Intervention Planning Using a Laser Navigation System for CT-Guided Interventions: A Phantom and Patient Study

Objective: To investigate the accuracy, efficiency and radiation dose of a novel laser navigation system (LNS) compared to those of free-handed punctures on computed tomography (CT). Materials and Methods: Sixty punctures were performed using a phantom body to compare accuracy, timely effort, and radiation dose of the conventional free-handed procedure to those of the LNS-guided method. An additional 20 LNS-guided interventions were performed on another phantom to confirm accuracy. Ten patients subsequently underwent LNS-guided punctures. Results: The phantom 1-LNS group showed a target point accuracy of $4.0{\pm}2.7mm$ (freehand, $6.3{\pm}3.6mm$; p = 0.008), entrance point accuracy of $0.8{\pm}0.6mm$ (freehand, $6.1{\pm}4.7mm$), needle angulation accuracy of $1.3{\pm}0.9^{\circ}$ (freehand, $3.4{\pm}3.1^{\circ}$; p < 0.001), intervention time of $7.03{\pm}5.18$ minutes (freehand, $8.38{\pm}4.09$ minutes; p = 0.006), and $4.2{\pm}3.6$ CT images (freehand, $7.9{\pm}5.1$; p < 0.001). These results show significant improvement in 60 punctures compared to freehand. The phantom 2-LNS group showed a target point accuracy of $3.6{\pm}2.5mm$, entrance point accuracy of $1.4{\pm}2.0mm$, needle angulation accuracy of $1.0{\pm}1.2^{\circ}$, intervention time of $1.44{\pm}0.22$ minutes, and $3.4{\pm}1.7$ CT images. The LNS group achieved target point accuracy of $5.0{\pm}1.2mm$, entrance point accuracy of $2.0{\pm}1.5mm$, needle angulation accuracy of $1.5{\pm}0.3^{\circ}$, intervention time of $12.08{\pm}3.07$ minutes, and used $5.7{\pm}1.6$ CT-images for the first experience with patients. Conclusion: Laser navigation system improved accuracy, duration of intervention, and radiation dose of CT-guided interventions.