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Mathews SJ, Little C, Zhang E, Beard P, Mastracci T, Rakhit R, Desjardins AE. Bend-insensitive fiber optic ultrasonic tracking probe for cardiovascular interventions. Med Phys 2023; 50:3490-3497. [PMID: 36842082 PMCID: PMC10615325 DOI: 10.1002/mp.16334] [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: 09/10/2022] [Revised: 02/13/2023] [Accepted: 02/18/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Transesophageal echocardiography (TEE) is widely used to guide medical device placement in minimally invasive cardiovascular procedures. However, visualization of the device tip with TEE can be challenging. Ultrasonic tracking, enabled by an integrated fiber optic ultrasound sensor (FOUS) that receives transmissions from the TEE probe, is very well suited to improving device localization in this context. The problem addressed in this study is that tight deflections of devices such as a steerable guide catheter can result in bending of the FOUS beyond its specifications and a corresponding loss of ultrasound sensitivity. PURPOSE A bend-insensitive FOUS was developed, and its utility with ultrasonic tracking of a steerable tip during TEE-based image guidance was demonstrated. METHODS Fiberoptic ultrasound sensors were fabricated using both standard and bend insensitive single mode fibers and subjected to static bending at the distal end. The interference transfer function and ultrasound sensitivities were compared for both types of FOUS. The bend-insensitive FOUS was integrated within a steerable guide catheter, which served as an exemplar device; the signal-to-noise ratio (SNR) of tracking signals from the catheter tip with a straight and a fully deflected distal end were measured in a cardiac ultrasound phantom for over 100 frames. RESULTS With tight bending at the distal end (bend radius < 10 mm), the standard FOUS experienced a complete loss of US sensitivity due to high attenuation in the fiber, whereas the bend-insensitive FOUS had largely unchanged performance, with a SNR of 47.7 for straight fiber and a SNR of 36.8 at a bend radius of 3.0 mm. When integrated into the steerable guide catheter, the mean SNRs of the ultrasonic tracking signals recorded with the catheter in a cardiac phantom were similar for straight and fully deflected distal ends: 195 and 163. CONCLUSION The FOUS fabricated from bend-insensitive fiber overcomes the bend restrictions associated with the FOUS fabricated from standard single mode fiber, thereby enabling its use in ultrasonic tracking in a wide range of cardiovascular devices.
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Affiliation(s)
- Sunish J. Mathews
- Wellcome/EPSRC Centre for Interventional and Surgical SciencesUniversity College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Callum Little
- Department of CardiologyImperial College Healthcare NHS Foundation TrustLondonUK
| | - Edward Zhang
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Paul Beard
- Wellcome/EPSRC Centre for Interventional and Surgical SciencesUniversity College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Tara Mastracci
- Department of CardiologyRoyal Free London NHS Foundation TrustLondonUK
| | - Roby Rakhit
- Department of CardiologyRoyal Free London NHS Foundation TrustLondonUK
| | - Adrien E. Desjardins
- Wellcome/EPSRC Centre for Interventional and Surgical SciencesUniversity College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
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2
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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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3
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A survey of catheter tracking concepts and methodologies. Med Image Anal 2022; 82:102584. [DOI: 10.1016/j.media.2022.102584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/01/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022]
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4
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Shi M, Bodian S, West SJ, Sathasivam S, Gordon RJ, Collier P, Vercauteren T, Desjardins AE, Noimark S, Xia W. Enhanced Photoacoustic Visualisation of Clinical Needles by Combining Interstitial and Extracorporeal Illumination of Elastomeric Nanocomposite Coatings. SENSORS (BASEL, SWITZERLAND) 2022; 22:6417. [PMID: 36080876 PMCID: PMC9460224 DOI: 10.3390/s22176417] [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: 07/19/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Ultrasound (US) image guidance is widely used for minimally invasive procedures, but the invasive medical devices (such as metallic needles), especially their tips, can be poorly visualised in US images, leading to significant complications. Photoacoustic (PA) imaging is promising for visualising invasive devices and peripheral tissue targets. Light-emitting diodes (LEDs) acting as PA excitation sources facilitate the clinical translation of PA imaging, but the image quality is degraded due to the low pulse energy leading to insufficient contrast with needles at deep locations. In this paper, photoacoustic visualisation of clinical needles was enhanced by elastomeric nanocomposite coatings with superficial and interstitial illumination. Candle soot nanoparticle-polydimethylsiloxane (CSNP-PDMS) composites with high optical absorption and large thermal expansion coefficients were applied onto the needle exterior and the end-face of an optical fibre placed in the needle lumen. The excitation light was delivered at the surface by LED arrays and through the embedded optical fibre by a pulsed diode laser to improve the visibility of the needle tip. The performance was validated using an ex-vivo tissue model. An LED-based PA/US imaging system was used for imaging the needle out-of-plane and in-plane insertions over approach angles of 20 deg to 55 deg. The CSNP-PDMS composite conferred substantial visual enhancements on both the needle shaft and the tip, with an average of 1.7- and 1.6-fold improvements in signal-to-noise ratios (SNRs), respectively. With the extended light field involving extracorporeal and interstitial illumination and the highly absorbing coatings, enhanced visualisation of the needle shaft and needle tip was achieved with PA imaging, which could be helpful in current US-guided minimally invasive surgeries.
