Integration and evaluation of a gradient-based needle navigation system for percutaneous MR-guided interventions.

The purpose of the present study was to integrate an interactive gradient-based needle navigation system and to evaluate the feasibility and accuracy of the system for real-time MR guided needle puncture in a multi-ring phantom and in vivo in a porcine model. The gradient-based navigation system was implemented in a 1.5T MRI. An interactive multi-slice real-time sequence was modified to provide the excitation gradients used by two sets of three orthogonal pick-up coils integrated into a needle holder. Position and orientation of the needle holder were determined and the trajectory was superimposed on pre-acquired MR images. A gel phantom with embedded ring targets was used to evaluate accuracy using 3D distance from needle tip to target. Six punctures were performed in animals to evaluate feasibility, time, overall error (target to needle tip) and system error (needle tip to the guidance needle trajectory) in vivo. In the phantom experiments, the overall error was 6.2±2.9 mm (mean±SD) and 4.4±1.3 mm, respectively. In the porcine model, the setup time ranged from 176 to 204 seconds, the average needle insertion time was 96.3±40.5 seconds (min: 42 seconds; max: 154 seconds). The overall error and the system error was 8.8±7.8 mm (min: 0.8 mm; max: 20.0 mm) and 3.3±1.4 mm (min: 1.8 mm; max: 5.2 mm), respectively.

Déclaration de conflit d'intérêts

The authors have read the journal's policy and the authors of this manuscript have the following competing interests: LP is a paid employee of Siemens Healthineers. KQ receives grant support from Siemens Healthineers and was an intern employee while working on this project. BF and AM are paid employees of Robin Medical. EN is the founder and a stock owner of Robin Medical, the company that developed the EndoScout tracking system. CW receives grant support from Siemens Healthineers, BTG, and Medtronic, and is a consultant for BSCI and Medtronic. FW receives institutional funding from Siemens Healthineers. There are no patents, products in development or marketed products associated with this research to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.