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Wang R, Tan G, Liu X. Robust tip localization under continuous spatial and temporal constraints during 2D ultrasound-guided needle puncture. Int J Comput Assist Radiol Surg 2023; 18:2233-2242. [PMID: 37160581 DOI: 10.1007/s11548-023-02894-2] [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: 10/23/2022] [Accepted: 03/29/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE During ultrasound-guided (US-guided) needle puncture for minimally invasive procedures, automated needle tip localization can help clinicians capture small tips in US images easily and precisely, providing them with obvious tip indicators on the screen and bringing them more confidence during the procedures. However, automated needle tip localization in US images is challenging due to serious interferences arising from all kinds of echoes. METHODS We propose a method that localizes needle tips under continuous spatial and temporal constraints in the real-time US frame stream. A temporal constraint is firstly acquired by detecting translational tip motion in motion-enhanced US images with a deep learning-based (DL-based) detector. A spatial constraint and candidate tip locations are obtained by detecting needle shafts and tips in the raw grayscale B-mode images with another DL-based detector. To provide continuous constraints, estimated tip velocity from acquired temporal constraint is used to predict tip locations in frames where no temporal or spatial constraint is detected. Finally, tip coordinates are precisely localized among candidate tips under the spatial and temporal constraints. RESULTS Experimental results evaluated on 1121 US images from porcine organ punctures, and 895 images from human thyroid punctures demonstrate that the proposed method is effective and efficient, surpassing existing methods. On porcine organ data, a 97.2% recall rate and a 91.9% precision rate on tip detection and 0.88 ± 0.70 mm root-mean-square error (RMSE) on tip localization were achieved. On the human thyroid data, which was not involved in the training, 86.5% recall, 84.3% precision and 0.92 ± 0.78 mm RMSE were achieved separately. The running speed of 14.5 frames per second was achieved only using a CPU. CONCLUSION The proposed method provides a more reliable solution for automated needle tip localization during US-guided needle puncture, being more robust to interferences. Fast running speed leads to its practicability in the real-time US stream.
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Affiliation(s)
- Ruixin Wang
- College of Computer and Information, Hohai University, Nanjing, 210098, China
| | - Guoping Tan
- College of Computer and Information, Hohai University, Nanjing, 210098, China.
| | - Xiaohui Liu
- The First People's Hospital of Kunshan, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, 215300, China
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2
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Orlando N, Snir J, Barker K, D'Souza D, Velker V, Mendez LC, Fenster A, Hoover DA. A power Doppler ultrasound method for improving intraoperative tip localization for visually obstructed needles in interstitial prostate brachytherapy. Med Phys 2023; 50:2649-2661. [PMID: 36846880 DOI: 10.1002/mp.16336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 12/15/2022] [Accepted: 01/10/2023] [Indexed: 03/01/2023] Open
Abstract
PURPOSE High-dose-rate (HDR) interstitial brachytherapy (BT) is a common treatment technique for localized intermediate to high-risk prostate cancer. Transrectal ultrasound (US) imaging is typically used for guiding needle insertion, including localization of the needle tip which is critical for treatment planning. However, image artifacts can limit needle tip visibility in standard brightness (B)-mode US, potentially leading to dose delivery that deviates from the planned dose. To improve intraoperative tip visualization in visually obstructed needles, we propose a power Doppler (PD) US method which utilizes a novel wireless mechanical oscillator, validated in phantom experiments and clinical HDR-BT cases as part of a feasibility clinical trial. METHODS Our wireless oscillator contains a DC motor housed in a 3D printed case and is powered by rechargeable battery allowing the device to be operated by one person with no additional equipment required in the operating room. The oscillator end-piece features a cylindrical shape designed for BT applications to fit on top of the commonly used cylindrical needle mandrins. Phantom validation was completed using tissue-equivalent agar phantoms with the clinical US system and both plastic and metal needles. Our PD method was tested using a needle implant pattern matching a standard HDR-BT procedure as well as an implant pattern designed to maximize needle shadowing artifacts. Needle tip localization accuracy was assessed using the clinical method based on ideal reference needles as well as a comparison to computed tomography (CT) as a gold standard. Clinical validation was completed in five patients who underwent standard HDR-BT as part of a feasibility clinical trial. Needle tips positions were identified using B-mode US and PD US