Anesthesia

Needle Based Applications

Current Graduate Students: Golafsoun Ameri and Jonathan McLeod

Needle-based procedures commonly used in the introduction of catheters or delivery of anaesthetics pose a unique set of challenges for image guided interventions. Although tracking systems and tracking-based navigational paradigms are employed, the set of pre-operative images of the relevant anatomy is minimal, meaning these procedures rely more heavily on the real-time processing of ultrasonic imaging.

Accurate needle guidance procedures depend on:

  • Positioning - The position and trajectory of the needle must be put in the context of the inter-operative imaging modality.
  • Real-time Image Processing - The inter-operative images must be processed as they are acquired, restricting the amount and complexity of the processing allowed during the intervention.
  • Visualization - The inter-operative images must be displayed in a manner that minimizing mental load on the interventionalist and promotes ready understanding of 3D relationships.

Our Research Objective

The objectives of our research in needle guidance are fourfold. We want to develop needle guidance systems that:
  • Incorporate and refine tracking information, whether this information is provided using magnetic, optical, or vision-based tracking,
  • Segment ultrasound images of the spine and neck to highlight relevant anatomy in each, distilling spatial information about what structures are targets to hit, or targets to avoid,
  • Use techniques in synthetic aperture imaging and post-processed beam forming to quickly collect high-resolution, focused ultrasonic images, and
  • Incorporate this information into a user-friendly system suitable for clinical use while minimizing disruptions to current clinical workflow in anesthesia.

Our Contribution

The CentralLine Platform provides interventional guidance for needle insertion applications, specifically targeting central line procedures, where large-diameter needles are inserted into the jugular vein in order to introduce catheters into the vascular system. This system incorporates magnetically tracked free-hand ultrasound and needle.

This tracking information is combined in real time and displayed to the interventionalist in a cognitive load minimal interface designed to guide the procedure while minimizing additions to clinical workflow.

The CentralLine Platform has received Health Canada approval (Class III) and is in the process of entering clinical trials with a clinical collaborator to determine it's effectiveness in improving central line procedures.

Key Questions

  • Can needle-based procedures be performed more safely and efficiently using the principles of image-guidance?
  • What types of image-guidance systems ensure optimal clinician performance for anesthesia?