PET/CT guided needle biopsy : Workflow based 3D Slicer module

We have been working closely with Children National Medical Center and Georgetown University for the last several years on improving the clinical effectiveness of liver lesion biopsy through the fusion of respiratory-compensated PET/CT with CT images. We recently significantly reworked the workflow-based 3D Slicer module that was implemented for this project. The module provides an easy-to-use interface for the following key steps required in the intervention: PET/CT data loading, registration, tracking connection, tool calibration, patient registration, needle path planing and guidance.  This video demonstrates the use of this module with a data acquired from a computer-controlled anthropomorphic phantom.

The computer-controlled anthropomorphic phantom has an embedded rib cage and a small opening in the thorax to allow percutaneous targeting. Within the thorax, we embedded FDG filled, sealable circular vials to serve as targets. These appear as areas of increased radiopharmaceutical activity on the PET image. The dose was injected into a small hollow plastic sphere with a threaded  seal. The spheres were sealed, placed inside a simulated liver made of foam, and then placed in the anthropomorphic phantom. The phantom was first imaged with a PET/CT scanner followed by a CT scanner in the interventional CT suite, where the biopsy procedure would typically be performed.  Using the visual guidance of the fused PET/CT image and real-time location and position information from an electromagnetic tracking device, the biopsy needle was inserted into the phantom to target the sphere. We are currently finishing up phantom evaluation and making final improvements to the interface. We will start soon recruiting patients at Georgetown University to conduct a feasibility study of the system. For more information, check out the project wiki.

Funding acknowledgment:

“Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R42CA153488. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.”

Video credit to Emmanuel Wilson at Children National Medical Center