three-dimensional-ultrasonic-needle-tip-tracking-with-fiber-optic

Three-Dimensional Ultrasonic Needle Tip Tracking with a Fiber-Optic Ultrasound Receiver

Ultrasound is frequently used for guiding minimally invasive procedures, but visualizing medical devices is often challenging with this imaging modality. ...

University of French Polynesia

Lamina cribrosa (LC) morphology could be implicated in the progression of glaucoma. To date, no established, quantifiable parameter to assess LC shape in vivo exists. We aim to introduce a new global shape index for the anterior LC (LC-GSI) and to identify associations with ocular factors in a healthy Indian population.

A Global Shape Index to Characterize Anterior Lamina Cribrosa Morphology and Its Determinants in Healthy Indian Eyes.

Accurate and efficient guidance of needles to procedural targets is critically important during percutaneous interventional procedures. Ultrasound imaging is widely used for real-time image guidance in a variety of clinical contexts, but with this modality, uncertainties about the location of the needle tip within the image plane lead to significant complications. Whilst several methods have been proposed to improve the visibility of the needle, achieving accuracy and compatibility with current clinical practice is an ongoing challenge. In this paper, the authors present a method for directly visualizing the needle tip using an integrated fiber-optic ultrasound receiver in conjunction with the imaging probe used to acquire B-mode ultrasound images.

In-plane ultrasonic needle tracking using a fiber-optic hydrophone.

Accurate and efficient identification of nerves is an essential component of peripheral nerve blocks. While ultrasound (US) imaging is increasingly used as a guidance modality, it often provides insufficient contrast for identifying nerves from surrounding tissues such as tendons. Electrical nerve stimulators can be used in conjunction with US imaging for discriminating nerves from surrounding tissues, but they are insufficient to reliably prevent neural punctures, so that alternative methods are highly desirable. In this study, an interventional multispectral photoacoustic (PA) imaging system was used to directly compare the signal amplitudes and spectra acquired from nerves and tendons ex vivo, for the first time. The results indicate that the system can provide significantly higher image contrast for discriminating nerves and tendons than that provided by US imaging. As such, photoacoustic imaging could be valuable as an adjunct to US for guiding peripheral nerve blocks.

Interventional multispectral photoacoustic imaging with a clinical ultrasound probe for discriminating nerves and tendons: an ex vivo pilot study.

Quantitative evaluation of lamina cribrosa (LC) posterior bowing in primary open-angle glaucoma (POAG) eyes using swept-source optical coherence tomography.

Clinical Assessment of Lamina Cribrosa Curvature in Eyes with Primary Open-Angle Glaucoma.

To investigate the characteristics of the prelamina and lamina cribrosa (LC) of both eyes in glaucoma patients with unilateral visual field (VF) defect.

Prelamina and Lamina Cribrosa in Glaucoma Patients With Unilateral Visual Field Loss.

To investigate lamina cribrosa (LC) displacement during the Valsalva maneuver in young healthy eyes using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT).

Anterior Displacement of Lamina Cribrosa during Valsalva Maneuver in Young Healthy Eyes.

To optimize conventional coronary optical coherence tomography (OCT) images using the attenuation-compensated technique to improve identification of plaques and the external elastic lamina (EEL) contour.

Optimization of coronary optical coherence tomography imaging using the attenuation-compensated technique: a validation study.

To investigate the variation of lamina cribrosa (LC) structure based on the baseline intraocular pressure (IOP) in eyes with primary open-angle glaucoma (POAG) and healthy individuals using swept-source optical coherence tomography.

Positional and Curvature Difference of Lamina Cribrosa According to the Baseline Intraocular Pressure in Primary Open-Angle Glaucoma: A Swept-Source Optical Coherence Tomography (SS-OCT) Study.

Ultrasound image guidance is widely used in minimally invasive procedures, including fetal surgery. In this context, maintaining visibility of medical devices is a significant challenge. Needles and catheters can readily deviate from the ultrasound imaging plane as they are inserted. When the medical device tips are not visible, they can damage critical structures, with potentially profound consequences including loss of pregnancy. In this study, we performed 3D ultrasonic tracking of a needle using a novel probe with a 1.5D array of transducer elements that was driven by a commercial ultrasound system. A fiber-optic hydrophone integrated into the needle received transmissions from the probe, and data from this sensor was processed to estimate the position of the hydrophone tip in the coordinate space of the probe. Golay coding was used to increase the signal-to-noise (SNR). The relative tracking accuracy was better than 0.4 mm in all dimensions, as evaluated using a water phantom. To obtain a preliminary indication of the clinical potential of 3D ultrasonic needle tracking, an intravascular needle insertion was performed in an in vivo pregnant sheep model. The SNR values ranged from 12 to 16 at depths of 20 to 31 mm and at an insertion angle of 49° relative to the probe surface normal. The results of this study demonstrate that 3D ultrasonic needle tracking with a fiber-optic hydrophone sensor and a 1.5D array is feasible in clinically realistic environments.

3D Ultrasonic Needle Tracking with a 1.5D Transducer Array for Guidance of Fetal Interventions.

