Fiber Bragg gratings-based sensing for real-time needle tracking during MR-guided brachytherapy.

PURPOSE: The development of MR-guided high dose rate (HDR) brachytherapy is under investigation due to the excellent tumor and organs at risk visualization of MRI. However, MR-based localization of needles (including catheters or tubes) has inherently a low update rate and the required image interpretation can be hampered by signal voids arising from blood vessels or calcifications limiting the precision of the needle guidance and reconstruction. In this paper, a new needle tracking prototype is investigated using fiber Bragg gratings (FBG)-based sensing: this prototype involves a MR-compatible stylet composed of three optic fibers with nine sets of embedded FBG sensors each. This stylet can be inserted into brachytherapy needles and allows a fast measurement of the needle deflection. This study aims to assess the potential of FBG-based sensing for real-time needle (including catheter or tube) tracking during MR-guided intervention. METHODS: First, the MR compatibility of FBG-based sensing and its accuracy was evaluated. Different known needle deflections were measured using FBG-based sensing during simultaneous MR-imaging. Then, a needle tracking procedure using FBG-based sensing was proposed. This procedure involved a MR-based calibration of the FBG-based system performed prior to the interventional procedure. The needle tracking system was assessed in an experiment with a moving phantom during MR imaging. The FBG-based system was quantified by comparing the gold-standard shapes, the shape manually segmented on MRI and the FBG-based measurements. RESULTS: The evaluation of the MR compatibility of FBG-based sensing and its accuracy shows that the needle deflection could be measured with an accuracy of 0.27 mm on average. Besides, the FBG-based measurements were comparable to the uncertainty of MR-based measurements estimated at half the voxel size in the MR image. Finally, the mean(standard deviation) Euclidean distance between MR- and FBG-based needle position measurements was equal to 0.79 mm(0.37 mm). The update rate and latency of the FBG-based needle position measurement were 100 and 300 ms, respectively. CONCLUSIONS: The FBG-based needle tracking procedure proposed in this paper is able to determine the position of the complete needle, under MR-imaging, with better accuracy and precision, higher update rate, and lower latency compared to current MR-based needle localization methods. This system would be eligible for MR-guided brachytherapy, in particular, for an improved needle guidance and reconstruction.

Performance and suitability assessment of a real-time 3D electromagnetic needle tracking system for interstitial brachytherapy.

PURPOSE: Accurate insertion and overall needle positioning are key requirements for effective brachytherapy treatments. This work aims at demonstrating the accuracy performance and the suitability of the Aurora(®) V1 Planar Field Generator (PFG) electromagnetic tracking system (EMTS) for real-time treatment assistance in interstitial brachytherapy procedures. MATERIAL AND METHODS: The system's performance was characterized in two distinct studies. First, in an environment free of EM disturbance, the boundaries of the detection volume of the EMTS were characterized and a tracking error analysis was performed. Secondly, a distortion analysis was conducted as a means of assessing the tracking accuracy performance of the system in the presence of potential EM disturbance generated by the proximity of standard brachytherapy components. RESULTS: The tracking accuracy experiments showed that positional errors were typically 2 ± 1 mm in a zone restricted to the first 30 cm of the detection volume. However, at the edges of the detection volume, sensor position errors of up to 16 mm were recorded. On the other hand, orientation errors remained low at ± 2° for most of the measurements. The EM distortion analysis showed that the presence of typical brachytherapy components in vicinity of the EMTS had little influence on tracking accuracy. Position errors of less than 1 mm were recorded with all components except with a metallic arm support, which induced a mean absolute error of approximately 1.4 mm when located 10 cm away from the needle sensor. CONCLUSIONS: The Aurora(®) V1 PFG EMTS possesses a great potential for real-time treatment assistance in general interstitial brachytherapy. In view of our experimental results, we however recommend that the needle axis remains as parallel as possible to the generator surface during treatment and that the tracking zone be restricted to the first 30 cm from the generator surface.

Fast, automatic, and accurate catheter reconstruction in HDR brachytherapy using an electromagnetic 3D tracking system.

PURPOSE: In high dose rate brachytherapy (HDR-B), current catheter reconstruction protocols are relatively slow and error prone. The purpose of this technical note is to evaluate the accuracy and the robustness of an electromagnetic (EM) tracking system for automated and real-time catheter reconstruction. METHODS: For this preclinical study, a total of ten catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a 18G biopsy needle, used as an EM stylet and equipped with a miniaturized sensor, and the second generation Aurora(®) Planar Field Generator from Northern Digital Inc. The Aurora EM system provides position and orientation value with precisions of 0.7 mm and 0.2°, respectively. Phantoms were also scanned using a µCT (GE Healthcare) and Philips Big Bore clinical computed tomography (CT) system with a spatial resolution of 89 µm and 2 mm, respectively. Reconstructions using the EM stylet were compared to µCT and CT. To assess the robustness of the EM reconstruction, five catheters were reconstructed twice and compared. RESULTS: Reconstruction time for one catheter was 10 s, leading to a total reconstruction time inferior to 3 min for a typical 17-catheter implant. When compared to the µCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.66 ± 0.33 mm and 1.08 ± 0.72 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be more accurate. A maximum difference of less than 0.6 mm was found between successive EM reconstructions. CONCLUSIONS: The EM reconstruction was found to be more accurate and precise than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators.