Needle navigation and catheter reconstruction for breast brachytherapy using open source software

Abstract

Interstitial breast brachytherapy is a method to deliver radiation therapy directly to the site of cancer. It is a challenging procedure because of issues in localizing the seroma, needles, and catheters within the soft tissue. In this paper we present two open-source technologies based on electromagnetic tracking: a navigation system to help target needles using a tracked needle guide, and software for electromagnetic reconstruction of catheter paths. These technologies were validated phantom studies. We found that the navigation system helped a radiation oncologist to target needles more accurately than under ultrasound guidance (60 needles under each condition, 3.8 vs 3.3 mm placement error, p = 0.04) and that reconstructed catheter paths were accurate within 0.6 mm to those determined on CT scans (144 catheters were compared to the 1.2 mm voxel size of CT scans, p < 0.001). We conclude that these technologies accurately localize anatomy and instruments in our study.