A miniature accelerometer-based guidance device for percutaneous computed tomography-guided punctures

  • Christoph Wilkmann
  • Nobutake Ito
  • Tobias Penzkofer
  • Peter Isfort
  • Hong-Sik Na
  • Michael Hennes
  • Catherine Disselhorst-Klug
  • Andreas H. Mahnken
  • Christiane K. Kuhl
  • Philipp Bruners
Original Article



   Percutaneous punctures are often performed under computed tomography (CT) guidance using a freehand method. Especially in challenging cases, initial accuracy of the needle placement is highly dependent on the radiologist’s experience. Thus, a miniature lightweight guidance device was developed which is capable of assisting a radiologist during the needle placement process.


   The device utilizes an accelerometer to measure the needle’s tilt by calculating a set of orientation angles. This set can be matched with the coordinate system of the CT imaging software during a simple alignment process. After that, the needle’s orientation can be expressed in terms of projected angles in the axial and sagittal planes. The accuracy of the device was evaluated in a phantom study, and initial clinical trials were carried out performing facet joint punctures in a swine cadaver.


   The sensor was embedded in a cube with dimensions of \(2\,\hbox {cm} \times 2\,\hbox {cm} \times 2\,\hbox {cm}\) and a total weight of about 11 g which can be attached to the puncture needle at its rear end or handgrip. A graphical user interface (GUÌ) has been created offering visual real-time orientation guidance. Results of the phantom experiments showed differences between planned target and performed puncture angles of \(0.96^{\circ } \pm 0.76^{\circ }\) for in-plane and \(1.78^{\circ } \pm 1.37^{\circ }\) for out-of-plane punctures.


   The results of the phantom and ex vivo study suggest that the device is useful to assist a radiologist in CT-guided percutaneous punctures and helps navigating the needle with high precision.


Accelerometers Assistive devices  Computed tomography CT-guided intervention  Real-time systems 



The authors want to thank Elmar Junker and Joachim Pfeffer for their support in the hardware design and assembly process of the device.


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Copyright information

© CARS 2014

Authors and Affiliations

  • Christoph Wilkmann
    • 1
  • Nobutake Ito
    • 1
    • 2
  • Tobias Penzkofer
    • 1
    • 3
  • Peter Isfort
    • 1
  • Hong-Sik Na
    • 1
  • Michael Hennes
    • 4
  • Catherine Disselhorst-Klug
    • 4
  • Andreas H. Mahnken
    • 1
    • 5
  • Christiane K. Kuhl
    • 1
  • Philipp Bruners
    • 1
  1. 1.Department of Diagnostic and Interventional RadiologyRWTH Aachen University HospitalAachenGermany
  2. 2.Department of Diagnostic RadiologySchool of Medicine, Keio UniversityTokyo Japan
  3. 3.Surgical Planning Laboratory, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  4. 4.Institute of Applied Medical EngineeringRWTH Aachen UniversityAachenGermany
  5. 5.Department of Diagnostic and Interventional RadiologyUniversity Hospital Marburg, Philipps University MarburgMarburgGermany

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