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Seitel A, Groener D, Eisenmann M, Aguilera Saiz L, Pekdemir B, Sridharan P, Nguyen CT, Häfele S, Feldmann C, Everitt B, Happel C, Herrmann E, Sabet A, Grünwald F, Franz AM, Maier-Hein L. Miniaturized electromagnetic tracking enables efficient ultrasound-navigated needle insertions. Sci Rep 2024; 14:14161. [PMID: 38898086 PMCID: PMC11187124 DOI: 10.1038/s41598-024-64530-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024] Open
Abstract
Ultrasound (US) has gained popularity as a guidance modality for percutaneous needle insertions because it is widely available and non-ionizing. However, coordinating scanning and needle insertion still requires significant experience. Current assistance solutions utilize optical or electromagnetic tracking (EMT) technology directly integrated into the US device or probe. This results in specialized devices or introduces additional hardware, limiting the ergonomics of both the scanning and insertion process. We developed the first ultrasound (US) navigation solution designed to be used as a non-permanent accessory for existing US devices while maintaining the ergonomics during the scanning process. A miniaturized EMT source is reversibly attached to the US probe, temporarily creating a combined modality that provides real-time anatomical imaging and instrument tracking at the same time. Studies performed with 11 clinical operators show that the proposed navigation solution can guide needle insertions with a targeting accuracy of about 5 mm, which is comparable to existing approaches and unaffected by repeated attachment and detachment of the miniaturized tracking solution. The assistance proved particularly helpful for non-expert users and needle insertions performed outside of the US plane. The small size and reversible attachability of the proposed navigation solution promises streamlined integration into the clinical workflow and widespread access to US navigated punctures.
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Affiliation(s)
- Alexander Seitel
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.
- National Center for Tumor Diseases (NCT), a partnership between DKFZ and Heidelberg University Hospital, 69120, Heidelberg, Germany.
| | - Daniel Groener
- Department of Nuclear Medicine, Clinic for Radiology and Nuclear Medicine, University Hospital, Goethe University Frankfurt, 60596, Frankfurt, Germany
| | - Matthias Eisenmann
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Laura Aguilera Saiz
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Bünyamin Pekdemir
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Patmaa Sridharan
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Cam Tu Nguyen
- Department of Nuclear Medicine, Clinic for Radiology and Nuclear Medicine, University Hospital, Goethe University Frankfurt, 60596, Frankfurt, Germany
| | - Sebastian Häfele
- Department of Nuclear Medicine, Clinic for Radiology and Nuclear Medicine, University Hospital, Goethe University Frankfurt, 60596, Frankfurt, Germany
| | - Carolin Feldmann
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Brittaney Everitt
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Christian Happel
- Department of Nuclear Medicine, Clinic for Radiology and Nuclear Medicine, University Hospital, Goethe University Frankfurt, 60596, Frankfurt, Germany
| | - Eva Herrmann
- Department of Medicine, Institute for Biostatistics, Goethe University Frankfurt, 60596, Frankfurt, Germany
| | - Amir Sabet
- Department of Nuclear Medicine, Clinic for Radiology and Nuclear Medicine, University Hospital, Goethe University Frankfurt, 60596, Frankfurt, Germany
| | - Frank Grünwald
- Department of Nuclear Medicine, Clinic for Radiology and Nuclear Medicine, University Hospital, Goethe University Frankfurt, 60596, Frankfurt, Germany
| | - Alfred Michael Franz
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.
- Institute for Computer Science, Ulm University of Applied Sciences, 89075, Ulm, Germany.
