| Ultrasound Innovation Award |
| Online Abstract Submission |
| (Author: Collin Clarke ) |
| Abstract |
| Type: New imaging technique |
| Title: Virtual Reality Imaging with Real Time Ultrasound for Facet Joint Injection – A proof of Concept |
| Disclosure Statements |
| My research & development of my invention is not supported by a commercial company |
| Abstract |
| Introduction: Facet injections, guided by fluoroscopy or computed tomography (CT) continues to be utilized in the management of back pain, exposing the patient and physician to radiation. However, previously acquired diagnostic CT scans can be registered into a virtual world that includes the image generated by an ultrasound probe tracked in real time, permitting the guidance of a tracked percutaneous needle without the use of intra-procedure X-Rays. The objective of this study was to examine the feasibility of using virtual imaging with real-time ultra-sound to guide the accurate placement of radio-opaque markers/dye into the facet joint spaces of 2 spinal models and a cadaver. Material and Methods: CT scans of the models and cadavers were acquired and reconstructed into 3D image volumes. Digital 3D representations of an ultrasound probe (US) and needle were also created. A magnetic tracking system was used to track the needle and US probe in real time during the procedure. Using the US, the 3D CT scan was registered to the model/cadaver. The 3D CT scan, and real time tracked tools were all displayed on a single screen. Facet joint injections at the right and left L2-L3 and L3-L4 were performed in the models with radio-opaque markers and in the cadaver with radio-opaque dye. Time for needle placement was recorded. Post procedure CT scans, read by a blinded radiologist, were attained to determine placement. Results: All markers were found to be within the expected facet joints of the models. Radio-opaque dye was found in and surrounding the right and left L2-L3 and L3-L4 facet joints. Mean time to Cadaveric needle placement was 213(+/-16) seconds. Discussion: This novel technique successfully combines the reduction of radiation exposure from US technique with the accurate visualization of the facet joint from the real time virtual integration of CT. The speed with which this procedure can be performed is enhanced by the application of virtual tools. This technique has the potential to be adapted in a cost effective manner to the clinical environment. |
| Clinical Significance |
| The described virtual reality tracking system allows for real time needle guidance with excellent visualization without the need of further ionizing radiation. This system combines the best of ultrasound and CT guidance. With few modifications it is anticipated that this system could soon be ready for clinical use in a wide variety of interventional spine procedures. |
| Ultrasound Equipment |
| Manufacturer: Phillips |
| Model: 7500 |
| Probe Used |
| Type: HP (PHILIPS) S3 linear phased array |
| Size: 4.0cm |
| Frequency: 1-3 MHz |
| Files |
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1. Filename: US-REG-CAS.wmv 2. Filename: Ultrasound-CT-fusion.wmv 3. Filename: Guided-Procedure.wmv 4. Filename: Procedure 1.jpg
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