Comparison of freehand-navigated and aiming device-navigated targeting of liver lesions

Wallach, Daphné Alice; Toporek, Grzegorz Andrzej; Weber, Stefan; Bale, Reto; Widmann, Gerlig (2014). Comparison of freehand-navigated and aiming device-navigated targeting of liver lesions. International journal of medical robotics and computer assisted surgery, 10(1), pp. 35-43. Wiley 10.1002/rcs.1505

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BACKGROUND
Accurate needle placement is crucial for the success of percutaneous radiological needle interventions. We compared three guiding methods using an optical-based navigation system: freehand, using a stereotactic aiming device and active depth control, and using a stereotactic aiming device and passive depth control.

METHODS
For each method, 25 punctures were performed on a non-rigid phantom. Five 1 mm metal screws were used as targets. Time requirements were recorded, and target positioning errors (TPE) were measured on control scans as the distance between needle tip and target.

RESULTS
Time requirements were reduced using the aiming device and passive depth control. The Euclidian TPE was similar for each method (4.6 ± 1.2-4.9 ± 1.7 mm). However, the lateral component was significantly lower when an aiming device was used (2.3 ± 1.3-2.8 ± 1.6 mm with an aiming device vs 4.2 ± 2.0 mm without).

DISCUSSION
Using an aiming device may increase the lateral accuracy of navigated needle insertion.

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