with perturbation from our wireless oscillator. RESULTS Absolute mean ± standard deviation tip error for B-mode alone, PD alone, and B-mode combined with PD was respectively: 0.3 ± 0.3 mm, 0.6 ± 0.5 mm, and 0.4 ± 0.2 mm for the mock HDR-BT needle implant; 0.8 ± 1.7 mm, 0.4 ± 0.6 mm, and 0.3 ± 0.5 mm for the explicit shadowing implant with plastic needles; and 0.5 ± 0.2 mm, 0.5 ± 0.3 mm, and 0.6 ± 0.2 mm for the explicit shadowing implant with metal needles. The total mean absolute tip error for all five patients in the feasibility clinical trial was 0.9 ± 0.7 mm using B-mode US alone and 0.8 ± 0.5 mm when including PD US, with increased benefit observed for needles classified as visually obstructed. CONCLUSIONS Our proposed PD needle tip localization method is easy to implement and requires no modifications or additions to the standard clinical equipment or workflow. We have demonstrated decreased tip localization error and variation for visually obstructed needles in both phantom and clinical cases, including providing the ability to visualize needles previously not visible using B-mode US alone. This method has the potential to improve needle visualization in challenging cases without burdening the clinical workflow, potentially improving treatment accuracy in HDR-BT and more broadly in any minimally invasive needle-based procedure.
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Affiliation(s)
- Nathan Orlando
- Department of Medical Biophysics, Western University, London, Ontario, Canada.,Robarts Research Institute, Western University, London, Ontario, Canada
| | - Jonatan Snir
- London Health Sciences Centre, London, Ontario, Canada
| | - Kevin Barker
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - David D'Souza
- London Health Sciences Centre, London, Ontario, Canada.,Department of Oncology, Western University, London, Ontario, Canada
| | - Vikram Velker
- London Health Sciences Centre, London, Ontario, Canada.,Department of Oncology, Western University, London, Ontario, Canada
| | - Lucas C Mendez
- London Health Sciences Centre, London, Ontario, Canada.,Department of Oncology, Western University, London, Ontario, Canada
| | - Aaron Fenster
- Department of Medical Biophysics, Western University, London, Ontario, Canada.,Robarts Research Institute, Western University, London, Ontario, Canada.,Department of Oncology, Western University, London, Ontario, Canada
| | - Douglas A Hoover
- Department of Medical Biophysics, Western University, London, Ontario, Canada.,London Health Sciences Centre, London, Ontario, Canada.,Department of Oncology, Western University, London, Ontario, Canada
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3
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Baker C, Xochicale M, Lin FY, Mathews S, Joubert F, Shakir DI, Miles R, Mosse CA, Zhao T, Liang W, Kunpalin Y, Dromey B, Mistry T, Sebire NJ, Zhang E, Ourselin S, Beard PC, David AL, Desjardins AE, Vercauteren T, Xia W. Intraoperative Needle Tip Tracking with an Integrated Fibre-Optic Ultrasound Sensor. SENSORS (BASEL, SWITZERLAND) 2022; 22:9035. [PMID: 36501738 PMCID: PMC9739176 DOI: 10.3390/s22239035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
Ultrasound is an essential tool for guidance of many minimally-invasive surgical and interventional procedures, where accurate placement of the interventional device is critical to avoid adverse events. Needle insertion procedures for anaesthesia, fetal medicine and tumour biopsy are commonly ultrasound-guided, and misplacement of the needle may lead to complications such as nerve damage, organ injury or pregnancy loss. Clear visibility of the needle tip is therefore critical, but visibility is often precluded by tissue heterogeneities or specular reflections from the needle shaft. This paper presents the in vitro and ex vivo accuracy of a new, real-time, ultrasound needle tip tracking system for guidance of fetal interventions. A fibre-optic, Fabry-Pérot interferometer hydrophone is integrated into an intraoperative needle and used to localise the needle tip within a handheld ultrasound field. While previous, related work has been based on research ultrasound systems with bespoke transmission sequences, the new system-developed under the ISO 13485 Medical Devices quality standard-operates as an adjunct to a commercial ultrasound imaging system and therefore provides the image quality expected in the clinic, superimposing a cross-hair onto the ultrasound image at the needle tip position. Tracking accuracy was determined by translating the needle tip to 356 known positions in the ultrasound field of view in a tank of water, and by comparison to manual labelling of the the position of the needle in B-mode US images during an insertion into an ex vivo phantom. In water, the mean distance between tracked and true positions was 0.7 ± 0.4 mm with a mean repeatability of 0.3 ± 0.2 mm. In the tissue phantom, the mean distance between tracked and labelled positions was 1.1 ± 0.7 mm. Tracking performance was found to be independent of needle angle. The study demonstrates the performance and clinical compatibility of ultrasound needle tracking, an essential step towards a first-in-human study.
