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CT-Navigation™ Clinical Survey

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*Required information

Hospital/Clinic*

Date*

Location*

Country*

Radiologist Name*

Email*

Main targeted organs (kidney, liver,...)*

Interventionnal procedures performed (biopsy,...)*

Number of Monthly Cases*

Modality*
CTCBCT

Is CT-Navigation easy to set-up?

YesNo

Do you find that CT-Navigation is an ergonomic and easy-to-use system?*

YesNo

Do you find the needle holder easy to maneuver?*

YesNo

Does it allow for all needle angulations when planning trajectory?*

YesNo

Do you find that CT-Navigation is an accurate system?*

YesNo

Does it decrease the number of needle passes and/or repositioning?*
YesNo
Are there lesions you would not attempt to target without CT-Navigation?*
YesNo

Does CT-Navigation save interventional time (from first CT scan to last CT control scan)?*

YesNo

Estimated time reduction per procedure?*
10%20%30%50%>50%
Does it improve the management of your workflow?*
YesNo

Is the number of CT-controls reduced when using CT-Navigation?*

YesNo

Estimated number of saved CT-scans per procedure?*

Typical needle-tip depth before your first CT-control?*
mm

Do you have an increased level of confidence when using CT-Navigation?*

YesNo

In your opinion, how many CT-Navigation procedures were necessary for you to be proficient?*

Would you find it useful for junior operator training?*

YesNo

Do you find that using CT-Navigation improves interventional safety?*

YesNo

For a specific procedure?*

For a specific organ?*

Do you anticipate a reduction in adverse events?*
YesNoN/A

What are CT-Navigation’s main clinical benefits?*

Reduced false negative biopsiesImproved biopsy sampleImproved ablation outcomeReduced false trajectoriesMulti-needle interventionReduced complication risk (pneumothorax, hemorrhage…)Other

Which?*

Does CT-Navigation improve the way you provide patient care?*

YesNo

Would you recommend CT-Navigation to other radiologists?*

YesNo

In your opinion, what improvements would be relevant ?

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♦ Phantom study involving 2 operators (junior & senior) and 4 dose reduction protocols

♦ Dose protocol, operator experience, obliquity and target location had no impact on accuracy

♦ The image quality and operator confidence decreased with dose reduction

Comparison of acquisition and iterative reconstruction parameters in abdominal computed tomography-guided procedures: a phantom study

J. Frandon, P. Akessoul, A. Hamard, E. Bezandry, R. Loffroy, T. Addala, M. Bertrand, J.-P. Beregi, J. Greffier – QIMS

♦ Prospective descriptive study involving 10 patients

♦ Primary technical success=93.75%, Secondary technical Success=100%

♦ All interventions were performed under local anesthesia

Percutaneous Navigation under Local Anesthesia for Computed Tomography-Guided Microwave Ablation of Malignant Liver Lesions Located in the Hepatic Dome

D. Filippiadis, G. Velonakis, A. Mazioti, A. Tsochatzis, T. Vrachliotis, A. Kelekis, N. Kelekis – Medicina

♦ Review of the system: description, intended use, procedure details, main benefits and clinical data

♦ CT-Navigation could be considered as a first option in the diagnosis and/or treatment of lesions in difficult locations, even if further studies are necessary

Imactis CT-Navigation system. A real alternative to different percutaneous interventional procedures in lesions in difficult locations. A pictorial essay

J. A. Gómez Patiño, S. Méndez Alonso, M. Alfageme, R. González Costero, A. García Suárez, J. González Plaza, V. Perdomo Suriel, M. L. Collado Torres – ECR 2020

♦ Retrospective, comparative study involving 120 patients

♦ The system demonstrated a very high diagnostic success rate

♦ Radiation exposure & needle insertion time were significantly lower in the navigation group

♦ The use of CT-Navigation is efficient, reliable & safe for lung biopsy compared to conventional CT guidance

Computed Tomography-Navigation Electromagnetic system Compared to Conventional Computed Tomography Guidance for Percutaneous Lung Biopsy: A Single-Centre Experience

M. Lanouzière, O. Varbedian, O. Chevallier, L. Griviau, K. Guillen, R. Popoff, S.-L. Aho-Glélé and R. Loffroy – Diagnostics

♦ Case review of seven patients: 4 biopsies (hepatic, pulmonary, retroperitoneal and osseous lesions) and 3 ablations (pulmonary, pancreatic and hepatic carcinomas)

♦ The system was easily operated, facilitated pre-procedure planing and displayed an accurate needle trajectory

♦ Benefits for ablations (higher accuracy, better targeting of small lesions) and biopsies (fewer CT controls) without significant post-procedure complications

A single centre experience accessing the usability and efficacy of the Imactis CT-Navigation system

J. Banat, P. Kennedy, R. Lindsay, R. Sathyanarayana, J. Farrell, S. Francis – BSIR 2020

♦ Retrospective analysis of 52 lung biopsy patients (26 NAV/26 conventional CT)

♦ Diagnostic yield was higher in the NAV group than in the CT group (100% vs 83%)

♦ The patient radiation dose and number of scans were significantly lower in the NAV group

♦ A significantly higher rate of non-axial approaches was used in the NAV group (61,5% vs 11,5%)

Electromagnetic navigation system for CT-guided biopsies compared with conventional CT guidance

G. Mauri, S. Tortora, G. Gorga, D. Maiettini, G. M. Varano, P. Della Vigna, G. Bonomo, E. Valconi, F. Orsi – ECR 2020

♦ Retrospective descriptive study involving 12 patients

♦ Technical success rate was 100% with no fracture during a mean follow-up time of 382 days

