A novel fusion imaging system for endoscopic ultrasound
Lucian Gheorghe Gruionu1, Adrian Saftoiu2, Gabriel Gruionu3
1 Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Clinical Care, Craiova, Romania
2 Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Craiova, Romania; Department of Endoscopy, Copenhagen University Hospital, Copenhagen, Denmark, USA
3 Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
Source of Support: This work was sponsored by the ANCS-CNDIUEFISCDI “PNII - Joint Applied Research Projects” program, contract number 87/2012, code PN-II-PT-PCCA-2011-3.2-0482, by the European Social Fund for Regional Development and National Agency for Scientifi c Research from Romania, contract number 285/16.12.2010, ID nr 983 Cod SMIS-CSNR 19782, and by SC MEDINSYS SRL., Conflict of Interest: Dr. Lucian Gruionu is the CEO and director of R&D of SC Medinsys SRL and holds equity in the company. Dr. Sãftoiu holds equity in SC Medinsys SRL. Dr. Gabriel Gruionu serves as a consultant for SC Medinsys SRL and holds equity in Restore Surgical LLC.
Background and Objective: Navigation of a flexible endoscopic ultrasound (EUS) probe inside the gastrointestinal (GI) tract is problematic due to the small window size and complex anatomy. The goal of the present study was to test the feasibility of a novel fusion imaging (FI) system which uses electromagnetic (EM) sensors to co-register the live EUS images with the pre-procedure computed tomography (CT) data with a novel navigation algorithm and catheter. Methods: An experienced gastroenterologist and a novice EUS operator tested the FI system on a GI tract bench top model. Also, the experienced gastroenterologist performed a case series of 20 patients during routine EUS examinations. Results: On the bench top model, the experienced and novice doctors reached the targets in 67 18 s and 150 24 s with a registration error of 6 3 mm and 11 4 mm, respectively. In the case series, the total procedure time was 24.6 6.6 min, while the time to reach the clinical target was 8.7 4.2 min. Conclusions: The FI system is feasible for clinical use, and can reduce the learning curve for EUS procedures and improve navigation and targeting in difficult anatomic locations.