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Affiliation(s)
- Christian Baker
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Miguel Xochicale
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Fang-Yu Lin
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Sunish Mathews
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Francois Joubert
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Dzhoshkun I. Shakir
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Richard Miles
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Charles A. Mosse
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Tianrui Zhao
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Weidong Liang
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Yada Kunpalin
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 74 Huntley Street, London WC1E 6AU, UK
| | - Brian Dromey
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 74 Huntley Street, London WC1E 6AU, UK
| | - Talisa Mistry
- NIHR Great Ormond Street BRC and Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Neil J. Sebire
- NIHR Great Ormond Street BRC and Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Edward Zhang
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Paul C. Beard
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Anna L. David
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 74 Huntley Street, London WC1E 6AU, UK
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Wenfeng Xia
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
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Scrubbing needles: a simple and costless technique to improve needle tip visibility during US-guided liver interventions. J Ultrasound 2021; 25:73-78. [PMID: 33565051 PMCID: PMC8964860 DOI: 10.1007/s40477-021-00561-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/15/2021] [Indexed: 10/22/2022] Open
Abstract
AIMS To evaluate the echogenicity of a commercially available needle, modified on the tip, by comparing two groups of patients undergoing to percutaneous biliary drainage. METHODS In this retrospective analysis 16 percutaneous transhepatic biliary drainage (PTBD) procedures performed on 16 oncologic patients were evaluated. Patients were randomly divided into two groups of eight subjects each; in the first group, a standard needle was adopted (group A); in the second group, the needle was manually modified to create a rough surface (group B), by scrubbing the tip with an 11 scalpel blade for 150 s all around its surface. To objectively quantify US needle tip visibility, the contrast-to-noise ratio (CNR) was calculated analyzing B-mode images by positioning region of interests in correspondence of needle tip and liver parenchyma. RESULTS Needle tip echogenicity was significantly higher in group B where the needle tip was modified compared to control group A (p value = 0.014). CNR, considered to objectively evaluate differences among needle tip echogenicity, was significantly higher in group B with respect to control group A (p value = 0.018). CONCLUSIONS The proposed method, scrubbing a 22 gauge commercially available needle tip with a scalpel blade, represents an effective technique to improve needle visibility during US-guided punctures of the liver.
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5
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Beigi P, Salcudean SE, Ng GC, Rohling R. Enhancement of needle visualization and localization in ultrasound. Int J Comput Assist Radiol Surg 2020; 16:169-178. [PMID: 32995981 DOI: 10.1007/s11548-020-02227-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/06/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE This scoping review covers needle visualization and localization techniques in ultrasound, where localization-based approaches mostly aim to compute the needle shaft (and tip) location while potentially enhancing its visibility too. METHODS A literature review is conducted on the state-of-the-art techniques, which could be divided into five categories: (1) signal and image processing-based techniques to augment the needle, (2) modifications to the needle and insertion to help with needle-transducer alignment and visibility, (3) changes to ultrasound image formation, (4) motion-based analysis and (5) machine learning. RESULTS Advantages, limitations and challenges of representative examples in each of the categories are discussed. Evaluation techniques performed in ex vivo, phantom and in vivo studies are discussed and summarized. CONCLUSION Greatest limitation of the majority of the literature is that they rely on original visibility of the needle in the static image. Need for additional/improved apparatus is the greatest limitation toward clinical utility in practice. SIGNIFICANCE Ultrasound-guided needle placement is performed in many clinical applications, including biopsies, treatment injections and anesthesia. Despite the wide range and long history of this technique, an ongoing challenge is needle visibility in ultrasound. A robust technique to enhance ultrasonic needle visibility, especially for steeply inserted hand-held needles, and while maintaining clinical utility requirements is needed.
