Three-Dimensional Endovascular Navigation With Electromagnetic Tracking: Ex Vivo and In Vivo Accuracy

• Published in: Journal of endovascular therapy 2011-04, Vol.18 (2), p.230-240
• Main Authors: Manstad-Hulaas, Frode, Tangen, Geir Arne, Gruionu, Lucian Gheorghe, Aadahl, Petter, Hernes, Toril A. N.
• Format: Article
• Language: English
• Subjects: Accuracy; Animals; Aortic Aneurysm, Thoracic - diagnostic imaging; Aortic Aneurysm, Thoracic - surgery; Catheters; Electromagnetic Phenomena; Endovascular Procedures - instrumentation; Equipment Design; Feasibility studies; Imaging, Three-Dimensional - instrumentation; Medical imaging; Medical technology; Models, Animal; Navigation systems; Phantoms, Imaging; Radiographic Image Interpretation, Computer-Assisted - instrumentation; Reproducibility of Results; Surgery; Surgery, Computer-Assisted - instrumentation; Sus scrofa; Tomography, X-Ray Computed - instrumentation; Veins & arteries
• ISSN: 1526-6028; 1545-1550
• DOI: 10.1583/10-3301.1

Purpose To evaluate the accuracy of a 3-dimensional (3D) navigation system using electromagnetically tracked tools to explore its potential in patients. Methods The 3D navigation accuracy was quantified on a phantom and in a porcine model using the same setup and vascular interventional suite. A box-shaped phantom with 16 markers was scanned in 5 different positions using computed tomography (CT). The 3D navigation system registered each CT volume in the magnetic field. A tracked needle was pointed at the physical markers, and the spatial distances between the tracked needle positions and the markers were calculated. Contrast-enhanced CT images were acquired from 6 swine. The 3D navigation system registered each CT volume in the magnetic field. An electromagnetically tracked guidewire and catheter were visualized in the 3D image and navigated to 4 specified targets. At each target, the spatial distance between the tracked guidewire tip position and the actual position, verified by a CT control, was calculated. Results The mean accuracy on the phantom was 1.28±0.53 mm, and 90% of the measured distances were ≤1.90 mm. The mean accuracy in swine was 4.18±1.76 mm, and 90% of the measured distances were ≤5.73 mm. Conclusion This 3D navigation system demonstrates good ex vivo accuracy and is sufficiently accurate in vivo to explore its potential for improved endovascular navigation.