Comparing Image Guidance Systems to Improve Complex Navigation in Medicine.

One of the most technically challenging procedure in interventional radiology is a transjugular intrahepatic portosystemic shunt (TIPS) placement. The main problem is the limited image guidance while navigating. The physician basically punctures blind through the liver into the target portal vein, leading to many unsuccessful punctures and unnecessary risks before access to the portal vein is gained. To be able to improve guidance, developers have to be sure to use the most promising image modality available. This paper compares the available modalities for TIPS to various criteria to find which modality is the most suitable to improve the success of the puncture. Results showed that, even though many user interface improvements are required, real-time three-dimensional ultrasound has the most potential to improve the puncture in the future. The study emphasizes the importance of thorough technology analysis before developing medical devices.