Reduced-Dose Imageless Needle and Patient Tracking in Interventional CT Procedures

This paper describes a new method for imageless needle and patient tracking in interventional CT procedures based on fractional CT scanning. Our method accurately locates a needle with a spherical marker attached to it at a known distance from the tip with respect to the patient in the CT scanner coordinate frame with online sparse scan sampling and without reconstructing the CT image. The key principle of our method is to detect the needle and attached spherical marker in projection (sinogram) space based on the strongly attenuated X-ray signal due to the metallic composition of the needle and the needle's thin cylindrical geometry, and based on the marker's spherical geometry. A transformation from projection space to physical space uniquely determines the location and orientation of the needle and the needle tip position. Our method works directly in projection space and simultaneously performs patient registration and needle localization for every fractional CT scanning acquisition using the same sparse set of views. We performed registration and needle tip localization in five abdomen phantom scans using a rigid needle, and obtained a voxel-size tip localization error. Our experimental results indicate a voxel-sized deviation of the localization from a comparable method in 3-D image space, with the benefit of allowing X-ray dose reduction via fractional scanning at each localization. This benefit enables more frequent tip localizations during needle insertion for a similar total dose, or a reduced total dose for the same frequency of tip localization.