Renal biopsy under augmented reality guidance.

Kidney biopsies are currently performed using preoperative imaging to identify the lesion of interest and intraoperative imaging used to guide the biopsy needle to the tissue of interest. Often, these are not the same modalities forcing the physician to perform a mental cross-modality fusion of the preoperative and intraoperative scans. This limits the accuracy and reproducibility of the biopsy procedure. In this study, we developed an augmented reality system to display holographic representations of lesions superimposed on a phantom. This system allows the integration of preoperative CT scans with intraoperative ultrasound scans to better determine the lesion's real-time location. An automated deformable registration algorithm was used to increase the accuracy of the holographic lesion locations, and a magnetic tracking system was developed to provide guidance for the biopsy procedure. Our method achieved a targeting accuracy of 2.9 ± 1.5 mm in a renal phantom study.

A complex dual-modality kidney phantom for renal biopsy studies.

We developed a reliable and repeatable process to create hyper-realistic, kidney phantoms with tunable image visibility under ultrasound (US) and CT imaging modalities. A methodology was defined to create phantoms that could be produced for renal biopsy evaluation. The final complex kidney phantom was devised containing critical structures of a kidney: kidney cortex, medulla, and ureter. Simultaneously, some lesions were integrated into the phantom to mimic the presence of tumors during biopsy. The phantoms were created and scanned by ultrasound and CT scanners to verify the visibility of the complex internal structures and to observe the interactions between material properties. The result was a successful advancement in knowledge of materials with ideal acoustic and impedance properties to replicate human organs for the field of image-guided interventions.