Polhemus EM tracked Micro Sensor for CT‐guided interventions

PURPOSE Electromagnetic (EM) tracking is a key technology in image-guided therapy. A new EM Micro Sensor was presented by Polhemus Inc.; it is the first to enable localization of medical instruments through their trackers. Different field generators (FGs) are available by Polhemus, one being almost as small as a sugar cube. As accuracy and robustness of tracking are known challenges to using EM trackers in clinical environments, the goal of this study was a standardized assessment of the Micro Sensor in both a laboratory (lab) and a computed tomography (CT) environment. METHODS The Micro Sensor was assessed by means of Hummel et al.'s standardized protocol; it was assessed in conjunction with a Polhemus Liberty tracker and three FGs - with edge lengths of 1 (TX1), 2 (TX2), and 4 (TX4) inches. Precision as well as positional and rotational accuracy were determined in a lab and a CT suite. Distortions by four different metallic cylinders and tracking of two typical medical instruments - a hypodermic needle and a flexible endoscope - were also tested. RESULTS A jitter of 0.02 mm or less was found for all FGs in the different environments, except for the TX2 FG for which no valid data could be obtained in the CT. Errors of 5 cm distance measurements were 0.6 mm or less for all FGs in the lab. While the distance errors of the TX1 FG were only slightly increased up to 1.6 mm in the CT, those of the TX4 FG were found to be up to around 10% of the measured distance (5.4 mm on average). The mean orientation error was found to be 0.9° /0.5° /0.1° for the TX4/TX2/TX1 FG in the lab. In the CT environment, rotation errors were in the same range: less than 1.2° /0.1° for the TX4/TX1 FG. Deviation under the presence of metallic cylinders stayed below 1 mm in most cases. Precision and orientational accuracy do not seem to be affected by instrument tracking and stayed in the same range as for the other measurements whereas distance errors were slightly increased up to 1.7 mm. CONCLUSION This study shows that accurate tracking of medical instruments is possible with the new Micro Sensor; it demonstrated a jitter of 0.01 mm or less, position errors below 2 mm, and rotation errors of less than 0.3° . As with other EM trackers, errors increase when large tracking volumes with ranges of up to 50 cm are required in clinical environments. For smaller tracking volumes with ranges of up to 15 cm, a high accuracy and robustness was found. This is interesting especially for the TX1 FG which can easily be placed in close vicinity to the region of interest.

[1]  Josien P. W. Pluim,et al.  Image registration , 2003, IEEE Transactions on Medical Imaging.

[2]  M. Figl,et al.  Design and application of an assessment protocol for electromagnetic tracking systems. , 2005, Medical physics.

[3]  M. Figl,et al.  Evaluation of a new electromagnetic tracking system using a standardized assessment protocol , 2006, Physics in medicine and biology.

[4]  Terry M. Peters,et al.  A hardware and software protocol for the evaluation of electromagnetic tracker accuracy in the clinical environment: a multi-center study , 2007, SPIE Medical Imaging.

[5]  Ziv Yaniv,et al.  Electromagnetic tracking in the clinical environment. , 2009, Medical physics.

[6]  Hans-Peter Meinzer,et al.  A novel fully automatic system for the evaluation of electromagnetic tracker , 2012, Medical Imaging.

[7]  A M Franz,et al.  Standardized assessment of new electromagnetic field generators in an interventional radiology setting. , 2012, Medical physics.

[8]  Wolfgang Birkfellner,et al.  Electromagnetic tracking for US-guided interventions: standardized assessment of a new compact field generator , 2012, International Journal of Computer Assisted Radiology and Surgery.

[9]  Michael Hoffmann,et al.  Next generation distal locking for intramedullary nails using an electromagnetic X-ray-radiation-free real-time navigation system , 2012, The journal of trauma and acute care surgery.

[10]  Yoshito Otake,et al.  An electromagnetic “Tracker-in-Table” configuration for X-ray fluoroscopy and cone-beam CT-guided surgery , 2012, International Journal of Computer Assisted Radiology and Surgery.

[11]  Klaus H. Maier-Hein,et al.  The Medical Imaging Interaction Toolkit: challenges and advances , 2013, International Journal of Computer Assisted Radiology and Surgery.

[12]  Wolfgang Birkfellner,et al.  Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications , 2014, IEEE Transactions on Medical Imaging.

[13]  Keno März,et al.  Interventional real-time ultrasound imaging with an integrated electromagnetic field generator , 2014, International Journal of Computer Assisted Radiology and Surgery.

[14]  Georg Rose,et al.  Construction of a conductive distortion reduced electromagnetic tracking system for computer assisted image-guided interventions. , 2014, Medical engineering & physics.

[15]  I Bricault,et al.  Phantom evaluation of a navigation system for out-of-plane CT-guided puncture. , 2015, Diagnostic and interventional imaging.

[16]  Ziv Yaniv,et al.  Which pivot calibration? , 2015, Medical Imaging.

[17]  Marco Nolden,et al.  MITK-OpenIGTLink for combining open-source toolkits in real-time computer-assisted interventions , 2017, International Journal of Computer Assisted Radiology and Surgery.

[18]  Lena Maier-Hein,et al.  Anser EMT: the first open-source electromagnetic tracking platform for image-guided interventions , 2017, International Journal of Computer Assisted Radiology and Surgery.