Preoperative trajectory planning for percutaneous procedures in deformable environments.

Area of Science:

• Medical Imaging and Image-Guided Therapy
• Computational Mechanics
• Surgical Planning

Background:

• Precise needle path planning is crucial for successful image-guided percutaneous interventions.
• Existing methods may not fully account for needle and soft tissue deformation during insertion.
• Tissue motion and needle bending present significant challenges in reaching surgical targets.

Purpose of the Study:

• To develop a novel method for computing patient-specific optimal needle trajectories.
• To account for needle deformation and soft tissue response during percutaneous interventions.
• To enable accurate targeting in the presence of tissue motion and needle bending.

Main Methods:

• An optimization method was developed to estimate preoperative curved trajectories.
• Needle insertions were simulated using a flexible needle model and finite element modeling of soft tissues.
• The planning algorithm was coupled with a fast needle insertion simulation.

Main Results:

• The algorithm was successfully tested on twelve patient-specific geometries.
• Fast convergence to the optimal solution was achieved.
• The method proved effective for the use-case of thermal ablation of liver tumors.

Conclusions:

• The proposed method provides a robust approach for planning optimal needle paths in image-guided interventions.
• It effectively addresses challenges posed by tissue deformation and needle bending.
• The technique is adaptable to a wide range of percutaneous procedures.