Ultrasonic Needle Tracking with a Fibre-Optic Ultrasound Transmitter for Guidance of Minimally Invasive Fetal Surgery

  • Wenfeng Xia
  • Sacha Noimark
  • Sebastien Ourselin
  • Simeon J. West
  • Malcolm C. Finlay
  • Anna L. David
  • Adrien E. Desjardins
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 10434)


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 \(0.39 \pm 0.19\) mm and \(1.85 \pm 0.29\) 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.



This work was supported by an Innovative Engineering for Health award by the Wellcome Trust (No. WT101957) and the Engineering and Physical Sciences Research Council (EPSRC) (No. NS/A000027/1), by a Starting Grant from the European Research Council (ERC-2012-StG, Proposal No. 310970 MOPHIM), and by an EPSRC First Grant (No. EP/J010952/1). A.L.D. is supported by the UCL/UCLH NIHR Comprehensive Biomedical Research Centre. The authors are grateful for the technical support provided by Dr. Richard J. Colchester, Dr. Erwin J. Alles and Dr. Sandy Mosse from UCL.


  1. 1.
    Daffos, F., et al.: Fetal blood, sampling during pregnancy with use of a needle guided by ultrasound: a study of 606 consecutive cases. Am. J. Obstet. Gynecol. 153(6), 655–660 (1985)CrossRefGoogle Scholar
  2. 2.
    Agarwal, K., et al.: Pregnancy loss after chorionic villus sampling and genetic amniocentesis in twin pregnancies: a systematic review. Ultras. Obstet. Gynecol. 40(2), 128–134 (2012)CrossRefGoogle Scholar
  3. 3.
    Breyer, B., et al.: Ultrasonically marked catheter-a method for positive echographic catheter position identification. Med. Biol. Eng. Comput. 22(3), 268–271 (1984)CrossRefGoogle Scholar
  4. 4.
    Winsberg, F., et al.: Use of an acoustic transponder for US visualization of biopsy needles. Radiology 180(3), 877–878 (1991)CrossRefMathSciNetGoogle Scholar
  5. 5.
    Mung, J., et al.: Ultrasonically marked instruments for ultrasound-guided interventions. In: IEEE Ultrasonics Symposium (IUS), pp. 2053–2056 (2013)Google Scholar
  6. 6.
    Xia, W., et al.: In-plane ultrasonic needle tracking using a fiber-optic hydrophone. Med. Phys. 42(10), 5983–5991 (2015)CrossRefGoogle Scholar
  7. 7.
    Xia, W., et al.: Interventional photoacoustic imaging of the human placenta with ultrasonic tracking for minimally invasive fetal surgeries. In: Navab, N., Hornegger, J., Wells, W.M., Frangi, A.F. (eds.) MICCAI 2015. LNCS, vol. 9349, pp. 371–378. Springer, Cham (2015). doi: 10.1007/978-3-319-24553-9_46 CrossRefGoogle Scholar
  8. 8.
    Xia, W., et al.: Coded excitation ultrasonic needle tracking: an in vivo study. Med. Phys. 43(7), 4065–4073 (2016)CrossRefGoogle Scholar
  9. 9.
    Xia, W., West, S.J., Mari, J.-M., Ourselin, S., David, A.L., Desjardins, A.E.: 3D ultrasonic needle tracking with a 1.5D transducer array for guidance of fetal interventions. In: Ourselin, S., Joskowicz, L., Sabuncu, M.R., Unal, G., Wells, W. (eds.) MICCAI 2016. LNCS, vol. 9900, pp. 353–361. Springer, Cham (2016). doi: 10.1007/978-3-319-46720-7_41 CrossRefGoogle Scholar
  10. 10.
    Morris, P., et al.: A Fabry-P\(\acute{e}\)rot fiber-optic ultrasonic hydrophone for the simultaneous measurement of temperature and acoustic pressure. J. Acoust. Soc. Am. 125(6), 3611–3622 (2009)CrossRefGoogle Scholar
  11. 11.
    Zhang., E.Z., et al.: A miniature all-optical photoacoustic imaging probe. In: Proceedings of SPIE 7899, pp. 78991F (2011)Google Scholar
  12. 12.