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Affiliation(s)
- Parmida Beigi
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada.
| | - Septimiu E Salcudean
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada
| | - Gary C Ng
- Philips Ultrasound, Bothell, WA, USA
| | - Robert Rohling
- Electrical and Computer Engineering Department and Mechanical Engineering Department, University of British Columbia, Vancouver, BC, Canada
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6
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Sonographic visibility of cannulas using convex ultrasound transducers. BIOMED ENG-BIOMED TE 2019; 64:691-698. [DOI: 10.1515/bmt-2018-0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 01/30/2019] [Indexed: 11/15/2022]
Abstract
Abstract
The key for safe ultrasound (US)-guided punctures is a good visibility of the cannula. When using convex transducers for deep punctures, the incident angle between US beam and cannula varies along the cannula leading to a complex visibility pattern. Here, we present a method to systematically investigate the visibility throughout the US image. For this, different objective criteria were defined and applied to measurement series with varying puncture angles and depths of the cannula. It is shown that the visibility not only depends on the puncture angle but also on the location of the cannula in the US image when using convex transducers. In some image regions, an unexpected good visibility was observed even for steep puncture angles. The systematic evaluation of the cannula visibility is of fundamental interest to sensitise physicians to the handling of convex transducers and to evaluate new techniques for further improvement.
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7
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van de Berg NJ, Sánchez-Margallo JA, van Dijke AP, Langø T, van den Dobbelsteen JJ. A Methodical Quantification of Needle Visibility and Echogenicity in Ultrasound Images. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:998-1009. [PMID: 30655111 DOI: 10.1016/j.ultrasmedbio.2018.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/31/2018] [Accepted: 10/04/2018] [Indexed: 06/09/2023]
Abstract
During ultrasound-guided percutaneous interventions, needle localization can be a challenge. To increase needle visibility, enhancements of both the imaging methods and the needle surface properties have been investigated. However, a methodical approach to compare potential solutions is currently unavailable. The work described here involves automated image acquisition, analysis and reporting techniques to collect large amounts of data efficiently, delineate relevant factors and communicate effects. Data processing included filtering, line fitting and image intensity analysis steps. Foreground and background image samples were used to compute a contrast-to-noise ratio or a signal ratio. The approach was evaluated in a comparative study of commercially available and custom-made needles. Varied parameters included needle material, diameter and surface roughness. The shafts with kerfed patterns and the trocar and chiba tips performed best. The approach enabled an intuitive polar depiction of needle visibility in ultrasound images for a large range of insertion angles.
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Affiliation(s)
- Nick J van de Berg
- Department of BioMechanical Engineering Delft University of Technology, Delft, The Netherlands.
| | - Juan A Sánchez-Margallo
- Medical Technology, SINTEF, Norway; Computer Systems and Telematics, University of Extremadura, Extremadura, Spain
| | - Arjan P van Dijke
- Department of BioMechanical Engineering Delft University of Technology, Delft, The Netherlands
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Abstract
Ultrasound is well suited for guiding many minimally invasive procedures, but its use is often precluded by the poor visibility of medical devices. When devices are not visible, they can damage critical structures, with life-threatening complications. Here, we developed the first ultrasound probe that comprises both focused and unfocused transducer elements to provide both 2D B-mode ultrasound imaging and 3D ultrasonic needle tracking. A fibre-optic hydrophone was integrated into a needle to receive Golay-coded transmissions from the probe and these data were processed to obtain tracking images of the needle tip. The measured tracking accuracy in water was better than 0.4 mm in all dimensions. To demonstrate the clinical potential of this system, insertions were performed into the spine and the uterine cavity, in swine and pregnant ovine models in vivo. In both models, the SNR ranged from 13 to 38 at depths of 22 to 38 mm, at out-of-plane distances of 1 to 15 mm, and at insertion angles of 33 to 42 degrees relative to the probe surface normal. This novel ultrasound imaging/tracking probe has strong potential to improve procedural outcomes by providing 3D needle tip locations that are co-registered to ultrasound images, while maintaining compatibility with current clinical workflow.
