Navigation-based needle puncture of a cadaver using a hybrid tracking navigational system

Purpose: The purpose of this study was to determine the puncture accuracy of a navigational system, Medarpa, in a soft tissue environment using augmented overlay imaging. Materials and Methods: Medarpa is an optical electromagnetic tracking system, which allows tracking of instruments, the radiologist's head position, and the transparent display. The display superimposes a computed tomography scan of a cadaver chest on a human cadaver in real time. In group A, needle puncture was performed using the Medarpa system. Three targets located inside the cadaver chest were selected. In group 13, the same targets were used to perform standard computed tomography-guided puncture using a single-slice technique. A total of 42 punctures were performed in each group. Postpuncture computed tomography scans were made to verify needle tip positions. Results: Mean deviation from targets was 8.42 min +/- 1.78 mm for group A and 8.90 mm +/- 1.71 mm for group B. No significant difference was found between group A and B in any target (P > 0.05). No significant difference was found between the targets of the same group (P > 0.05). Procedural time for 42 punctures was 160 minutes in group A versus 289 minutes in group B (P < 0.05). Conclusion: Needle puncture in a soft tissue environment using the navigational system Medarpa can be reliably performed and matches the accuracy achieved by a computed tomography-guided puncture technique.