Penzkofer Tobias, Bruners Philipp, Isfort Peter, Schoth Felix, Günther Rolf W, Schmitz-Rode Thomas, Mahnken Andreas H
Applied Medical Engineering, Helmholtz-Institute Aachen, RWTH Aachen University, Aachen, Germany.
Minim Invasive Ther Allied Technol. 2011 Jul;20(4):226-33. doi: 10.3109/13645706.2011.553256. Epub 2011 Mar 14.
The purpose of this paper was to evaluate computed tomography (CT) based electromagnetically tip-tracked (EMT) interventions in various clinical applications. An EMT system was utilized to perform percutaneous interventions based on CT datasets. Procedure times and spatial accuracy of needle placement were analyzed using logging data in combination with periprocedurally acquired CT control scans. Dose estimations in comparison to a set of standard CT-guided interventions were carried out. Reasons for non-completion of planned interventions were analyzed. Twenty-five procedures scheduled for EMT were analyzed, 23 of which were successfully completed using EMT. The average time for performing the procedure was 23.7 ± 17.2 min. Time for preparation was 5.8 ± 7.3 min while the interventional (skin-to-target) time was 2.7 ± 2.4 min. The average puncture length was 7.2 ± 2.5 cm. Spatial accuracy was 3.1 ± 2.1 mm. Non-completed procedures were due to patient movement and reference fixation problems. Radiation doses (dosis-length-product) were significantly lower (p = 0.012) for EMT-based interventions (732 ± 481 mGy x cm) in comparison to the control group of standard CT-guided interventions (1343 ± 1054 mGy x cm). Electromagnetic navigation can accurately guide percutaneous interventions in a variety of indications. Accuracy and time usage permit the routine use of the utilized system. Lower radiation exposure for EMT-based punctures provides a relevant potential for dose saving.
本文旨在评估基于计算机断层扫描（CT）的电磁尖端跟踪（EMT）干预在各种临床应用中的效果。利用一个EMT系统基于CT数据集进行经皮干预。结合术中获取的CT对照扫描的日志数据，分析了操作时间和针放置的空间准确性。与一组标准CT引导干预相比，进行了剂量估计。分析了计划干预未完成的原因。分析了计划进行EMT的25例手术，其中23例使用EMT成功完成。手术的平均时间为23.7±17.2分钟。准备时间为5.8±7.3分钟，而介入（皮肤到靶点）时间为2.7±2.4分钟。平均穿刺长度为7.2±2.5厘米。空间准确性为3.1±2.1毫米。未完成的手术是由于患者移动和参考固定问题。与标准CT引导干预的对照组（1343±1054 mGy×cm）相比，基于EMT的干预（732±481 mGy×cm）的辐射剂量（剂量长度乘积）显著更低（p = 0.012）。电磁导航可以准确地引导各种适应症的经皮干预。准确性和时间使用情况允许常规使用所采用的系统。基于EMT的穿刺辐射暴露更低，具有显著的剂量节省潜力。
