research partnership with Siemens XP (Erlangen, Germany), and grants TEC2013-48251-C2-1-R (Ministerio de Economía y Competitividad), DTS14/00192 (ISCIII), EU FP7 IRSES TAHITI (#269300), and FEDER funds.Publicad