Value-assessment of computer-assisted navigation strategies during percutaneous needle placement.
Imke Boekestijn, Samaneh Azargoshasb, Matthias N van Oosterom, Leon J Slof, Petra Dibbets-Schneider, Jenny Dankelman, Arian R van Erkel, Daphne D D Rietbergen, Fijs W B van Leeuwen
Author Information
Imke Boekestijn: Interventional Molecular Imaging-Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Samaneh Azargoshasb: Interventional Molecular Imaging-Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Matthias N van Oosterom: Interventional Molecular Imaging-Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Leon J Slof: Interventional Molecular Imaging-Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Petra Dibbets-Schneider: Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Jenny Dankelman: Department of Biomedical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands.
Arian R van Erkel: Interventional Radiology Section, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Daphne D D Rietbergen: Interventional Molecular Imaging-Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Fijs W B van Leeuwen: Interventional Molecular Imaging-Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. F.W.B.van_Leeuwen@lumc.nl. ORCID
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 = 0.43 vs. PS = 0.57 vs. PS = 0.51). Interestingly, the expert group yielded a reversed trend (PS = 0.71 vs PS = 0.58 vs PS = 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.
