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Smartphone-Guided Needle Angle Selection During CT-Guided Procedures.

Sheng Xu1, Venkatesh Krishnasamy1, Elliot Levy1

  • 11 Department of Radiology and Imaging Sciences, National Institutes of Health, Clinical Center, 9000 Rockville Pike, Bldg 10, Rm 1C351, Bethesda, MD 20892.

AJR. American Journal of Roentgenology
|September 28, 2017
PubMed
Summary

An iPhone app aids physicians in CT-guided interventions by providing real-time angle guidance, reducing reliance on visuospatial skills. This mobile-guided approach improves needle insertion accuracy and reduces targeting errors.

Keywords:
CTablationbiopsyimage guidanceinterventionneedle

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Area of Science:

  • Medical Imaging and Interventional Radiology
  • Mobile Health Technology
  • Surgical Navigation

Background:

  • CT-guided interventions traditionally rely on operator visuospatial skills for accurate needle angulation.
  • Estimating and reproducing planned needle insertion angles can be challenging, potentially impacting procedural accuracy and efficiency.

Purpose of the Study:

  • To develop and evaluate an iPhone application designed to assist in CT-guided interventions by providing real-time angulation guidance.
  • To reduce the dependence on subjective visuospatial estimation in needle placement during image-guided procedures.

Main Methods:

  • An iPhone app was developed to overlay planned angles onto the camera display in real-time, utilizing smartphone orientation.
  • Two guidance modes, Guideline and Bull's-Eye View, were implemented for needle angle selection.
  • Phantom studies assessed hardware and mode accuracy, alongside clinical efficacy demonstrated in a proof-of-concept case.

Main Results:

  • The developed hardware demonstrated high accuracy (0.37° ± 0.27°).
  • Combined CT and smartphone guidance significantly improved accuracy for the first needle pass (p = 0.046) compared to CT-only guidance.
  • This led to a substantial reduction in the final targeting error (2.5 mm vs 7.9 mm).

Conclusions:

  • Mobile device technology offers a viable, low-cost solution for enhancing needle-based interventions.
  • The developed app is accurate, effective, and easily implementable, improving procedural outcomes.
  • This approach has the potential to increase precision and reduce errors in image-guided procedures.