Real-Time 3D fluoroscopy guidance during needle interventions: technique, accuracy, and feasibility

Area of Science:

• Medical Imaging
• Interventional Radiology
• Surgical Navigation

Background:

• Real-time 3D fluoroscopy with cone beam CT (CBCT) and needle path planning software represents an advancement in interventional radiology.
• This technology integrates fluoroscopy with 3D datasets for precise needle guidance.

Purpose of the Study:

• To evaluate the procedural aspects of real-time 3D fluoroscopy guidance.
• To assess the accuracy and feasibility of this technique for various needle interventions.

Main Methods:

• Procedures utilized a flat-panel fluoroscopy system with CBCT capabilities and specialized needle path-planning software.
• Needle trajectories were planned in 3D datasets and projected onto real-time fluoroscopy images.
• Data collected included fluoroscopy time, accuracy, technical success, procedure time, and complications for 145 interventions.

Main Results:

• 145 needle interventions were performed across five anatomic regions, including thoracic, abdominal, and musculoskeletal areas.
• All procedures achieved 100% technical success within a 5-mm safety margin.
• Median procedure time was 28.5 minutes, median fluoroscopy time was 2 minutes 58 seconds, with a low complication rate (4.3% minor, 0.7% major).

Conclusions:

• Real-time 3D fluoroscopy guidance is a feasible and promising technique for needle interventions.
• The method provides high accuracy and successful outcomes in diagnostic biopsies and therapeutic procedures.