Technical Note: Assessment of electromagnetic tracking systems in a surgical environment using ultrasonography and ureteroscopy instruments for percutaneous renal access

Distortion-Free Magnetic Tracking of Metal Instruments in Image-Guided Interventions

Electromagnetic tracking (EMT) can benefit image-guided interventions in cases where line of sight is unavailable. However, EMT can suffer from electromagnetic distortion in the presence of metal instruments. Metal instruments are widely used in laparoscopic surgery, ENT surgery, arthroscopy and many other clinical applications. In this work, we investigate the feasibility of tracking such metal instruments by placing the inductive sensor within the instrument shaft. We propose a magnetostatic model of the field within the instrument, and verify the results experimentally for frequencies from 6 kHz to 60 kHz. The impact of the instrument's dimensions, conductivity and transmitting field frequency is quantified for ranges representative of typical metal instruments used in image-guided interventions. We then performed tracking using the open-source Anser EMT system and quantify the error caused by the presence of the rod as a function of the frequency of the eight emitting coils for the system. The work clearly demonstrates why smaller tool diameters (less than 8 mm) are less susceptible to distortion, as well as identifying optimal frequencies (1 kHz to 2 kHz) for transmitter design to minimise for distortion in larger instruments.

A comprehensive quality assurance protocol for electromagnetic tracking in brachytherapy

BACKGROUND

Electromagnetic tracking (EMT) systems have proven to be a valuable source of information regarding the location and geometry of applicators in patients undergoing brachytherapy (BT). As an important element of an enhanced and individualized pre-treatment verification, EMT can play a pivotal role in detecting treatment errors and uncertainties to increase patient safety.

PURPOSE

The purpose of this study is two-fold: to design, develop and test a dedicated measurement protocol for the use of EMT-enabled afterloaders in BT and to collect and compare the data acquired from three different radiation oncology centers in different clinical environments.

METHODS

A novel quality assurance (QA) phantom composed of a scaffold with supports to fix the field generator, different BT applicators, and reference sensors (sensor verification tools) was used to assess the precision (jitter error) and accuracy (relative distance errors and target registration error) of the EMT sensor integrated into an afterloader prototype. Measurements were repeated in different environments where EMT measurements are likely to be performed, namely an electromagnetically clean laboratory, a BT suite, an operating room, and, if available, a CT suite and an MRI suite dedicated to BT.

RESULTS

The mean positional jitter was consistently under 0.1 mm across all measurement points, with a slight trend of increased jitter at greater distances from the field generator. The mean variability of sensor positioning in the tested tandem and ring gynecological applicator was also below 0.1 mm. The tracking accuracy close to the center of the measurement volume was higher than at its edges. The relative distance error at the center was 0.2-0.3 mm with maximum values reaching 1.2-1.8 mm, but up to 5.5 mm for measurement points close to the edges. In general, similar accuracy results were obtained in the clinical environments and in all investigated institutions (median distance error 0.1-0.4 mm, maximum error 1.0-2.0 mm), however, errors were found to be larger in the CT suite (median distance error up to 1.0 mm, maximum error up to 3.6 mm).

CONCLUSION

The presented quality assessment protocol for EMT systems in BT has demonstrated that EMT offers a high-accuracy determination of the applicator/implant geometry even in clinical environments. In addition to that, it has provided valuable insights into the performance of EMT-enabled afterloaders across different radiation oncology centers.

Synthesis and characterization of high-sensitivity Dy,Eu co-doped CaSO4 thermoluminescent phosphor using coprecipitation technique

In this work, (99 - x)CaSO4 -Dy2 O3 -xEu2 O3 , (where x = 0, 0.05, 0.1, 0.2, 0.3, 0.4, 0.5) thermoluminescence phosphors were prepared using a coprecipitation method. The thermoluminescence (TL) dosimetry (TLD) characteristics such as TL sensitivity, dose-response, minimum detectable dose, thermal fading, and the effect of sunlight on the prepared phosphors were investigated. The obtained results indicated that the most sensitive phosphor was obtained at x = 0.05. Large thermal fading of 6% after 1 h and 26% after 24 h from irradiation followed by 71% after 1 month with no additional fading was observed within a time frame exceeding 2 months throughout the remaining duration of the investigation, which also spanned over 2 months. Despite the phosphor's high fading rate, the relative sensitivity of the prepared samples was ~90% compared with TLD-100. The marked effect of day sunlight was also determined. High dose-response within the low-dose range from 0.01 to 5 Gy was observed. The obtained results suggested that the synthesized phosphor is well suited for applications involving radiation biology and radiotherapy dosimetry.

