Grant: Collaborative Health Research Projects (NSERC partnered)

Image-guided musculoskeletal needle placement procedures, such as facet joint and nerve block injection, epidural blocks, arthrography injections, biopsies and vertebroplasty are performed by the millions in Canada and around the world. Computed tomography is widely used in musculoskeletal applications; magnetic resonance imaging has become the gold standard in imaging a variety of osseous and joint conditions. To date, there has been limited success in needle guidance using these imaging modalities. Accurate, simple, intuitive and affordable technology for image-guided needle placement procedures for average care facilities does not exist. A concurrent challenge will be to teach these procedures in a manner that parallels practice. The mobile image overlay system (MIOS) we propose will reflect a display image by a semi-transparent mirror so that the image, in correct pose and magnification, appears floating inside the patient. We expect to improve the accuracy of needle insertion, providing the operator with the best chance of first pass success. Beyond simplicity and low cost, MIOS will provide a view of the target anatomy at the needle tip for multiple observers, which makes it an ideal hands-on teaching tool. When the MIOS is detached from clinical imaging scanners, the identical image guidance experience can be provided in instructor-led or self-guided simulation training. MIOS promises to enhance the skill among future practitioners and, as a result, improve patient outcomes. Also, using the current installed base of imaging scanners, this effective, simple, affordable needle placement guidance system can increase the number of access points for procedures, reducing wait times. In the long-term, MIOS can be generalized to in-room image-guided needle placement in diagnostic or therapeutic interventions like cancer biopsy or tissue ablation with immediate application in head and neck procedures, along with appropriate hands-on teaching and training tools.