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Affiliation(s)
- Mengjie Shi
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Semyon Bodian
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Simeon J. West
- Department of Anaesthesia, University College Hospital, London NW1 2BU, UK
| | - Sanjayan Sathasivam
- Department of Chemistry, University College London, London WC1H 0AJ, UK or
- School of Engineering, London South Bank University, London SE1 0AA, UK
| | | | - Paul Collier
- Johnson Matthey Technology Centre, Reading RG4 9NH, UK
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Sacha Noimark
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Wenfeng Xia
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
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5
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Kuniyil Ajith Singh M, Xia W. Portable and Affordable Light Source-Based Photoacoustic Tomography. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6173. [PMID: 33138296 PMCID: PMC7663770 DOI: 10.3390/s20216173] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/27/2022]
Abstract
Photoacoustic imaging is a hybrid imaging modality that offers the advantages of optical (spectroscopic contrast) and ultrasound imaging (scalable spatial resolution and imaging depth). This promising modality has shown excellent potential in a wide range of preclinical and clinical imaging and sensing applications. Even though photoacoustic imaging technology has matured in research settings, its clinical translation is not happening at the expected pace. One of the main reasons for this is the requirement of bulky and expensive pulsed lasers for excitation. To accelerate the clinical translation of photoacoustic imaging and explore its potential in resource-limited settings, it is of paramount importance to develop portable and affordable light sources that can be used as the excitation light source. In this review, we focus on the following aspects: (1) the basic theory of photoacoustic imaging; (2) inexpensive light sources and different implementations; and (3) important preclinical and clinical applications, demonstrated using affordable light source-based photoacoustics. The main focus will be on laser diodes and light-emitting diodes as they have demonstrated promise in photoacoustic tomography-the key technological developments in these areas will be thoroughly reviewed. We believe that this review will be a useful opus for both the beginners and experts in the field of biomedical photoacoustic imaging.
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Affiliation(s)
- Mithun Kuniyil Ajith Singh
- Research and Business Development Division, CYBERDYNE INC., Stationsplein 45, A4.004, 3013 AK Rotterdam, The Netherlands;
| | - Wenfeng Xia
- School of Biomedical Engineering& Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, UK
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6
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Maneas E, Aughwane R, Huynh N, Xia W, Ansari R, Kuniyil Ajith Singh M, Hutchinson JC, Sebire NJ, Arthurs OJ, Deprest J, Ourselin S, Beard PC, Melbourne A, Vercauteren T, David AL, Desjardins AE. Photoacoustic imaging of the human placental vasculature. JOURNAL OF BIOPHOTONICS 2020; 13:e201900167. [PMID: 31661594 PMCID: PMC8425327 DOI: 10.1002/jbio.201900167] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 09/02/2019] [Accepted: 10/03/2019] [Indexed: 05/06/2023]
Abstract
Minimally invasive fetal interventions require accurate imaging from inside the uterine cavity. Twin-to-twin transfusion syndrome (TTTS), a condition considered in this study, occurs from abnormal vascular anastomoses in the placenta that allow blood to flow unevenly between the fetuses. Currently, TTTS is treated fetoscopically by identifying the anastomosing vessels, and then performing laser photocoagulation. However, white light fetoscopy provides limited visibility of placental vasculature, which can lead to missed anastomoses or incomplete photocoagulation. Photoacoustic (PA) imaging is an alternative imaging method that provides contrast for hemoglobin, and in this study, two PA systems were used to visualize chorionic (fetal) superficial and subsurface vasculature in human placentas. The first system comprised an optical parametric oscillator for PA excitation and a 2D Fabry-Pérot cavity ultrasound sensor; the second, light emitting diode arrays and a 1D clinical linear-array ultrasound imaging probe. Volumetric photoacoustic images were acquired from ex vivo normal term and TTTS-treated placentas. It was shown that superficial and subsurface branching blood vessels could be visualized to depths of approximately 7 mm, and that ablated tissue yielded negative image contrast. This study demonstrated the strong potential of PA imaging to guide minimally invasive fetal therapies.
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Affiliation(s)
- Efthymios Maneas
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Rosalind Aughwane
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- Institute for Women's Health, University College LondonLondonUK
| | - Nam Huynh
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Wenfeng Xia
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- School of Biomedical Engineering and Imaging Sciences, King's College LondonLondonUK
| | - Rehman Ansari
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | | | - J. Ciaran Hutchinson
- NIHR Great Ormond Street Institute of Child Health Biomedical Research Centre, University College LondonLondonUK
- Department of HistopathologyGreat Ormond Street Hospital for Children NHS TrustLondonUK
| | - Neil J. Sebire
- NIHR Great Ormond Street Institute of Child Health Biomedical Research Centre, University College LondonLondonUK
- Department of HistopathologyGreat Ormond Street Hospital for Children NHS TrustLondonUK
| | - Owen J. Arthurs
- NIHR Great Ormond Street Institute of Child Health Biomedical Research Centre, University College LondonLondonUK
- Paediatric Radiology, Great Ormond Street Hospital for Children NHS TrustLondonUK
| | - Jan Deprest
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Institute for Women's Health, University College LondonLondonUK
- Department of Obstetrics and GynaecologyUniversity Hospitals LeuvenLeuvenBelgium
| | - Sebastien Ourselin
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- School of Biomedical Engineering and Imaging Sciences, King's College LondonLondonUK
| | - Paul C. Beard
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Andrew Melbourne
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- School of Biomedical Engineering and Imaging Sciences, King's College LondonLondonUK
| | - Tom Vercauteren
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- School of Biomedical Engineering and Imaging Sciences, King's College LondonLondonUK
| | - Anna L. David
- Institute for Women's Health, University College LondonLondonUK
| | - Adrien E. Desjardins
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
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7
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Lee CC, Chuang CC, Lai BC, Huang YC, Chen JY, Lin BS. A Novel Smart Assistance System for Blood Vessel Approaching: A Technical Report Based on Oximetry. SENSORS 2020; 20:s20071891. [PMID: 32235314 PMCID: PMC7180434 DOI: 10.3390/s20071891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 11/16/2022]
Abstract
In clinical practice, the catheter has to be placed at an accurate position during anesthesia administration. However, effectively guiding the catheter to the accurate position in deeper tissues can be difficult for an inexperienced practitioner. We aimed to address the current issues associated with catheter placement using a novel smart assistance system for blood vessel catheter placement. We used a hollow introducer needle embedded with dual wavelength (690 and 850 nm) optical fibers to advance the tip into the subclavian vessels in anesthetized piglets. The results showed average optical density changes, and the difference between the absorption spectra and hemoglobin concentrations of different tissue components effectively identified different tissues (p < 0.05). The radial basis function neural network (RBFNN) technique was applied to distinguish tissue components (the F-measure value and accuracy were 93.02% and 94%, respectively). Finally, animal experiments were designed to validate the performance of the proposed system. Using this system based on oximetry, we easily navigated the needle tip to the target vessel. Based on the experimental results, the proposed system could effectively distinguish different tissue layers of the animals.