Recent Advances in Tracking Devices for Biomedical Ultrasound Imaging Applications

With the rapid advancement of tracking technologies, the applications of tracking systems in ultrasound imaging have expanded across a wide range of fields. In this review article, we discuss the basic tracking principles, system components, performance analyses, as well as the main sources of error for popular tracking technologies that are utilized in ultrasound imaging. In light of the growing demand for object tracking, this article explores both the potential and challenges associated with different tracking technologies applied to various ultrasound imaging applications, including freehand 3D ultrasound imaging, ultrasound image fusion, ultrasound-guided intervention and treatment. Recent development in tracking technology has led to increased accuracy and intuitiveness of ultrasound imaging and navigation with less reliance on operator skills, thereby benefiting the medical diagnosis and treatment. Although commercially available tracking systems are capable of achieving sub-millimeter resolution for positional tracking and sub-degree resolution for orientational tracking, such systems are subject to a number of disadvantages, including high costs and time-consuming calibration procedures. While some emerging tracking technologies are still in the research stage, their potentials have been demonstrated in terms of the compactness, light weight, and easy integration with existing standard or portable ultrasound machines.

Ultrasound training simulator using augmented reality glasses: an accuracy and precision assessment study

Ultrasound (US) imaging despite being safe, cost-effective, and radiation-free, presents poor quality and artifacts, requiring specific medical training in US probe handling and image evaluation. The use of simulators to train physicians has proven its effectiveness, but most of them require specific facilities and hardware. In the last few years, augmented reality has gained relevance to simulate real scenarios which can avoid large setups and broaden medical training to more physicians. This work proposes a new framework for the training of US images acquisition. It consists of a custom-made application that runs on AR glasses (Microsoft HoloLens 2) and interacts with a US simulator application. The AR glasses track the orientation of a QR code mounted on a US probe, communicating its orientation with the US simulator application. This allows the physician to interact with a US probe seeing in real-time the US image in the physician's field of view. The QR code tracking assessment of the AR glasses was conducted by measuring the orientation accuracy and precision when compared with the measures of an electromagnetic tracking device (i.e., NDI Aurora). The proposed solution presented a good performance, rendering the US image in AR glasses with real-time feedback. Moreover, it can track the QR code on the US probe with an accuracy of 0.755°, and a precision of 0.018°. Overall, the proposed framework presents promising results and the use of AR glasses as a tracking device reached a good performance. Clinical Relevance- Simulation is a relevant tool to train physicians, especially in US imaging. AR glasses can broaden the training to less trained physicians by reducing the need for complex setups. This technology allows the implementation of a more natural user interface, which can be relevant in scenarios where good coordination between the eyes and hands of the physician is necessary (i.e., Biopsies).

Exploring the role of vacancy defects in the optical properties of LiMgPO4

Linearity in dose response up to very high radiation doses and sufficient sensitivity to even low radiation doses are extremely important for the measurement of radiation dose in the field of radiation technology, ranging from medical to industrial applications. Olivine type LiMgPO4 has been shown immense interest as a phosphor material in the fields of thermoluminescence and optically stimulated luminescence dosimetry. In the present study, we have explored the role of different vacancy defects in the optical properties of LiMgPO4 aiming at enhancing its sensitivity for the measurement of radiation dose. For this purpose, we have systematically investigated the electronic structure of LiMgPO4 in the absence and presence of various vacancy defects using density functional theory as a tool. The present study considers all possible vacancy defects including neutral, charged and mixed lattice vacancy defects in LiMgPO4. To find the most energetically favourable vacancy defect, we have compared the defect formation energy of all the vacancy defects. We have also calculated vacancy formation energy in different chemical environments to investigate how the formation of different types of vacancy defect can be controlled by tuning the chemical environment. Finally, the origin of the different optical properties of LiMgPO4 has been explained by using a possible mechanism based on our detailed electronic structure calculations. Thus, the present study is believed to provide valuable insight for the development of materials with improved features for the measurement of radiation dose.