Steerable needles for radio-frequency ablation in cirrhotic livers

被引:9
作者
van de Berg, Nick J. [1 ,2 ]
Meeuwsen, Frederique C. [3 ]
Doukas, Michail [3 ]
Kronreif, Gernot [4 ]
Moelker, Adriaan [2 ]
van den Dobbelsteen, John J. [1 ]
机构
[1] Delft Univ Technol, Dept Biomech Engn, Mekelweg 2, NL-2628 CD Delft, Netherlands
[2] Erasmus MC, Univ Med Ctr, Dept Radiol & Nucl Med, Rotterdam, Netherlands
[3] Erasmus MC, Univ Med Ctr, Dept Pathol, Rotterdam, Netherlands
[4] Austrian Ctr Med Innovat & Technol, Wiener Neustadt, Austria
基金
荷兰研究理事会;
关键词
HEPATIC RESECTION;
D O I
10.1038/s41598-020-77869-3
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Accurate needle placement in deep-seated liver tumours can be difficult. In this work, we disclose two new manually controlled steerable needles for 17G radio-frequency ablation probe placement. The needles contain stylets with embedded compliant joints for active tip articulations, and concentric tubes for (curved-path) guidance. Needle steering was evaluated sequentially by intended users and in intended-use tissue types. Six interventional radiologists evaluated the needle in repeated ultrasound-guided steering tasks in liver-mimicking phantoms. Targets were located at a 100 mm depth and 20 mm lateral offset from the initial insertion line. The resulting mean absolute tip placement error was 1.0 +/- 1.0 mm. Subsequently, steering-induced tissue damage was evaluated in fresh cirrhotic human liver explants. The surface area of puncture holes was estimated in scanned histology slides, using a connected-components analysis. The mean surface area was 0.26 +/- 0.16 mm(2) after steering with a median radius of curvature of 0.7 x 10(3) mm, versus 0.35 +/- 0.15 mm(2) after straight-path insertions with the steerable needle and 0.15 +/- 0.09 mm(2) after straight-path RFA probe insertions. The steering mechanisms proposed enable clinically relevant path corrections for 17G needles. Radiologists were quickly adept in curved-path RFA probe placement and the evaluation of histological tissue damage demonstrated a potentially safe use during liver interventions.
引用
收藏
页数:9
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