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Affiliation(s)
- Chien-Ching Lee
- Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Tainan 71150, Taiwan; (C.-C.L.); (B.-C.L.); (Y.-C.H.)
- Department of Anesthesia, An Nan Hospital, China Medical University, Tainan 70965, Taiwan;
- Department of Medical Sciences Industry, Chang Jung Christian University, Tainan 71101, Taiwan
| | - Chia-Chun Chuang
- Department of Anesthesia, An Nan Hospital, China Medical University, Tainan 70965, Taiwan;
- Department of Medical Sciences Industry, Chang Jung Christian University, Tainan 71101, Taiwan
| | - Bo-Cheng Lai
- Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Tainan 71150, Taiwan; (C.-C.L.); (B.-C.L.); (Y.-C.H.)
| | - Yi-Chia Huang
- Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Tainan 71150, Taiwan; (C.-C.L.); (B.-C.L.); (Y.-C.H.)
| | - Jen-Yin Chen
- Department of Anesthesiology, Chimei Medical Center, Tainan 71004, Taiwan;
| | - Bor-Shyh Lin
- Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Tainan 71150, Taiwan; (C.-C.L.); (B.-C.L.); (Y.-C.H.)
- Correspondence: ; Tel.: +886-6-3032121-57835
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8
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Zhao T, Desjardins AE, Ourselin S, Vercauteren T, Xia W. Minimally invasive photoacoustic imaging: Current status and future perspectives. PHOTOACOUSTICS 2019; 16:100146. [PMID: 31871889 PMCID: PMC6909166 DOI: 10.1016/j.pacs.2019.100146] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/26/2019] [Accepted: 09/30/2019] [Indexed: 05/09/2023]
Abstract
Photoacoustic imaging (PAI) is an emerging biomedical imaging modality that is based on optical absorption contrast, capable of revealing distinct spectroscopic signatures of tissue at high spatial resolution and large imaging depths. However, clinical applications of conventional non-invasive PAI systems have been restricted to examinations of tissues at depths less than a few cm due to strong light attenuation. Minimally invasive photoacoustic imaging (miPAI) has greatly extended the landscape of PAI by delivering excitation light within tissue through miniature fibre-optic probes. In the past decade, various miPAI systems have been developed with demonstrated applicability in several clinical fields. In this article, we present an overview of the current status of miPAI and our thoughts on future perspectives.
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Affiliation(s)
- Tianrui Zhao
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing St Thomas’ Hospital London, London SE1 7EH, United Kingdom
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, United Kingdom
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing St Thomas’ Hospital London, London SE1 7EH, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing St Thomas’ Hospital London, London SE1 7EH, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Wenfeng Xia
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing St Thomas’ Hospital London, London SE1 7EH, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
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9
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Abstract
Ultrasound image guidance is widely used in minimally invasive procedures, including fetal surgery. In this context, maintaining visibility of medical devices is a significant challenge. Needles and catheters can readily deviate from the ultrasound imaging plane as they are inserted. When the medical device tips are not visible, they can damage critical structures, with potentially profound consequences including loss of pregnancy. In this study, we performed 3D ultrasonic tracking of a needle using a novel probe with a 1.5D array of transducer elements that was driven by a commercial ultrasound system. A fiber-optic hydrophone integrated into the needle received transmissions from the probe, and data from this sensor was processed to estimate the position of the hydrophone tip in the coordinate space of the probe. Golay coding was used to increase the signal-to-noise (SNR). The relative tracking accuracy was better than 0.4 mm in all dimensions, as evaluated using a water phantom. To obtain a preliminary indication of the clinical potential of 3D ultrasonic needle tracking, an intravascular needle insertion was performed in an in vivo pregnant sheep model. The SNR values ranged from 12 to 16 at depths of 20 to 31 mm and at an insertion angle of 49° relative to the probe surface normal. The results of this study demonstrate that 3D ultrasonic needle tracking with a fiber-optic hydrophone sensor and a 1.5D array is feasible in clinically realistic environments.
