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Needle guidance technology for image-guided percutaneous procedures : assessment of clinical applicability and feasibility

Lobbes, M. (2018) Needle guidance technology for image-guided percutaneous procedures : assessment of clinical applicability and feasibility.

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Abstract:During diagnostic and therapeutic interventional radiological procedures, a step-wise approach is often employed during needle positioning, but each adjustment and reinsertion of the needle may increase procedural time, radiation exposure and soft tissue trauma. The use of needle guidance technology (NGT) could be of added value, especially in case of technically challenging target lesions. However, widespread clinical adoption is lacking. In the author's experience, two important factors play a role in this. First, the amount of high-quality evidence showing the added value within clinical practice is limited. The disadvantages of the conventional approach are often emphasized, but the effect on current procedures and the extent to which NGT may improve this, are rarely quantified. This research has contributed by evaluating the efficacy of the freehand approach for a broad spectrum of procedures and targets. The relevance of the improvements associated with adopting NGT seems limited. However, the high accuracy that is provided by NGT could improve the procedural success rates and provide clinical benefit during complex cases. The second factor that plays an important role in the (lack of) adoption of these techniques is that an adequate method to account for the needle positioning errors induced by perprocedural lesion displacements is often lacking, which reduces the feasibility of several (prototypes of) NGT. A method based on end-expiratory gating and biofeedback was proposed to account for the needle tip positioning errors caused by breathing-induced lesion displacements.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/76856
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