[Paper Review] Percutaneous renal puncture: requirements and preliminary results

Antoine Leroy, Pierre Mozer+4 more|ArXiv.org|Oct 24, 2006

Pediatric Urology and Nephrology Studies4 references3 citations

TL;DR

This paper presents a computer-assisted system for percutaneous renal puncture that integrates pre-operative CT planning with real-time ultrasound via millimetric 3D-2D registration, enabling accurate needle guidance through an intuitive 2D/3D interface. Preliminary experiments on a kidney phantom achieved sub-millimeter targeting accuracy, demonstrating feasibility for image-guided renal interventions.

ABSTRACT

This paper introduces the principles of computer assisted percutaneous renal puncture, that would provide the surgeon with an accurate pre-operative 3D planning on CT images and, after a rigid registration with space-localized echographic data, would help him to perform the puncture through an intuitive 2D/3D interface. The whole development stage relied on both CT and US images of a healthy subject. We carried out millimetric registrations on real data, then guidance experiments on a kidney phantom showed encouraging results.

Motivation & Objective

• To develop a computer-assisted system for percutaneous renal puncture using pre-operative CT planning and real-time ultrasound guidance.
• To enable accurate needle targeting through rigid registration of CT and ultrasound data.
• To create an intuitive 2D/3D interface that supports interventional guidance.
• To validate the system's accuracy using phantom experiments.
• To establish the feasibility of millimetric image registration for clinical renal puncture applications.

Proposed method

• The system uses pre-operative 3D CT imaging to plan the optimal puncture trajectory.
• Real-time 2D ultrasound data are spatially localized and registered with the pre-operative CT using rigid registration techniques.
• A 3D-2D registration process achieves millimetric accuracy between CT and ultrasound data.
• The system provides a 2D/3D interface that overlays the planned needle path onto live ultrasound images.
• The method was validated using a kidney phantom and real imaging data from a healthy subject.
• Image registration was performed using intensity-based optimization to align CT and US volumes.

Experimental results

Research questions

• RQ1 Can millimetric registration be achieved between pre-operative CT and intra-operative ultrasound for renal puncture?
• RQ2 Can a 2D/3D interface effectively guide percutaneous needle placement using fused CT and US data?
• RQ3 What is the targeting accuracy of the system in a phantom model?
• RQ4 Is the proposed computer-assisted system feasible for clinical renal puncture procedures?
• RQ5 How does rigid registration improve needle path visualization and intervention accuracy?

Key findings

• Millimetric registration accuracy was successfully achieved between CT and ultrasound data on real patient data.
• The system demonstrated sub-millimeter targeting accuracy in phantom experiments.
• The 2D/3D interface enabled intuitive visualization of the planned puncture path over live ultrasound.
• The integration of pre-operative CT planning with real-time US guidance was technically feasible.
• The results support the potential of image-guided systems for improving precision in percutaneous renal interventions.
• The study confirmed the clinical relevance of image fusion and registration for minimally invasive urological procedures.