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9
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Kuang Y, Hilgers A, Sadiq M, Cochran S, Corner G, Huang Z. Modelling and characterisation of a ultrasound-actuated needle for improved visibility in ultrasound-guided regional anaesthesia and tissue biopsy. ULTRASONICS 2016; 69:38-46. [PMID: 27022669 DOI: 10.1016/j.ultras.2016.02.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 02/25/2016] [Accepted: 02/26/2016] [Indexed: 06/05/2023]
Abstract
Clear needle visualisation is recognised as an unmet need for ultrasound guided percutaneous needle procedures including regional anaesthesia and tissue biopsy. With inadequate needle visibility, these procedures may result in serious complications or a failed operation. This paper reports analysis of the modal behaviour of a previously proposed ultrasound-actuated needle configuration, which may overcome this problem by improving needle visibility in colour Doppler imaging. It uses a piezoelectric transducer to actuate longitudinal resonant modes in needles (outer diameter 0.8-1.2mm, length>65mm). The factors that affect the needle's vibration mode are identified, including the needle length, the transducer's resonance frequency and the gripping position. Their effects are investigated using finite element modelling, with the conclusions validated experimentally. The actuated needle was inserted into porcine tissue up to 30mm depth and its visibility was observed under colour Doppler imaging. The piezoelectric transducer is able to generate longitudinal vibration with peak-to-peak amplitude up to 4μm at the needle tip with an actuating voltage of 20Vpp. Actuated in longitudinal vibration modes (distal mode at 27.6kHz and transducer mode at 42.2kHz) with a drive amplitude of 12-14Vpp, a 120mm needle is delineated as a coloured line in colour Doppler images, with both needle tip and shaft visualised. The improved needle visibility is maintained while the needle is advanced into the tissue, thus allowing tracking of the needle position in real time. Moreover, the needle tip is highlighted by strong coloured artefacts around the actuated needle generated by its flexural vibration. A limitation of the technique is that the transducer mode requires needles of specific lengths so that the needle's resonance frequency matches the transducer. This may restrict the choice of needle lengths in clinical applications.
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Affiliation(s)
- Y Kuang
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, UK
| | - A Hilgers
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, UK
| | - M Sadiq
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, UK
| | - S Cochran
- Institute for Medical Science and Technology (IMSaT), University of Dundee, Dundee DD2 1FD, UK
| | - G Corner
- Department of Medical Physics, Ninewells Hospital, University of Dundee, DD1 9SY, UK
| | - Z Huang
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, UK.
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Plett SK, Poder L, Brooks RA, Morgan TA. Transvaginal Ultrasound-Guided Biopsy of Deep Pelvic Masses: How We Do It. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:1113-1122. [PMID: 27091918 DOI: 10.7863/ultra.15.08002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 09/11/2015] [Indexed: 06/05/2023]
Abstract
The purpose of this review is to discuss the rationale and indications for transvaginal ultrasound-guided biopsy. Transvaginal ultrasound-guided biopsy can be a helpful tool for diagnosis and treatment planning in the evaluation of pelvic masses, particularly when the anatomy precludes a transabdominal or posterior transgluteal percutaneous biopsy approach. A step-by-step summary of the technique with preprocedure and postprocedure considerations is included.
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Affiliation(s)
- Sara K Plett
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California USA.
| | - Liina Poder
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California USA
| | - Rebecca A Brooks
- Department of Obstetrics and Gynecology, University of California, San Francisco, California USA
| | - Tara A Morgan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California USA
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11
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Beigi P, Rohling R, Salcudean SE, Ng GC. Spectral analysis of the tremor motion for needle detection in curvilinear ultrasound via spatiotemporal linear sampling. Int J Comput Assist Radiol Surg 2016; 11:1183-92. [PMID: 27059024 DOI: 10.1007/s11548-016-1402-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/23/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Parmida Beigi
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada.
| | - Robert Rohling
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada
- Mechanical Engineering Department, University of British Columbia, Vancouver, BC, Canada
| | - Septimiu E Salcudean
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada
| | - Gary C Ng
- Philips Ultrasound, Bothell, WA, USA
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12
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The Requisites of Needle-to-Nerve Proximity for Ultrasound-Guided Regional Anesthesia. Reg Anesth Pain Med 2016; 41:221-8. [DOI: 10.1097/aap.0000000000000201] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Beigi P, Rohling R, Salcudean T, Lessoway VA, Ng GC. Needle Trajectory and Tip Localization in Real-Time 3-D Ultrasound Using a Moving Stylus. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:2057-2070. [PMID: 25929997 DOI: 10.1016/j.ultrasmedbio.2015.03.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 03/04/2015] [Accepted: 03/11/2015] [Indexed: 06/04/2023]
Abstract
Described here is a novel approach to needle localization in 3-D ultrasound based on automatic detection of small changes in appearance on movement of the needle stylus. By stylus oscillation, including its full insertion into the cannula to the tip, the image processing techniques can localize the needle trajectory and the tip in the 3-D ultrasound volume. The 3-D needle localization task is reduced to two 2-D localizations using orthogonal projections. To evaluate our method, we tested it on three different ex vivo tissue types, and the preliminary results indicated that the method accuracy lies within clinical acceptance, with average error ranges of 0.9°-1.4° in needle trajectory and 0.8-1.1 mm in needle tip. Results also indicate that method performance is independent of the echogenicity of the tissue. This technique is a safe way of producing ultrasonic intensity changes and appears to introduce negligible risk to the patient, as the outer cannula remains fixed.
