Print Email Facebook Twitter Steerable needles for radio-frequency ablation in cirrhotic livers Title Steerable needles for radio-frequency ablation in cirrhotic livers Author van de Berg, N.J. (TU Delft Medical Instruments & Bio-Inspired Technology; Erasmus MC) Meeuwsen, F.C. (Erasmus MC) Doukas, Michail (Erasmus MC) Kronreif, Gernot (Austrian Center for Medical Innovation and Technology (ACMIT)) Moelker, Adriaan (Erasmus MC) van den Dobbelsteen, J.J. (TU Delft Medical Instruments & Bio-Inspired Technology) Date 2021 Abstract Accurate needle placement in deep-seated liver tumours can be difficult. In this work, we disclose two new manually controlled steerable needles for 17G radio-frequency ablation probe placement. The needles contain stylets with embedded compliant joints for active tip articulations, and concentric tubes for (curved-path) guidance. Needle steering was evaluated sequentially by intended users and in intended-use tissue types. Six interventional radiologists evaluated the needle in repeated ultrasound-guided steering tasks in liver-mimicking phantoms. Targets were located at a 100 mm depth and 20 mm lateral offset from the initial insertion line. The resulting mean absolute tip placement error was 1.0 ± 1.0 mm. Subsequently, steering-induced tissue damage was evaluated in fresh cirrhotic human liver explants. The surface area of puncture holes was estimated in scanned histology slides, using a connected-components analysis. The mean surface area was 0.26 ± 0.16 mm2 after steering with a median radius of curvature of 0.7 × 103 mm, versus 0.35 ± 0.15 mm2 after straight-path insertions with the steerable needle and 0.15 ± 0.09 mm2 after straight-path RFA probe insertions. The steering mechanisms proposed enable clinically relevant path corrections for 17G needles. Radiologists were quickly adept in curved-path RFA probe placement and the evaluation of histological tissue damage demonstrated a potentially safe use during liver interventions. Subject OA-Fund TU Delft To reference this document use: http://resolver.tudelft.nl/uuid:5019c376-f4da-430c-9370-d08d56c53a07 DOI https://doi.org/10.1038/s41598-020-77869-3 ISSN 2045-2322 Source Scientific Reports, 11 (1) Part of collection Institutional Repository Document type journal article Rights © 2021 N.J. van de Berg, F.C. Meeuwsen, Michail Doukas, Gernot Kronreif, Adriaan Moelker, J.J. van den Dobbelsteen Files PDF s41598_020_77869_3.pdf 2.22 MB Close viewer /islandora/object/uuid:5019c376-f4da-430c-9370-d08d56c53a07/datastream/OBJ/view