MR image overlay guidance: System evaluation for preclinical use

Paweena U-Thainual, Jan Fritz, Choladawan Moonjaita, Tamas Ungi, Aaron Flammang, John A. Carrino, Gabor Fichtinger, Iulian Iordachita

Research output: Contribution to journalArticle

Abstract

Purpose: A clinical augmented reality guidance system was developed for MRI-guided musculoskeletal interventions Magnetic Resonance Image Overlay System (MR-IOS). The purpose of this study was to assess MRI compatibility, system accuracy, technical efficacy, and operator performance of the MR-IOS. Methods and materials: The impact of the MR-IOS on the MR environment was assessed by measuring image quality with signal-to-noise ratio (SNR) and signal intensity uniformity with the system in various on/off states. The system accuracy was assessed with an in-room preclinical experiment by performing 62 needle insertions on a spine phantom by an expert operator measuring entry, depth, angle, and target errors. Technical efficacy and operator performance were tested in laboratory by running an experiment with 40 novice operators (20 using freehand technique versus 20 MR-IOS-guided) with each operator inserting 10 needles into a geometric phantom. Technical efficacy was measured by comparing the success rates of needle insertions between the two operator groups. Operator performance was assessed by comparing total procedure times, total needle path distance, presumed tissue damage, and speed of individual insertions between the two operator groups. Results: The MR-IOS maximally altered SNR by 2% with no perceptible change in image quality or uniformity. Accuracy assessment showed mean entry error of 1.6 ± 0.6 mm, depth error of 0.7 ± 0.5 mm, angle error of 1.5 ± 1.1, and target error of 1.9 ± 0.8 mm. Technical efficacy showed a statistically significant difference (p = 0.031) between success rates (freehand 35.0% vs. MR-IOS 80.95%). Operator performance showed: mean total procedure time of 40.3 ± 4.4 (s) for freehand and 37.0 ± 3.7 (s) for MR-IOS (p = 0.584), needle path distances of 152.6 ± 15.0 mm for freehand and 116.9 ± 8.7 mm for MR-IOS (p = 0.074), presumed tissue damage of 7,417.2 ± 955.6 mm2 for freehand and 6062.2 ± 678.5 mm2 for MR-IOS (p = 0.347), and speed of insertion 5.9 ± 0.4 mm/s for freehand and 4.3 ± 0.3 mm/s for MR-IOS (p = 0.003). Conclusion: The MR-IOS is compatible within a clinical MR imaging environment, accurate for needle placement, technically efficacious, and improves operator performance over the unassisted insertion technique. The MR-IOS was found to be suitable for further testing in a clinical setting.

Original languageEnglish (US)
Pages (from-to)365-378
Number of pages14
JournalInternational journal of computer assisted radiology and surgery
Volume8
Issue number3
DOIs
StatePublished - May 2013

Fingerprint

Magnetic resonance
Magnetic Resonance Spectroscopy
Needles
Signal-To-Noise Ratio
Magnetic resonance imaging
Image quality
Signal to noise ratio
Tissue
Augmented reality
Spine
Experiments
Imaging techniques

Keywords

  • Augmented reality
  • Image overlay
  • Needle guidance
  • Percutaneous interventions

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Health Informatics
  • Surgery

Cite this

MR image overlay guidance : System evaluation for preclinical use. / U-Thainual, Paweena; Fritz, Jan; Moonjaita, Choladawan; Ungi, Tamas; Flammang, Aaron; Carrino, John A.; Fichtinger, Gabor; Iordachita, Iulian.

In: International journal of computer assisted radiology and surgery, Vol. 8, No. 3, 05.2013, p. 365-378.