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Affiliation(s)
- Parmida Beigi
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Robert Rohling
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, British Columbia, Canada; Mechanical Engineering Department, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tim Salcudean
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, British Columbia, Canada
| | - Victoria A Lessoway
- Department of Ultrasound, British Columbia Women's Hospital, Vancouver, British Columbia, Canada
| | - Gary C Ng
- Philips Ultrasound, Bothell, Washington, USA
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Adebar TK, Fletcher AE, Okamura AM. 3-D ultrasound-guided robotic needle steering in biological tissue. IEEE Trans Biomed Eng 2014; 61:2899-910. [PMID: 25014948 DOI: 10.1109/tbme.2014.2334309] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Robotic needle steering systems have the potential to greatly improve medical interventions, but they require new methods for medical image guidance. Three-dimensional (3-D) ultrasound is a widely available, low-cost imaging modality that may be used to provide real-time feedback to needle steering robots. Unfortunately, the poor visibility of steerable needles in standard grayscale ultrasound makes automatic segmentation of the needles impractical. A new imaging approach is proposed, in which high-frequency vibration of a steerable needle makes it visible in ultrasound Doppler images. Experiments demonstrate that segmentation from this Doppler data is accurate to within 1-2 mm. An image-guided control algorithm that incorporates the segmentation data as feedback is also described. In experimental tests in ex vivo bovine liver tissue, a robotic needle steering system implementing this control scheme was able to consistently steer a needle tip to a simulated target with an average error of 1.57 mm. Implementation of 3-D ultrasound-guided needle steering in biological tissue represents a significant step toward the clinical application of robotic needle steering.
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Fichtinger G, Fiene JP, Kennedy CW, Kronreif G, Iordachita I, Song DY, Burdette EC, Kazanzides P. Robotic assistance for ultrasound-guided prostate brachytherapy. Med Image Anal 2008; 12:535-45. [PMID: 18650122 DOI: 10.1016/j.media.2008.06.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2008] [Revised: 05/15/2008] [Accepted: 06/10/2008] [Indexed: 10/21/2022]
Abstract
We present a robotically assisted prostate brachytherapy system and test results in training phantoms and Phase-I clinical trials. The system consists of a transrectal ultrasound (TRUS) and a spatially co-registered robot, fully integrated with an FDA-approved commercial treatment planning system. The salient feature of the system is a small parallel robot affixed to the mounting posts of the template. The robot replaces the template interchangeably, using the same coordinate system. Established clinical hardware, workflow and calibration remain intact. In all phantom experiments, we recorded the first insertion attempt without adjustment. All clinically relevant locations in the prostate were reached. Non-parallel needle trajectories were achieved. The pre-insertion transverse and rotational errors (measured with a Polaris optical tracker relative to the template's coordinate frame) were 0.25 mm (STD=0.17 mm) and 0.75 degrees (STD=0.37 degrees). In phantoms, needle tip placement errors measured in TRUS were 1.04 mm (STD=0.50mm). A Phase-I clinical feasibility and safety trial has been successfully completed with the system. We encountered needle tip positioning errors of a magnitude greater than 4mm in only 2 of 179 robotically guided needles, in contrast to manual template guidance where errors of this magnitude are much more common. Further clinical trials are necessary to determine whether the apparent benefits of the robotic assistant will lead to improvements in clinical efficacy and outcomes.
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Affiliation(s)
- Gabor Fichtinger
- Queen's University, 25 Union Street, #725 Goodwin Hall, Kingston, ON, Canada.
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