    Mung, J., et al.: Design and in vitro evaluation of a real-time catheter localization system using time of flight measurements from seven 3.5 MHz single element ultrasound transducers towards abdominal aortic aneurysm procedures. Ultrasonics 51(6), 768–775 (2011)CrossRefGoogle Scholar
  13. 13.
    Xia, W., et al.: Performance characteristics of an interventional multispectral photoacoustic imaging system for guiding minimally invasive procedures. J. Biomed. Opt. 20(8), 086005 (2015)CrossRefGoogle Scholar
  14. 14.
    Colchester, R.J., et al.: Laser-generated ultrasound with optical fibres using functionalised carbon nanotube composite coatings. Appl. Phys. Lett. 104(17), 173502 (2014)CrossRefGoogle Scholar
  15. 15.
    Noimark, S., et al.: Carbon-nanotube-PDMS composite coatings on optical fibers for all-optical ultrasound imaging. Adv. Funct. Mater. 26(46), 8390–8396 (2016)CrossRefGoogle Scholar
  16. 16.
    Hill, E.R., et al.: Identification and removal of laser-induced noise in photoacoustic imaging using singular value decomposition. Biomed. Opt. Express 8(1), 275501 (2017)CrossRefGoogle Scholar
  17. 17.
    Treeby, B.E., et al.: k-Wave: MATLAB toolbox for the simulation and reconstruction of photoacoustic wave fields. J. Biomed. Opt. 15(2), 021314 (2010)CrossRefGoogle Scholar
  18. 18.
    David, A.L., et al.: Recombinant adeno-associated virus-mediated in utero gene transfer gives therapeutic transgene expression in the sheep. Hum. Gene Ther. 22, 419–426 (2010)CrossRefGoogle Scholar
  19. 19.
    Piras, D., et al.: Photoacoustic needle: minimally invasive guidance to biopsy. J. Biomed. Opt. 18(7), 070502 (2013)CrossRefGoogle Scholar
  20. 20.
    Mari, J.M., et al.: Interventional multispectral photoacoustic imaging with a clinical ultrasound probe for discriminating nerves and tendons: an ex vivo pilot study. J. Biomed. Opt. 20(11), 110503 (2015)CrossRefGoogle Scholar
  21. 21.
    Guo, X., et al.: Active ultrasound pattern injection system (AUSPIS) for interventional tool guidance. PLoS One 9(10), e104262 (2014)CrossRefGoogle Scholar
  22. 22.
    Kang, H.J., et al.: Needle visualization using photoacoustic effect. In: SPIE BiOS, pp. 93232Y. International Society for Optics and Photonics (2015)Google Scholar
  23. 23.
    Su, J., et al.: Photoacoustic imaging of clinical metal needles in tissue. J. Biomed. Opt. 15(2), 021309 (2010)CrossRefGoogle Scholar
  24. 24.
    Wei, C.W., et al.: Clinically translatable ultrasound/photoacoustic imaging for real-time needle biopsy guidance. In: IEEE International Ultrasonics Symposium (IUS), pp. 839–842 (2014)Google Scholar
  25. 25.
    Singh, M.K.A., et al.: Photoacoustic-guided focused ultrasound for accurate visualization of brachytherapy seeds with the photoacoustic needle. J. Biomed. Opt. 21(12), 120501 (2016)CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Wenfeng Xia
    • 1
  • Sacha Noimark
    • 1
    • 2
  • Sebastien Ourselin
    • 1
  • Simeon J. West
    • 3
  • Malcolm C. Finlay
    • 1
    • 4
  • Anna L. David
    • 5
  • Adrien E. Desjardins
    • 1
  1. 1.Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
  2. 2.Materials Chemistry Research Centre, Department of ChemistryUniversity College LondonLondonUK
  3. 3.Department of AnaesthesiaUniversity College HospitalLondonUK
  4. 4.St Bartholomew’s Hospital and Queen Mary University of LondonLondonUK
  5. 5.Institute for Women’s HealthUniversity College LondonLondonUK

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