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10
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Xia W, West SJ, Finlay MC, Pratt R, Mathews S, Mari JM, Ourselin S, David AL, Desjardins AE. Three-Dimensional Ultrasonic Needle Tip Tracking with a Fiber-Optic Ultrasound Receiver. J Vis Exp 2018. [PMID: 30199033 PMCID: PMC6231697 DOI: 10.3791/57207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Ultrasound is frequently used for guiding minimally invasive procedures, but visualizing medical devices is often challenging with this imaging modality. When visualization is lost, the medical device can cause trauma to critical tissue structures. Here, a method to track the needle tip during ultrasound image-guided procedures is presented. This method involves the use of a fiber-optic ultrasound receiver that is affixed within the cannula of a medical needle to communicate ultrasonically with the external ultrasound probe. This custom probe comprises a central transducer element array and side element arrays. In addition to conventional two-dimensional (2D) B-mode ultrasound imaging provided by the central array, three-dimensional (3D) needle tip tracking is provided by the side arrays. For B-mode ultrasound imaging, a standard transmit-receive sequence with electronic beamforming is performed. For ultrasonic tracking, Golay-coded ultrasound transmissions from the 4 side arrays are received by the hydrophone sensor, and subsequently the received signals are decoded to identify the needle tip's spatial location with respect to the ultrasound imaging probe. As a preliminary validation of this method, insertions of the needle/hydrophone pair were performed in clinically realistic contexts. This novel ultrasound imaging/tracking method is compatible with current clinical workflow, and it provides reliable device tracking during in-plane and out-of-plane needle insertions.
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Affiliation(s)
- Wenfeng Xia
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London;
| | - Simeon J West
- Department of Anaesthesia, University College Hospital
| | - Malcolm C Finlay
- Department of Medical Physics and Biomedical Engineering, University College London; St Bartholomew's Hospital and Queen Mary University of London
| | - Rosalind Pratt
- Institute for Women's Health, University College London; Centre for Medical Imaging Computing, University College London
| | - Sunish Mathews
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London
| | | | - Sebastien Ourselin
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London; Centre for Medical Imaging Computing, University College London
| | - Anna L David
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London; Institute for Women's Health, University College London; Department of Development and Regeneration, KU Leuven (Katholieke Universiteit); NIHR University College London Hospitals Biomedical Research Centre
| | - Adrien E Desjardins
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London
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11
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Xia W, Kuniyil Ajith Singh M, Maneas E, Sato N, Shigeta Y, Agano T, Ourselin S, J West S, E Desjardins A. Handheld Real-Time LED-Based Photoacoustic and Ultrasound Imaging System for Accurate Visualization of Clinical Metal Needles and Superficial Vasculature to Guide Minimally Invasive Procedures. SENSORS (BASEL, SWITZERLAND) 2018; 18:E1394. [PMID: 29724014 PMCID: PMC5982119 DOI: 10.3390/s18051394] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 04/25/2018] [Accepted: 04/27/2018] [Indexed: 01/11/2023]
Abstract
Ultrasound imaging is widely used to guide minimally invasive procedures, but the visualization of the invasive medical device and the procedure’s target is often challenging. Photoacoustic imaging has shown great promise for guiding minimally invasive procedures, but clinical translation of this technology has often been limited by bulky and expensive excitation sources. In this work, we demonstrate the feasibility of guiding minimally invasive procedures using a dual-mode photoacoustic and ultrasound imaging system with excitation from compact arrays of light-emitting diodes (LEDs) at 850 nm. Three validation experiments were performed. First, clinical metal needles inserted into biological tissue were imaged. Second, the imaging depth of the system was characterized using a blood-vessel-mimicking phantom. Third, the superficial vasculature in human volunteers was imaged. It was found that photoacoustic imaging enabled needle visualization with signal-to-noise ratios that were 1.2 to 2.2 times higher than those obtained with ultrasound imaging, over insertion angles of 26 to 51 degrees. With the blood vessel mimicking phantom, the maximum imaging depth was 38 mm. The superficial vasculature of a human middle finger and a human wrist were clearly visualized in real-time. We conclude that the LED-based system is promising for guiding minimally invasive procedures with peripheral tissue targets.
