Helck A, Schumann C, Aumann J, Thierfelder K, Strobl F F, Braunagel M, Niethammer M, Clevert D A, Hoffmann R T, Reiser M, Sandner T, Trumm C
Institute for Clinical Radiology, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany.
Int J Comput Assist Radiol Surg. 2016 Dec;11(12):2199-2205. doi: 10.1007/s11548-015-1349-0. Epub 2016 Jan 25.
To evaluate feasibility of automatic software-based path proposals for CT-guided percutaneous biopsies.
Thirty-three patients (60 [Formula: see text] 12 years) referred for CT-guided biopsy of focal liver lesions were consecutively included. Pre-interventional CT and dedicated software (FraunhoferMeVis Pathfinder) were used for (semi)automatic segmentation of relevant structures. The software subsequently generated three path proposals in downward quality for CT-guided biopsy. Proposed needle paths were compared with consensus proposal of two experts (comparable, less suitable, not feasible). In case of comparable results, equivalent approach to software-based path proposal was used. Quality of segmentation process was evaluated (Likert scale, 1 [Formula: see text] best, 6 [Formula: see text] worst), and time for processing was registered.
All biopsies were performed successfully without complications. In 91 % one of the three automatic path proposals was rated comparable to experts' proposal. None of the first proposals was rated not feasible, and 76 % were rated comparable to the experts' proposal. 7 % automatic path proposals were rated not feasible, all being second choice ([Formula: see text]) or third choice ([Formula: see text]). In 79 %, segmentation at least was good. Average total time for establishing automatic path proposal was 42 [Formula: see text] 9 s.
Automatic software-based path proposal for CT-guided liver biopsies in the majority provides path proposals that are easy to establish and comparable to experts' insertion trajectories.
评估基于软件自动生成CT引导下经皮活检路径建议的可行性。
连续纳入33例(年龄60 [公式:见正文] 12岁)因局灶性肝病变接受CT引导活检的患者。介入前CT和专用软件(弗劳恩霍夫-梅维斯路径探测器)用于相关结构的(半)自动分割。该软件随后生成三条质量递减的CT引导活检路径建议。将建议的针道与两位专家的一致建议进行比较(可比、不太合适、不可行)。如果结果可比,则采用与基于软件的路径建议等效的方法。评估分割过程的质量(李克特量表,1 [公式:见正文] 最佳,6 [公式:见正文] 最差),并记录处理时间。
所有活检均成功完成,无并发症。在91%的病例中,三条自动路径建议中的一条被评为与专家建议可比。没有第一条建议被评为不可行,76%被评为与专家建议可比。7%的自动路径建议被评为不可行,均为第二选择([公式:见正文])或第三选择([公式:见正文])。在79%的病例中,分割至少良好。建立自动路径建议的平均总时间为42 [公式:见正文] 9秒。
大多数情况下,基于软件自动生成的CT引导肝活检路径建议易于建立,且与专家的穿刺轨迹可比。