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Preclinical evaluation of ultrasound-augmented needle navigation for laparoscopic liver ablation

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

For laparoscopic ablation to be successful, accurate placement of the needle to the tumor is essential. Laparoscopic ultrasound is an essential tool to guide needle placement, but the ultrasound image is generally presented separately from the laparoscopic image. We aim to evaluate an augmented reality (AR) system which combines laparoscopic ultrasound image, laparoscope video, and the needle trajectory in a unified view.

Methods

We created a tissue phantom made of gelatin. Artificial tumors represented by plastic spheres were secured in the gelatin at various depths. The top point of the sphere surface was our target, and its 3D coordinates were known. The participants were invited to perform needle placement with and without AR guidance. Once the participant reported that the needle tip had reached the target, the needle tip location was recorded and compared to the ground truth location of the target, and the difference was the target localization error (TLE). The time of the needle placement was also recorded. We further tested the technical feasibility of the AR system in vivo on a 40-kg swine.

Results

The AR guidance system was evaluated by two experienced surgeons and two surgical fellows. The users performed needle placement on a total of 26 targets, 13 with AR and 13 without (i.e., the conventional approach). The average TLE for the conventional and the AR approaches was 14.9 mm and 11.1 mm, respectively. The average needle placement time needed for the conventional and AR approaches was 59.4 s and 22.9 s, respectively. For the animal study, ultrasound image and needle trajectory were successfully fused with the laparoscopic video in real time and presented on a single screen for the surgeons.

Conclusion

By providing projected needle trajectory, we believe our AR system can assist the surgeon with more efficient and precise needle placement.

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Acknowledgements

This work was supported by the National Institutes of Health Grant 2R42CA192504.

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Authors and Affiliations

  1. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Hospital, Washington, DC, USA

    Xinyang Liu, Timothy D. Kane, Lung W. Lau, Jun Tashiro, Karun Sharma & Raj Shekhar

  2. IGI Technologies, Inc., College Park, MD, USA

    William Plishker & Raj Shekhar

  3. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    David A. Geller

Authors
  1. Xinyang Liu
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  2. William Plishker
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  3. Timothy D. Kane
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  4. David A. Geller
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  5. Lung W. Lau
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  6. Jun Tashiro
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  7. Karun Sharma
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  8. Raj Shekhar
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Corresponding author

Correspondence to Raj Shekhar.

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Conflict of interest

Raj Shekhar and William Plishker are cofounders of IGI Technologies, Inc. All other authors have no conflicts of interest or financial ties to disclose.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Human and animal rights

All procedures performed in this study involving animals were in accordance with Public Health Service Policy on Humane Care and Use of Laboratory Animals, the National Institutes of Health Guide for the Care and Use of Laboratory Animals, and the Animal Welfare Act. The study was approved by the Institutional Animal Care and Use Committee (No. 00030557).

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Liu, X., Plishker, W., Kane, T.D. et al. Preclinical evaluation of ultrasound-augmented needle navigation for laparoscopic liver ablation. Int J CARS 15, 803–810 (2020). https://doi.org/10.1007/s11548-020-02164-5

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  • DOI: https://doi.org/10.1007/s11548-020-02164-5

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