System for CT-guided needle placement in the thorax and abdomen: A design for clinical acceptability, applicability and usability

Background: Various systems exist for CT-guided needle placement in the thorax and abdomen, but widespread adoption is lacking. The goal of this work is to develop a system for precise needle placement with a design focus on clinical acceptability, applicability and usability. Methods: A system was outlined incorporating a needle guide on a mechanism with a remote centre of motion, manually placeable around the patient at the desired entry point and lockable by push-button to the CT table. System and patient are scanned for system-to-CT registration and target specification. The needle guide is automatically aimed at the target, for manual needle insertion to specified depth. Results: A fully functional prototype was realized, achieving 1.20.6 mm placement error at 79.0 +/- 8.4 mm depth and 2.1 +/- 0.7 mm at 156.0 +/- 6.9 mm for 2x12 in- and out-of-plane punctures in a gelatin phantom. Conclusions: The system enables precise needle placement in a single insertion and is ready for its first clinical deployment.