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Affiliation(s)
- Wenfeng Xia
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK.
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK.
| | - Mithun Kuniyil Ajith Singh
- Research and Business Development Division, PreXion Corporation, Stationsplein 45 A4.004, 3013AK Rotterdam, The Netherlands.
| | - Efthymios Maneas
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK.
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK.
| | - Naoto Sato
- Research and Development Division, 1-14-1, Kandasudacho, Chiyoda-ku, Tokyo 101-0041, Japan.
| | - Yusuke Shigeta
- Research and Development Division, 1-14-1, Kandasudacho, Chiyoda-ku, Tokyo 101-0041, Japan.
| | - Toshitaka Agano
- Research and Development Division, 1-14-1, Kandasudacho, Chiyoda-ku, Tokyo 101-0041, Japan.
| | - Sebastian Ourselin
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK.
- Centre for Medical Imaging Computing, University College London, Gower Street, London WC1E 6BT, UK.
| | - Simeon J West
- Department of Anaesthesia, University College Hospital, Main Theatres, Maple Bridge Link Corridor, Podium 3, 235 Euston Road, London NW1 2BU, UK.
| | - Adrien E Desjardins
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK.
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK.
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12
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Gruijthuijsen C, Colchester R, Devreker A, Javaux A, Maneas E, Noimark S, Xia W, Stoyanov D, Reynaerts D, Deprest J, Ourselin S, Desjardins A, Vercauteren T, Vander Poorten E. Haptic Guidance Based on All-Optical Ultrasound Distance Sensing for Safer Minimally Invasive Fetal Surgery. JOURNAL OF MEDICAL ROBOTICS RESEARCH 2018; 3:10.1142/S2424905X18410015. [PMID: 30820482 PMCID: PMC6390942 DOI: 10.1142/s2424905x18410015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
By intervening during the early stage of gestation, fetal surgeons aim to correct or minimize the effects of congenital disorders. As compared to postnatal treatment of these disorders, such early interventions can often actually save the life of the fetus and also improve the quality of life of the newborn. However, fetal surgery is considered one of the most challenging disciplines within Minimally Invasive Surgery (MIS), owing to factors such as the fragility of the anatomic features, poor visibility, limited manoeuvrability, and extreme requirements in terms of instrument handling with precise positioning. This work is centered on a fetal laser surgery procedure treating placental disorders. It proposes the use of haptic guidance to enhance the overall safety of this procedure and to simplify instrument handling. A method is described that provides effective guidance by installing a forbidden region virtual fixture over the placenta, thereby safeguarding adequate clearance between the instrument tip and the placenta. With a novel application of all-optical ultrasound distance sensing in which transmission and reception are performed with fibre optics, this method can be used with a sole reliance on intraoperatively acquired data. The added value of the guidance approach, in terms of safety and performance, is demonstrated in a series of experiments with a robotic platform.
