SIR 2024
Interventional Oncology
Tabea Borde, MD, PhD
Clinical Research Fellow
National Institutes of Health
Financial relationships: Full list of relationships is listed on the CME information page.
Laetitia Saccenti, MD (she/her/hers)
Research Fellow
National Institutes of Health
Financial relationships: Full list of relationships is listed on the CME information page.
Lindsey Hazen, Clinical Nurse
Clinical Research Nurse
National Institutes of Health
Disclosure information not submitted.
Ifechi Ukeh, MD
Deputy Chief, Interventional Radiology
National Institutes of Health
Financial relationships: Full list of relationships is listed on the CME information page.
Keith M. Horton, MD, RPVI, FSIR (he/him/his)
Associate Professor of Radiology
MedStar Washington Hospital Center/ Georgetown University School of Medicine
Disclosure information not submitted.
Jose F. Delgado, PhD Candidate (he/him/his)
Graduate student
National Institutes of Health, Clinical Center/ Fischell Department of Bioengineering,University of Maryland - College Park
Disclosure information not submitted.
Sheng Xu, PhD
Staff Scientist
National Institutes of Health Clinical Center
Financial relationships: Full list of relationships is listed on the CME information page.
William Pritchard, MD, PhD
Medical Officer
National Institutes of Health Clinical Center
Disclosure information not submitted.
John Karanian, PhD
Staff Scientist
National Institutes of Health, Clinical Center
Disclosure information not submitted.
Bradford J. Wood, MD, FSIR
Director NIH Center for IO, Chief IR
NIH
Financial relationships: Full list of relationships is listed on the CME information page.
Six interventional radiologists each performed 24 independent needle placements in an anthropomorphic phantom (CIRS 057A) in 4 needle-guidance cohorts (n=6 each): 1. US-based fusion, 2. goggle-based AR with holographic anatomical overlay (AR-overlay), 3. goggle-AR without the overlay (AR-plain), and 4. CT-guided freehand. US-based fusion included US/CT registration with electromagnetic (EM) needle, transducer, and patient tracking. For AR-overlay, US, EM tracked needle, holographic anatomical structures and targets were superimposed over the phantom. Needle placement accuracy (distance from needle tip to target center), placement time (from skin puncture to final position), and procedure time (time to completion) were measured.
Results: Mean needle placement accuracy using US-based fusion, AR-overlay, AR-plain, and freehand was 4.5±1.7mm, 7.0±4.7mm, 4.7±1.7mm, and 9.2±5.8mm, respectively. AR-plain demonstrated comparable accuracy to US-based fusion (p=0.7) and AR-overlay (p=0.06). Excluding two outliers, AR-overlay accuracy was 5.9 ± 2.6 mm. US-based fusion had the highest mean placement time (44.3±27.7sec) compared to all navigation cohorts (p< 0.001). Longest procedure times were recorded with AR-overlay (34±10min) compared to AR-plain (22.7±8.6min, p=0.08), US-based fusion (19.5±5.5min, p=0.02), and freehand (14.8±1.5min, p=0.002).
Conclusion: Goggle-based AR showed needle placement accuracy comparable to the commercially available US-based fusion. Small differences in accuracy and procedure times were apparent with different display modes (with or without holographic overlay). An AR-based projection of the US and needle trajectory over the body may be a helpful tool to enhance visuospatial orientation.