Free-hand CT-based electromagnetically guided interventions: Accuracy, efficiency and dose usage
Free-hand CT-based electromagnetically guided interventions: Accuracy, efficiency and dose usage
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DOI：
10.3109/13645706.2011.553256
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发表时间：
2011-07-01
影响因子：
1.7
通讯作者：
Mahnken, Andreas H.
中科院分区：
文献类型：
--
作者：
Penzkofer, Tobias;Bruners, Philipp;Mahnken, Andreas H.
本文旨在评价基于计算机断层扫描（CT）的电磁尖端跟踪（EMT）干预在各种临床应用中的作用。使用EMT系统根据CT数据集进行经皮介入。使用记录数据结合围手术期采集的CT对照扫描分析手术时间和穿刺针放置的空间准确性。与一组标准CT引导干预相比，进行了剂量估计。分析了未完成计划干预的原因。分析了25例计划进行EMT的手术，其中23例使用EMT成功完成。进行手术的平均时间为23.7 +/-+/- 17.2 min。准备时间为5.8 +/-+/- 7.3 min，而介入（皮肤至靶点）时间为2.7 +/-+/- 2.4 min。平均穿刺长度为7.2 +/-+/- 2.5 cm。空间精度为3.1 +/-+/- 2.1 mm。未完成的手术是由于患者移动和参考固定问题。与标准CT引导介入治疗的对照组（1343 +/-+/- 1054 mGy** cm）相比，基于EMT的介入治疗（732 +/-+/- 481 mGy ** cm）的辐射剂量（剂量-长度-乘积）显著更低（p == 0.012）。电磁导航可以准确引导各种适应症的经皮介入治疗。准确性和时间使用允许所用系统的日常使用。基于EMT的穿刺的较低辐射暴露提供了剂量节省的相关潜力。
The purpose of this paper was to evaluate computed tomography (CT) based electromagnetically tip-tracked (EMT) interventions in various clinical applications. An EMT system was utilized to perform percutaneous interventions based on CT datasets. Procedure times and spatial accuracy of needle placement were analyzed using logging data in combination with periprocedurally acquired CT control scans. Dose estimations in comparison to a set of standard CT-guided interventions were carried out. Reasons for non-completion of planned interventions were analyzed. Twenty-five procedures scheduled for EMT were analyzed, 23 of which were successfully completed using EMT. The average time for performing the procedure was 23.7 +/-+/- 17.2 min. Time for preparation was 5.8 +/-+/- 7.3 min while the interventional (skin-to-target) time was 2.7 +/-+/- 2.4 min. The average puncture length was 7.2 +/-+/- 2.5 cm. Spatial accuracy was 3.1 +/-+/- 2.1 mm. Non-completed procedures were due to patient movement and reference fixation problems. Radiation doses (dosis-length-product) were significantly lower (p == 0.012) for EMT-based interventions (732 +/-+/- 481 mGy**cm) in comparison to the control group of standard CT-guided interventions (1343 +/-+/- 1054 mGy**cm). Electromagnetic navigation can accurately guide percutaneous interventions in a variety of indications. Accuracy and time usage permit the routine use of the utilized system. Lower radiation exposure for EMT-based punctures provides a relevant potential for dose saving.