Navigation with Electromagnetic Tracking for Interventional Radiology Procedures: A Feasibility Study

doi:10.1097/01.RVI.0000148827.62296.B4

Journal of Vascular and Interventional Radiology

Volume 16, Issue 4, April 2005, Pages 493-505

https://doi.org/10.1097/01.RVI.0000148827.62296.B4 Get rights and content

PURPOSE:

To assess the feasibility of the use of preprocedural imaging for guide wire, catheter, and needle navigation with electromagnetic tracking in phantom and animal models.

MATERIALS AND METHODS:

An image-guided intervention software system was developed based on open-source software components. Catheters, needles, and guide wires were constructed with small position and orientation sensors in the tips. A tetrahedral-shaped weak electromagnetic field generator was placed in proximity to an abdominal vascular phantom or three pigs on the angiography table. Preprocedural computed tomographic (CT) images of the phantom or pig were loaded into custom-developed tracking, registration, navigation, and rendering software. Devices were manipulated within the phantom or pig with guidance from the previously acquired CT scan and simultaneous real-time angiography. Navigation within positron emission tomography (PET) and magnetic resonance (MR) volumetric datasets was also performed. External and endovascular fiducials were used for registration in the phantom, and registration error and tracking error were estimated.

RESULTS:

The CT scan position of the devices within phantoms and pigs was accurately determined during angiography and biopsy procedures, with manageable error for some applications. Preprocedural CT depicted the anatomy in the region of the devices with real-time position updating and minimal registration error and tracking error (<5 mm). PET can also be used with this system to guide percutaneous biopsies to the most metabolically active region of a tumor.

CONCLUSIONS:

Previously acquired CT, MR, or PET data can be accurately codisplayed during procedures with reconstructed imaging based on the position and orientation of catheters, guide wires, or needles. Multimodality interventions are feasible by allowing the real-time updated display of previously acquired functional or morphologic imaging during angiography, biopsy, and ablation.

Section snippets

Tracking/Navigation Steps

Electromagnetic tracking requires several steps to allow the use of preprocedural images during procedures. Step 1 is preprocedural image acquisition with (skin or anatomic) fiducial markers in place. Step 2 is the registration of the imaging space with electromagnetic space, which requires choosing the markers on the patient with a wand (or needle guide wire or catheter) and simultaneously selecting those markers on the preprocedural image. Step 3 is real-time tracking of the device within

DISCUSSION

Electromagnetic tracking of instruments in interventional radiology can provide real-time display of position and orientation within previously acquired three-dimensional imaging datasets. This may facilitate use of preprocedural spatial or anatomic information during interventional procedures. This registration joins imaging space to magnetic space of the patient. The patient also undergoes imaging in real time with the same or a different modality. Tracking may enable accurate and precise

Acknowledgments

This work was funded by U.S. Army grant DAMD17–99–1–9022. The content of this manuscript does not necessarily reflect the position or policy of the U.S. Government. Thanks are also due to the animal care staff at Georgetown University including veterinary technician Heidi Derr and director Lisa Portnoy, DVM. Thanks to David Sun for assistance building the vascular phantom.

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: B.J.W. and K.C. are coinventors on related US Patent Application #10/377,528, “Interstitial Magnetic Position Sensor System and Needle for Surgical and Image-guided Therapy Navigation.” B.J.W. and N.G. are coinventors on US Patent Application: “Design for Guiding and Electromagnetic Tracking of Radiofrequency Ablation Needle” (US Provisional Patent Application # 60/625,186). Philips owns intellectual property and has market interest in this area. J.K., J.B., and S.K. are salaried employees of Philips Electronics. The mention of commercial devices or products, their source, or their use in connection with material reported herein is not to be construed as either an actual or implied endorsement of such products by the National Institutes of Health, the Department of Health and Human Services, or the Public Health Service. N.G. is President and a major shareholder of Traxtal, Inc.

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Laboratory InvestigationsNavigation with Electromagnetic Tracking for Interventional Radiology Procedures: A Feasibility Study

PURPOSE:

MATERIALS AND METHODS:

RESULTS:

CONCLUSIONS:

Section snippets

Tracking/Navigation Steps

DISCUSSION

Acknowledgments

Chest

J Vasc Intervent Radiol

A novel tracking technique for the continuous precise measurement of tumour positions in conformal radiotherapy

Phys Med Biol

Accuracy assessment protocols for electromagnetic tracking systems

Phys Med Biol

Real-time cardiac catheter navigation on three-dimensional CT images

J Intervent Cardiac Electrophysiol

Laboratory Investigations
Navigation with Electromagnetic Tracking for Interventional Radiology Procedures: A Feasibility Study