Acoustic reflector-enabled forward-viewing ultrasound image-guided access

Area of Science:

• Medical Imaging
• Surgical Technology
• Biomedical Engineering

Background:

• Ultrasound (US) image-guided needle access in surgery, like percutaneous nephrolithotomy, struggles with maintaining needle tip visibility due to misalignment between the US image and the needle.
• Current methods lack guaranteed alignment, complicating precise needle insertion and potentially affecting procedural success.

Purpose of the Study:

• To develop and evaluate a novel needle insertion mechanism with reflector-integrated US imaging for enhanced needle guidance.
• To achieve mechanical alignment between the US image plane and the needle for intuitive, forward-viewing access.
• To improve needle tip visibility and accuracy during insertion in surgical procedures.

Main Methods:

• An acoustic reflector was integrated to redirect the US image plane, aligning it with the needle path through a slit in the reflector.
• The needle holder and reflector were designed to be rotatable, allowing clinicians to optimize needle insertion orientation.
• Needle tip visibility was assessed in water and ex vivo tissue, and access accuracy was evaluated using X-ray imaging of targets in gelatin.

Main Results:

• The slit in the reflector minimally impacted post-reflection ultrasound image quality.
• Consistent needle tip visibility was achieved in both water and ex vivo beef tissue, quantified by signal-to-noise ratio.
• The mechanism demonstrated high accuracy, with an average needle insertion error of less than 3 mm.

Conclusions:

• The reflector-enabled, forward-viewing US image-guided access mechanism shows significant clinical potential.
• This technology offers a more intuitive and accurate approach to needle insertion for various surgical applications.
• The findings support the integration of this system into clinical practice for improved surgical outcomes.