♦ All patients were able to walk on the day following osteosynthesis

Percutaneous osteosynthesis and cementoplasty (POC) for stabilization of malignant pathological fractures of the proximal femur

E.Mavrovi, J.B.Pialat, H.Beji, A.C.Kalenderian, G.Vaz, B.Richioud – Diagnostic and Interventional Imaging

♦ Prospective corpse study (3 forensic examinations)

♦ The magnitude of the organ displacements was highly variable

♦ All organs were successfully biopsied in corpse 3, only the liver could be biopsied in corpses 1 and 2

Evaluation of a Computed Assisted Medical Intervention (CAMI) system in scientific autopsy

F.Grenier, S.Voros, V.Scolan, F.Paysant, J.Boutonnat, I.Bricault, A.Moreau-Gaudry – Journal of Forensic Radiology and Imaging

♦ Prospective comparative phantom study involving interventional and diagnostic fellows

♦ The number of successful attempts was significantly higher for interventional fellows (when using the EM system)

♦ All fellows had a significantly higher successful attempt rate with the EM system than with conventional targeting

♦ No significant difference when comparing groups with different levels of experience

Use of an Electromagnetic Navigation System on a Phantom as a Training Simulator for CT-guided Procedures

Yadiel Sánchez, BA, Dmitry S. Trifanov, MD, Taj M. Kattapuram, MD, Haiyang Tao, MD, PhD, Anand M. Prabhakar, MD, MBA, Ronald S. Arellano, MD, Raul N. Uppot, MD – Journal of the American College of Radiology

♦ Prospective controlled multicenter study protocol (500 patients maximum)

♦ The aim is to assess the safety, efficacy and performance within the 2 patient groups

Evaluation of the clinical benefit of an EMN system for CT-guided IR procedures in the thoraco-abdominal region compared with conventional CT guidance (CTNAV II): study protocol for a randomized controlled trial

RC. Rouchy, A. Moreau-Gaudry, E. Chipon, S. Aubry, L. Pazart, B. Lapuyade, M. Durand, M. Hajjam, S. Pottier, B. Renard, R. Logier, X. Orry, A. Cherifi, E. Quehen, G. Kervio, O. Favelle, F. Patat, E. De Kerviler, C. Hughes, M. Medici, J. Ghelfi, A. Mounier & I. Bricault – Trials

♦ Prospective controlled study involving 120 patients

♦ Accuracy improved by a factor of 2 (when using the navigation system)

♦ Fewer acquisition scans: 2 vs 3 (when using the navigation system)

Computer assisted electromagnetic navigation improves accuracy in computed tomography guided interventions: A prospective randomized clinical trial

Pierre Durand, Alexandre Moreau-Gaudry, Anne-Sophie Silvent, Julien Frandon, Emilie Chipon, Maud Médici, Ivan Bricault – PLoS ONE

♦ Retrospective descriptive study involving 21 patients

♦ Complete ablation was obtained in 100% of cases

♦ The ablation probe was correctly placed on the first pass in 96% of cases

EM navigation system combined High-Frequency-Jet-Ventilation (HFJV) for CT-guided hepatic ablation of small US-undetectable and difficult to access lesions

Stephanie Volpi, Georgia Tsoumakidou, Amélie Loriaud, Arnaud Hocquelet, Rafael Duran & Alban Denys – International Journal of Hyperthermia

♦ Retrospective descriptive study involving 50 patients

♦ 96% technical success rate

CT guidance assisted by EM navigation system for percutaneous fixation by internal cemented screws (FICS)

Benjamin Moulin, Lambros Tselikas, Thierry De Baere, Florent Varin, Abdellahi Abed, Laura Debays, Cécile Bardoulat, Antoine Hakime, Christophe Teriitehau, Fréderic Deschamps, Guillaume Gravel – European Radiology

♦ Prospective abdominal phantom study comparing EM Navigation and 3D Image Fusion with Fluoroscopy

♦ While all methods reached 100% technical efficiency, EM Navigation was not limited to acute angle access

♦ The combination of both technologies offered the best accuracy but was slightly longer and irradiant compared to EMN

CBCT-Based Image Guidance for Percutaneous Access: Electromagnetic Navigation Versus 3D Image Fusion with Fluoroscopy Versus Combination of Both Technologies – A Phantom Study

Vania Tacher, Maxime Blain, Edouard Hérin, Manuel Vitellius, Mélanie Chiaradia, Nadia Oubaya, Haytham Derbel & Hicham Kobeiter – CVIR

♦ Retrospective controlled study involving 37 patients

♦ Interventional Dose-Length Product was reduced by a 3.2 factor (in the CT-Navigation group)

♦ Median procedure time was halved (in the CT-Navigation group)

Reduction of patient radiation dose during CT vertebroplasty: Impact of a new computer-assisted navigation (CAN) system

C. Teriitehau, H. Rabeh, E. Pessis, Q. Sénéchal, F. Besse and M. Bravetti– Radioprotection

♦ Prospective inclusion of navigation group patients along with retrospective matching with a control group patient (34 patients total)

♦ Implementation of the EM Navigation System for CT-guided MWA significantly improved the accuracy of antenna positioning

♦ The number of control scans and the radiation exposure were significantly lower in the Navigation group

Electromagnetic Navigation System-Guided Microwave Ablation of Hepatic Tumors: A Matched Cohort Study
K. I. Ringe, G. H. Pöhler, H. Rabeh & F. Wacker – CVIR

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