| | - Lena Maier-Hein
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- National Center for Tumor Diseases (NCT), a partnership between DKFZ and Heidelberg University Hospital, 69120, Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, 69120, Heidelberg, Germany
- Medical Faculty, Heidelberg University, 69120, Heidelberg, Germany
- Helmholtz Information and Data Science School for Health, Karlsruhe/Heidelberg, Germany
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Li J, Li S, Zhou W, Duan Y, Zheng H. Enhancing malignancy prediction in thyroid nodules: A multimodal ultrasound radiomics approach in TI-RADS category 4 lesions. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:511-521. [PMID: 38465504 DOI: 10.1002/jcu.23662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/03/2024] [Accepted: 02/12/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE To explore the diagnostic value of intralesional and perilesional radiomics based on multimodal ultrasound (US) images in predicting the malignant ACR TIRADS 4 thyroid nodules (TNs). METHODS A total of 297 cases of TNs in patients who underwent preoperative thyroid grayscale US and shear wave elastography (STE) were enrolled (training cohort: n = 150, internal validation cohort: n = 77, external validation cohort: n = 70). Regions of interests (ROIs) were delineated on grayscale US images and STE images, and then an isotropic expansion of 1.0, 1.5, 2.0, 2.5, and 3.0 mm was applied. Predictive models were established using recursive feature elimination-support vector machines (RFE-SVM) based on radiomics features calculated by random forest. RESULTS The perilesional ROI1.5mm expansion achieved the highest area under curve (AUC) (AUC: 0.753 for grayscale US, 0.728 for STE; 95% confidence interval (CI): 0.664-0.743, 0.684-0.739, respectively). The joint model had the highest AUC values of 0.936 in the training dataset, 0.926 in internal dataset, and 0.893 in external dataset. The calibration curve showed good consistency and the decision curve indicated a greater clinical net benefit of the joint model. CONCLUSION Joint model containing perilesional radiomics (1.5 mm) had significant value in predicting the malignant ACR TIRADS 4 TNs.
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Affiliation(s)
- Jian Li
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Siyao Li
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Ultrasound, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong Province, China
| | - Wang Zhou
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Yayang Duan
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Hui Zheng
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
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Boers T, Brink W, Bianchi L, Saccomandi P, van Hespen J, Wennemars G, Braak S, Versluis M, Manohar S. An anthropomorphic thyroid phantom for ultrasound-guided radiofrequency ablation of nodules. Med Phys 2024; 51:826-838. [PMID: 38141047 DOI: 10.1002/mp.16906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/01/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Needle-based procedures, such as fine needle aspiration and thermal ablation, are often applied for thyroid nodule diagnosis and therapeutic purposes, respectively. With blood vessels and nerves nearby, these procedures can pose risks in damaging surrounding critical structures. PURPOSE The development and validation of innovative strategies to manage these risks require a test object with well-characterized physical properties. For this work, we focus on the application of ultrasound-guided thermal radiofrequency ablation. METHODS We have developed a single-use anthropomorphic phantom mimicking the thyroid and surrounding anatomical and physiological structures that are relevant to ultrasound-guided thermal ablation. The phantom was composed of a mixture of polyacrylamide, water, and egg white extract and was cast using molds in multiple steps. The thermal, acoustical, and electrical characteristics were experimentally validated. The ablation zones were analyzed via non-destructive T2 -weighted magnetic resonance imaging scans utilizing the relaxometry changes of coagulated egg albumen, and the temperature distribution was monitored using an array of fiber Bragg grating sensors. RESULTS The physical properties of the phantom were verified both on ultrasound as well as in terms of the phantom response to thermal ablation. The final temperature achieved (92°C), the median percentage of the nodule ablated (82.1%), the median volume ablated outside the nodule (0.8 mL), and the median number of critical structures affected (0) were quantified. CONCLUSION An anthropomorphic phantom that can provide a realistic model for development and training in ultrasound-guided needle-based thermal interventions for thyroid nodules has been presented.
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Affiliation(s)
- Tim Boers
- Multi-Modality Medical Imaging group, TechMed Centre, University of Twente, Enschede, the Netherlands
| | - Wyger Brink
- Magnetic Detection and Imaging group, TechMed Centre, University of Twente, Enschede, the Netherlands
| | - Leonardo Bianchi
- Multi-Modality Medical Imaging group, TechMed Centre, University of Twente, Enschede, the Netherlands
- Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy
| | - Paola Saccomandi
- Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy
| | - Johan van Hespen
- Multi-Modality Medical Imaging group, TechMed Centre, University of Twente, Enschede, the Netherlands
| | - Germen Wennemars
- Magnetic Detection and Imaging group, TechMed Centre, University of Twente, Enschede, the Netherlands
| | - Sicco Braak
- Department of Radiology, Ziekenhuisgroep Twente, Almelo, the Netherlands
| | - Michel Versluis
- Physics of Fluids group, TechMed Centre, University of Twente, Enschede, the Netherlands
| | - Srirang Manohar
- Multi-Modality Medical Imaging group, TechMed Centre, University of Twente, Enschede, the Netherlands
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