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Electromagnetic (EM) catheter path tracking in ultrasound-guided brachytherapy of the breast

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

Abstract

Purpose

To evaluate a novel navigation system for breast brachytherapy, based on ultrasound (US)-guided catheter needle implantations followed by electromagnetic (EM) tracking of catheter paths.

Methods

Breast phantoms were produced, containing US–visible tumors. Ultrasound was used to localize the tumor pose and volume within the phantom, followed by planning an optimal catheter pattern through the tumor using navigation software. An electromagnetic (EM)-tracked catheter needle was used to insert the catheters in the desired pattern. The inserted catheters were visualized on a post-implant CT, serving as ground truth. Electromagnetic (EM) tracking and reconstruction of the inserted catheter paths were performed by pulling a flexible EM guidewire through each catheter, performed in two clinical brachytherapy suites. The accuracy of EM catheter tracking was evaluated by calculating the Hausdorff distance between the EM-tracked and CT-based catheter paths. The accuracy and clinical feasibility of EM catheter tracking were also evaluated in three breast cancer patients, performed in a separate experiment room.

Results

A total of 71 catheter needles were implanted into 12 phantoms using US guidance and EM navigation, in an average ± SD time of 8.1 ± 2.9 min. The accuracy of EM catheter tracking was dependent on the brachytherapy suite: 2.0 ± 1.2 mm in suite 1 and 0.6 ± 0.2 mm in suite 2. EM catheter tracking was successfully performed in three breast brachytherapy patients. Catheter tracking typically took less than 5 min and had an average accuracy of 1.7 ± 0.3 mm.

Conclusion

Our preliminary results show a potential role for US guidance and EM needle navigation for implantation of catheters for breast brachytherapy. EM catheter tracking can accurately assess the implant geometry in breast brachytherapy patients. This methodology has the potential to evaluate catheter positions directly after the implantation and during the several fractions of the treatment.

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Funding

Gabor Fichtinger is supported as a Canada Research Chair in Computer-Integrated Surgery. This work was funded, in part, by NIH/NIBIB and NIH/NIGMS (via Grant 1R01EB021396-01A1-Slicer + PLUS: Point-of-Care Ultrasound) and by CANARIE’s Research Software Program.

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Authors and Affiliations

  1. School of Computing, Queen’s University, Kingston, ON, Canada

    Natasja N. Y. Janssen, Thomas Vaughan, Tamas Ungi, Andras Lasso & Gabor Fichtinger

  2. Department of Radiation Oncology, Kingston General Hospital, Kingston, ON, Canada

    Harry Brastianos, Tim Olding, Chandra Joshi, Martin Korzeniowski & Conrad Falkson

  3. School of Medicine, Queen’s University, Kingston, ON, Canada

    Aquila Akingbade

Authors
  1. Natasja N. Y. Janssen
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  2. Harry Brastianos
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  4. Tim Olding
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  5. Thomas Vaughan
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  6. Tamas Ungi
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  7. Andras Lasso
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  9. Martin Korzeniowski
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  10. Conrad Falkson
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  11. Gabor Fichtinger
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Correspondence to Natasja N. Y. Janssen.

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Janssen, N.N.Y., Brastianos, H., Akingbade, A. et al. Electromagnetic (EM) catheter path tracking in ultrasound-guided brachytherapy of the breast. Int J CARS 15, 1645–1652 (2020). https://doi.org/10.1007/s11548-020-02233-9

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  • DOI: https://doi.org/10.1007/s11548-020-02233-9

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