Research output: Contribution to journalArticle

U-Thainual, P, Fritz, J, Moonjaita, C, Ungi, T, Flammang, A, Carrino, JA, Fichtinger, G & Iordachita, I 2013, 'MR image overlay guidance: System evaluation for preclinical use', International journal of computer assisted radiology and surgery, vol. 8, no. 3, pp. 365-378. https://doi.org/10.1007/s11548-012-0788-0
U-Thainual, Paweena ; Fritz, Jan ; Moonjaita, Choladawan ; Ungi, Tamas ; Flammang, Aaron ; Carrino, John A. ; Fichtinger, Gabor ; Iordachita, Iulian. / MR image overlay guidance : System evaluation for preclinical use. In: International journal of computer assisted radiology and surgery. 2013 ; Vol. 8, No. 3. pp. 365-378.
@article{15c1dc723f224b3792e38e8d52b0ce77,
title = "MR image overlay guidance: System evaluation for preclinical use",
abstract = "Purpose: A clinical augmented reality guidance system was developed for MRI-guided musculoskeletal interventions Magnetic Resonance Image Overlay System (MR-IOS). The purpose of this study was to assess MRI compatibility, system accuracy, technical efficacy, and operator performance of the MR-IOS. Methods and materials: The impact of the MR-IOS on the MR environment was assessed by measuring image quality with signal-to-noise ratio (SNR) and signal intensity uniformity with the system in various on/off states. The system accuracy was assessed with an in-room preclinical experiment by performing 62 needle insertions on a spine phantom by an expert operator measuring entry, depth, angle, and target errors. Technical efficacy and operator performance were tested in laboratory by running an experiment with 40 novice operators (20 using freehand technique versus 20 MR-IOS-guided) with each operator inserting 10 needles into a geometric phantom. Technical efficacy was measured by comparing the success rates of needle insertions between the two operator groups. Operator performance was assessed by comparing total procedure times, total needle path distance, presumed tissue damage, and speed of individual insertions between the two operator groups. Results: The MR-IOS maximally altered SNR by 2{\%} with no perceptible change in image quality or uniformity. Accuracy assessment showed mean entry error of 1.6 ± 0.6 mm, depth error of 0.7 ± 0.5 mm, angle error of 1.5 ± 1.1, and target error of 1.9 ± 0.8 mm. Technical efficacy showed a statistically significant difference (p = 0.031) between success rates (freehand 35.0{\%} vs. MR-IOS 80.95{\%}). Operator performance showed: mean total procedure time of 40.3 ± 4.4 (s) for freehand and 37.0 ± 3.7 (s) for MR-IOS (p = 0.584), needle path distances of 152.6 ± 15.0 mm for freehand and 116.9 ± 8.7 mm for MR-IOS (p = 0.074), presumed tissue damage of 7,417.2 ± 955.6 mm2 for freehand and 6062.2 ± 678.5 mm2 for MR-IOS (p = 0.347), and speed of insertion 5.9 ± 0.4 mm/s for freehand and 4.3 ± 0.3 mm/s for MR-IOS (p = 0.003). Conclusion: The MR-IOS is compatible within a clinical MR imaging environment, accurate for needle placement, technically efficacious, and improves operator performance over the unassisted insertion technique. The MR-IOS was found to be suitable for further testing in a clinical setting.",
keywords = "Augmented reality, Image overlay, Needle guidance, Percutaneous interventions",
author = "Paweena U-Thainual and Jan Fritz and Choladawan Moonjaita and Tamas Ungi and Aaron Flammang and Carrino, {John A.} and Gabor Fichtinger and Iulian Iordachita",
year = "2013",
month = "5",
doi = "10.1007/s11548-012-0788-0",
language = "English (US)",
volume = "8",
pages = "365--378",
journal = "Computer-Assisted Radiology and Surgery",
issn = "1861-6410",
publisher = "Springer Verlag",
number = "3",

}

TY - JOUR

T1 - MR image overlay guidance

T2 - System evaluation for preclinical use

AU - U-Thainual, Paweena

AU - Fritz, Jan

AU - Moonjaita, Choladawan

AU - Ungi, Tamas

AU - Flammang, Aaron

AU - Carrino, John A.