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Affiliation(s)
| | - Richard Colchester
- Department of Medical Physics & Biomedical Engineering, University College London, UK
| | - Alain Devreker
- Department of Mechanical Engineering, KU Leuven, Belgium
| | - Allan Javaux
- Department of Mechanical Engineering, KU Leuven, Belgium
| | - Efthymios Maneas
- Department of Medical Physics & Biomedical Engineering, University College London, UK
| | - Sacha Noimark
- Department of Medical Physics & Biomedical Engineering, University College London, UK
| | - Wenfeng Xia
- Department of Medical Physics & Biomedical Engineering, University College London, UK
| | - Danail Stoyanov
- Centre for Medical Imaging Computing, University College London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, UK
| | | | - Jan Deprest
- Department of Obstetrics and Gynecology, Division Woman and Child, Fetal Medicine Unit, KU Leuven, Belgium
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, UK
| | - Sebastien Ourselin
- Centre for Medical Imaging Computing, University College London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, UK
| | - Adrien Desjardins
- Department of Medical Physics & Biomedical Engineering, University College London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, UK
| | - Tom Vercauteren
- Department of Medical Physics & Biomedical Engineering, University College London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, UK
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13
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Xia W, Noimark S, Ourselin S, West SJ, Finlay MC, David AL, Desjardins AE. Ultrasonic Needle Tracking with a Fibre-Optic Ultrasound Transmitter for Guidance of Minimally Invasive Fetal Surgery. MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION : MICCAI ... INTERNATIONAL CONFERENCE ON MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION 2017; 10434:637-645. [PMID: 28948240 DOI: 10.1007/978-3-319-66185-8_72] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ultrasound imaging is widely used for guiding minimally invasive procedures, including fetal surgery. Visualisation of medical devices such as medical needles is critically important and it remains challenging in many clinical contexts. During in-plane insertions, a needle can have poor visibility at steep insertion angles and at large insertion depths. During out-of-plane insertions, the needle tip can have a similar ultrasonic appearance to the needle shaft when it intersects with the ultrasound imaging plane. When the needle tip is not accurately identified, it can damage critical structures, with potentially severe consequences, including loss of pregnancy. In this paper, we present a tracking system to directly visualise the needle tip with an ultrasonic beacon. The waves transmitted by the beacon were received by an external ultrasound imaging probe. Pairs of co-registered images were acquired in rapid succession with this probe: a photoacoustic image obtained with the system in receive-only mode, and a conventional B-mode ultrasound image. The beacon comprised a custom elastomeric nanocomposite coating at the distal end of an optical fibre, which was positioned within the lumen of a commercial 22 gauge needle. Delivery of pulsed light to the coating resulted in the photoacoustic generation of ultrasonic waves. The measured tracking accuracies in water in the axial and lateral dimensions were 0.39±0.19 mm and 1.85±0.29 mm, respectively. To obtain a preliminary indication of the clinical potential of this ultrasonic needle tracking system, needle insertions were performed in an in vivo fetal sheep model. The results demonstrate that ultrasonic needle tracking with a fibre-optic transmitter is feasible in a clinically realistic fetal surgery environment, and that it could be useful to guide minimally invasive procedures by providing accurate visualisation of the medical device tip.
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Affiliation(s)
- Wenfeng Xia
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
| | - Sacha Noimark
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK.,Materials Chemistry Research Centre, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - Sebastien Ourselin
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
| | - Simeon J West
- Department of Anaesthesia, University College Hospital, 235 Euston Road, London NW1 2BU, UK
| | - Malcolm C Finlay
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK.,St Bartholomew's Hospital and Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Anna L David
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK
| | - Adrien E Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
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14
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Katayama M, Zarbatany D, Cha SS, Fatemi M, Belohlavek M. Acoustically Active Catheter for Intracardiac Navigation by Color Doppler Ultrasonography. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:1888-1896. [PMID: 28595853 PMCID: PMC5515670 DOI: 10.1016/j.ultrasmedbio.2017.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 04/10/2017] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
Navigation of intracardiac catheters by echocardiography is challenging because of the fundamental limitations of B-mode ultrasonography. We describe a catheter fitted with a piezoelectric crystal, which vibrates and produces an instantaneous marker in color flow Doppler scans. The navigation learning curve was explored first in six pigs. Accuracy and precision of targeting with the navigation marker "off" (i.e., B-mode imaging) and "on" were assessed in another six pigs. Paired comparisons confirmed significantly (p = 0.04) shorter mean distances achieved in each pig with the color Doppler marker. Pooled (mean ± standard deviation) distance of the catheter tip from the target crystal was 5.27 ± 1.62 mm by B-mode guidance and 3.66 ± 1.45 mm by color Doppler marker navigation. Dye injection targeted into the ischemic border zone was successful in 8 of 10 pigs. Intracardiac catheter navigation with color Doppler ultrasonography is more accurate compared with conventional guidance by B-mode imaging.
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Affiliation(s)
- Minako Katayama
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA
| | - David Zarbatany
- Independent Engineering Consultant, Laguna Niguel, California, USA
| | - Stephen S Cha
- Department of Biostatistics, Mayo Clinic, Scottsdale, Arizona, USA
| | - Mostafa Fatemi
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Marek Belohlavek
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA.
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15
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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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