Minho Lee PhD, Abstract Co-Author: Nothing to Disclose

Namkug Kim PhD, Presenter: Stockholder, Coreline Soft, Inc

Joon Beom Seo MD, PhD, Abstract Co-Author: Nothing to Disclose

Sang Min Lee MD, Abstract Co-Author: Nothing to Disclose

Recently, image based biopsy has been popular, because CT fluoroscopy or C-arm fluoroscopy imaging modality is becoming accurate and fast, by which the trajectory of biopsy needle can be guided and planned. Therefore, we proposed the automatic biopsy planning method to find minimally invasive insertion trajectory of biopsy needle in the pre-operation stage of volumetric chest CT. 

Volumetric CT scans of twenty lung biopsy patients were performed. At first, semi-automatic multi-organ segmentation including rib-bone, airway, pulmonary vessels, heart, skin, and soft tissue were performed with in-house software. Then, distance maps from critical organs including lung boundary, peripheral of rib-bone, airway, pulmonary vessels, and heart and set 2mm as a safety margin from possible needle trajectory were generated. In addition, shortest and near vertical trajectory from skin to target lesion picked by the physician were evaluated. Finally, the minimally invasive insertion trajectory which collide the fewest number of pulmonary vessels less than 2mm in the 3D cone with 30° around the trajectory was evaluated. This trajectory was compared with manually determined trajectory by a physician. The trajectories of 2, 2, and 12 cases in the shortest trajectories, near vertical trajectories, manually determined trajectory by a physician, respectively were within 2mm of critical organs. The pulmonary vessel invasiveness less than 2mm were 0.25±0.57mm, 0.03±0.13mm, and 6.35±4.55mm (mean ± SD) in the shortest trajectories, near vertical trajectories, manually determined trajectory by a physician (all p-values < 0.001, paired t-test).

This insertion trajectory planning which depends on the experience of a physician could be determination by the quantitative degree of invasiveness, such as blood vessels invasiveness and distance from virtual walls. 

This method could be used for planning minimally invasive biopsy trajectory based on the quantitative degree of invasiveness, such as blood vessels invasiveness and distance from virtual walls. 

http://abstract.rsna.org/uploads/2014/14018316/14018316_jq9j.jpg

Lee, M, Kim, N, Seo, J, Lee, S, Planning Software of Minimally Invasive Needle Trajectory for Lung Biopsy in 3D Volumetric Chest CT: Considering Quantitative Pulmonary Vessels Invasiveness and Distance from Virtual Walls.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018316.html