Advantages of Ultrasound and Needle Tip Tracking Technology Include High Technical Success and Accuracy

SUMMARY & METHODS

In this clinical investigation, the authors conduct a study to evaluate the accuracy and safety of electromagnetic needle tracking for use during ultrasound-guided percutaneous liver biopsy. Using a 16-gauge eTRAX™ Needle Tip Tracking System (CIVCO Medical Solutions, Kalona, IA) as a cannula, two 18-gauge tissue cores were retrieved using an automated biopsy needle (Cook, Bloomington, IN) and an ultrasound system with positioning sensor technology (GE Healthcare LOGIQ E9, Chalfont St. Giles, UK). In total, 23 liver biopsy procedures were performed. The majority of the procedures were completed using an in-plane approach, however, the out-of-plane approach was utilized during cases deemed inconvenient or unsafe for the traditional method.

Data was gathered during each case to evaluate the feasibility, accuracy, usefulness and safety of electromagnetic guidance with needle tip sensor technology for US-guided liver biopsy.

DISCUSSION & RESULTS

The use of ultrasound as the modality of choice for percutaneous liver biopsy is increasing in popularity due to improvements in imaging quality and device technology and the overall low cost and invasiveness of the procedure. The primary difficulties with performing US-guided biopsy is the ability to maintain constant visualization of the needle tip throughout the procedure, to predict the path the needle will take as it advances toward a lesion and the lack of access to an accurate out-of-plane method of approach.

The accuracy of the electromagnetic needle tip tracking system to the actual device needle tip is proven to be approximately 2mm. The median total procedure time was 30 seconds; not significantly different due to tumor size, location, depth or operator experience and approach. Set-up time for the additional guidance system hardware and needle sensor was approximately 2 minutes.

CONCLUSIONS

In this study, the authors prove the advantages of using ultrasound guidance in combination with an electromagnetic needle tip tracking system to be:

• High technical success
• High accuracy
• Low complication rate
• Easy operation.