Towards Seamless Integration of Magnetic Tracking Into Fluoroscopy-Guided Interventions

Area of Science:

• Medical Imaging and Interventional Radiology
• Biomedical Engineering
• Surgical Navigation Technologies

Background:

• Fluoroscopy-guided interventions suffer from limited depth perception and high radiation exposure due to 2D imaging.
• Integrating magnetic tracking (MT) offers potential solutions but faces integration and accuracy challenges.
• Current research and practice have under-explored seamless MT integration into fluoroscopy workflows.

Purpose of the Study:

• To develop and evaluate a radiolucent magnetic field generator (FG) prototype for seamless magnetic tracking integration in fluoroscopy-guided interventions.
• To address technical challenges in C-arm pose estimation, fluoro-CT registration, and 3D navigation for enhanced interventional accuracy.
• To demonstrate the clinical applicability and efficacy of MT-assisted navigation in a representative endoleak repair phantom study.

Main Methods:

• Designed a two-layer radiolucent FG mounting frame for C-arm X-ray system compatibility.
• Incorporated external aluminum fiducials to facilitate accurate C-arm pose estimation and robust fluoro-CT registration.
• Evaluated MT accuracy with fiducials and C-arm presence, assessed fluoro-CT registration accuracy, and performed a phantom insertion experiment for endoleak repair.

Main Results:

• Experimental evaluation confirmed no clinically significant impact of aluminum fiducials or the C-arm on MT accuracy.
• Achieved high accuracy (mean projection distance ≈ 0.7 mm), robustness, and generalizability in fluoro-CT registration.
• Demonstrated needle insertion accuracy between 2-3 mm in a phantom study using real-time 2D and 3D navigation.

Conclusions:

• The developed radiolucent FG and integrated MT approach are effective and clinically applicable for fluoroscopy-guided interventions.
• This study represents the first integration of a radiolucent FG into a fluoroscopy-guided workflow, paving the way for improved interventional procedures.
• The proposed methods overcome key technical challenges, enhancing navigation accuracy and potentially reducing radiation exposure in interventional radiology.