Ultrasound is well suited for guiding many minimally invasive procedures, but its use is often precluded by the poor visibility of medical devices. When devices are not visible, they can damage critical structures, with life-threatening complications. Here, we developed the first ultrasound probe that comprises both focused and unfocused transducer elements to provide both 2D B-mode ultrasound imaging and 3D ultrasonic needle tracking. A fibre-optic hydrophone was integrated into a needle to receive Golay-coded transmissions from the probe and these data were processed to obtain tracking images of the needle tip. The measured tracking accuracy in water was better than 0.4 mm in all dimensions. To demonstrate the clinical potential of this system, insertions were performed into the spine and the uterine cavity, in swine and pregnant ovine models in vivo. In both models, the SNR ranged from 13 to 38 at depths of 22 to 38 mm, at out-of-plane distances of 1 to 15 mm, and at insertion angles of 33 to 42 degrees relative to the probe surface normal. This novel ultrasound imaging/tracking probe has strong potential to improve procedural outcomes by providing 3D needle tip locations that are co-registered to ultrasound images, while maintaining compatibility with current clinical workflow.

Looking beyond the imaging plane: 3D needle tracking with a linear array ultrasound probe.

Change in Optic Nerve After Intracranial Pressure Reduction in Children.

Although early diagnosis and treatment reduce the risk of blindness from glaucoma, the decision on whether or not to begin treatment in patients with suspected glaucoma is often a dilemma because the majority of patients never develop definite glaucoma. A growing body of evidences suggests that posterior bowing of the lamina cribrosa (LC) is the earliest structural change preceding the retinal nerve fiber layer (RNFL) loss in glaucomatous optic neuropathy. Based on this notion, we conducted a prospective study enrolling 87 eyes suspected of having glaucoma to investigate whether the future rate of RNFL loss is associated with the baseline LC curve evaluated by measuring the LC curve index (LCCI) using enhanced depth imaging optical coherence tomography. A faster rate of RNFL loss was significantly associated with greater LCCI (P < 0.001;standardized coefficient beta = -0.392), older age (P = 0.008;beta = -0.314), and greater vertical cup-to-disc ratio (P = 0.040;beta = -0.233). Assessment of LC morphology may help predict the disease outcome in eyes with suspected glaucoma.

Lamina Cribrosa Morphology Predicts Progressive Retinal Nerve Fiber Layer Loss In Eyes with Suspected Glaucoma.

To investigate the relationship between the degree of posterior bowing of the lamina cribrosa (LC) at baseline and the rate of subsequent visual field (VF) progression in eyes with primary open-angle glaucoma (POAG).

Baseline Lamina Cribrosa Curvature and Subsequent Visual Field Progression Rate in Primary Open-Angle Glaucoma.

To evaluate changes in lamina cribrosa (LC) shape, curvature, and depth after trabeculectomy.

Article	Year
A Global Shape Index to Characterize Anterior Lamina Cribrosa Morphology and Its Determinants in Healthy Indian Eyes. Investigative ophthalmology & visual science\| PubMed ID: 26047047	2015
In-plane ultrasonic needle tracking using a fiber-optic hydrophone. Medical physics\| PubMed ID: 26429273	2015
Interventional multispectral photoacoustic imaging with a clinical ultrasound probe for discriminating nerves and tendons: an ex vivo pilot study. Journal of biomedical optics\| PubMed ID: 26580699	2015
Clinical Assessment of Lamina Cribrosa Curvature in Eyes with Primary Open-Angle Glaucoma. PloS one\| PubMed ID: 26963816	2016
Prelamina and Lamina Cribrosa in Glaucoma Patients With Unilateral Visual Field Loss. Investigative ophthalmology & visual science\| PubMed ID: 27054519	2016
Anterior Displacement of Lamina Cribrosa during Valsalva Maneuver in Young Healthy Eyes. PloS one\| PubMed ID: 27442120	2016
Optimization of coronary optical coherence tomography imaging using the attenuation-compensated technique: a validation study. European heart journal cardiovascular Imaging\| PubMed ID: 27469587	2017
Positional and Curvature Difference of Lamina Cribrosa According to the Baseline Intraocular Pressure in Primary Open-Angle Glaucoma: A Swept-Source Optical Coherence Tomography (SS-OCT) Stu... PloS one\| PubMed ID: 27611970	2016
3D Ultrasonic Needle Tracking with a 1.5D Transducer Array for Guidance of Fetal Interventions. Medical image computing and computer-assisted intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Intervention\| PubMed ID: 28111644	2016
Looking beyond the imaging plane: 3D needle tracking with a linear array ultrasound probe. Scientific reports\| PubMed ID: 28623369	2017
Change in Optic Nerve After Intracranial Pressure Reduction in Children. Ophthalmology\| PubMed ID: 28624169	2017
Lamina Cribrosa Morphology Predicts Progressive Retinal Nerve Fiber Layer Loss In Eyes with Suspected Glaucoma. Scientific reports\| PubMed ID: 29335420	2018
Baseline Lamina Cribrosa Curvature and Subsequent Visual Field Progression Rate in Primary Open-Angle Glaucoma. Ophthalmology\| PubMed ID: 29945800	2018
Long-Term Shape, Curvature, and Depth Changes of the Lamina Cribrosa after Trabeculectomy. Ophthalmology\| PubMed ID: 29961552	2018

Jean-Martial Mari

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