AU - Fichtinger, Gabor

AU - Iordachita, Iulian

PY - 2013/5

Y1 - 2013/5

N2 - Purpose: A clinical augmented reality guidance system was developed for MRI-guided musculoskeletal interventions Magnetic Resonance Image Overlay System (MR-IOS). The purpose of this study was to assess MRI compatibility, system accuracy, technical efficacy, and operator performance of the MR-IOS. Methods and materials: The impact of the MR-IOS on the MR environment was assessed by measuring image quality with signal-to-noise ratio (SNR) and signal intensity uniformity with the system in various on/off states. The system accuracy was assessed with an in-room preclinical experiment by performing 62 needle insertions on a spine phantom by an expert operator measuring entry, depth, angle, and target errors. Technical efficacy and operator performance were tested in laboratory by running an experiment with 40 novice operators (20 using freehand technique versus 20 MR-IOS-guided) with each operator inserting 10 needles into a geometric phantom. Technical efficacy was measured by comparing the success rates of needle insertions between the two operator groups. Operator performance was assessed by comparing total procedure times, total needle path distance, presumed tissue damage, and speed of individual insertions between the two operator groups. Results: The MR-IOS maximally altered SNR by 2% with no perceptible change in image quality or uniformity. Accuracy assessment showed mean entry error of 1.6 ± 0.6 mm, depth error of 0.7 ± 0.5 mm, angle error of 1.5 ± 1.1, and target error of 1.9 ± 0.8 mm. Technical efficacy showed a statistically significant difference (p = 0.031) between success rates (freehand 35.0% vs. MR-IOS 80.95%). Operator performance showed: mean total procedure time of 40.3 ± 4.4 (s) for freehand and 37.0 ± 3.7 (s) for MR-IOS (p = 0.584), needle path distances of 152.6 ± 15.0 mm for freehand and 116.9 ± 8.7 mm for MR-IOS (p = 0.074), presumed tissue damage of 7,417.2 ± 955.6 mm2 for freehand and 6062.2 ± 678.5 mm2 for MR-IOS (p = 0.347), and speed of insertion 5.9 ± 0.4 mm/s for freehand and 4.3 ± 0.3 mm/s for MR-IOS (p = 0.003). Conclusion: The MR-IOS is compatible within a clinical MR imaging environment, accurate for needle placement, technically efficacious, and improves operator performance over the unassisted insertion technique. The MR-IOS was found to be suitable for further testing in a clinical setting.

AB - Purpose: A clinical augmented reality guidance system was developed for MRI-guided musculoskeletal interventions Magnetic Resonance Image Overlay System (MR-IOS). The purpose of this study was to assess MRI compatibility, system accuracy, technical efficacy, and operator performance of the MR-IOS. Methods and materials: The impact of the MR-IOS on the MR environment was assessed by measuring image quality with signal-to-noise ratio (SNR) and signal intensity uniformity with the system in various on/off states. The system accuracy was assessed with an in-room preclinical experiment by performing 62 needle insertions on a spine phantom by an expert operator measuring entry, depth, angle, and target errors. Technical efficacy and operator performance were tested in laboratory by running an experiment with 40 novice operators (20 using freehand technique versus 20 MR-IOS-guided) with each operator inserting 10 needles into a geometric phantom. Technical efficacy was measured by comparing the success rates of needle insertions between the two operator groups. Operator performance was assessed by comparing total procedure times, total needle path distance, presumed tissue damage, and speed of individual insertions between the two operator groups. Results: The MR-IOS maximally altered SNR by 2% with no perceptible change in image quality or uniformity. Accuracy assessment showed mean entry error of 1.6 ± 0.6 mm, depth error of 0.7 ± 0.5 mm, angle error of 1.5 ± 1.1, and target error of 1.9 ± 0.8 mm. Technical efficacy showed a statistically significant difference (p = 0.031) between success rates (freehand 35.0% vs. MR-IOS 80.95%). Operator performance showed: mean total procedure time of 40.3 ± 4.4 (s) for freehand and 37.0 ± 3.7 (s) for MR-IOS (p = 0.584), needle path distances of 152.6 ± 15.0 mm for freehand and 116.9 ± 8.7 mm for MR-IOS (p = 0.074), presumed tissue damage of 7,417.2 ± 955.6 mm2 for freehand and 6062.2 ± 678.5 mm2 for MR-IOS (p = 0.347), and speed of insertion 5.9 ± 0.4 mm/s for freehand and 4.3 ± 0.3 mm/s for MR-IOS (p = 0.003). Conclusion: The MR-IOS is compatible within a clinical MR imaging environment, accurate for needle placement, technically efficacious, and improves operator performance over the unassisted insertion technique. The MR-IOS was found to be suitable for further testing in a clinical setting.

KW - Augmented reality

KW - Image overlay

KW - Needle guidance

KW - Percutaneous interventions

UR - http://www.scopus.com/inward/record.url?scp=84878015347&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878015347&partnerID=8YFLogxK

U2 - 10.1007/s11548-012-0788-0

DO - 10.1007/s11548-012-0788-0

M3 - Article

C2 - 22926549

AN - SCOPUS:84878015347

VL - 8

SP - 365

EP - 378

JO - Computer-Assisted Radiology and Surgery

JF - Computer-Assisted Radiology and Surgery

SN - 1861-6410

IS - 3

ER -