European journal of radiology · 2026
Assessment of the accuracy and feasibility of CT fusion with real-time US guidance for percutaneous radiofrequency trigeminal rhizotomy.
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Guo Chia-Hong, Hsu Yung-Chi, Liao Wei-Chen, Kao Hao-Lun, Li Kung-Fu, Chang Wei-Chou, Hsu Yi-Chih
Аннотация
PURPOSE: To quantitatively assess the spatial accuracy and technical feasibility of computed tomography (CT) fusion with real-time ultrasound (US) guidance (CTF-USG) for percutaneous radiofrequency trigeminal rhizotomy (PRF-TR) in patients with trigeminal neuralgia (TN).
METHODS: This prospective observational study included consecutive CTF-USG procedures performed between July 2024 and December 2025. Preprocedural CT-US registration accuracy was quantified as synchronization error using predefined bony landmarks. Postprocedural needle-targeting accuracy was assessed by the three-dimensional distance between the final needle tip and the center of the intended region of interest (ROI) on CT. Technical success, radiofrequency sensory stimulation (RFSS), and identification of predefined bony landmarks and vessels were recorded. Interobserver reliability was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. The association between synchronization error and needle tip-to-ROI distance was explored using Spearman rank correlation.
RESULTS: Twenty-six target sites in 22 patients were analyzed. Mean CT-US synchronization error was 2.09 ± 1.67 mm, and mean needle tip-to-ROI distance was 2.65 ± 1.05 mm. Interobserver reliability was high (ICC[2,1] = 0.846 and 0.941), with close Bland-Altman agreement. First-attempt technical success and positive RFSS responses were achieved in all procedures. All predefined bony landmarks and vessels were identified, and no procedure-related complications occurred. No evident association was observed between synchronization error and needle tip-to-ROI distance (Spearman's ρ = 0.131, P = 0.522).
CONCLUSION: CTF-USG demonstrated technical feasibility and quantifiable spatial accuracy for PRF-TR in TN. Objective spatial measurements and high interobserver reliability provide a reproducible framework for evaluating fusion-guided needle navigation. Larger comparative studies are warranted to determine its reproducibility and clinical benefit.
METHODS: This prospective observational study included consecutive CTF-USG procedures performed between July 2024 and December 2025. Preprocedural CT-US registration accuracy was quantified as synchronization error using predefined bony landmarks. Postprocedural needle-targeting accuracy was assessed by the three-dimensional distance between the final needle tip and the center of the intended region of interest (ROI) on CT. Technical success, radiofrequency sensory stimulation (RFSS), and identification of predefined bony landmarks and vessels were recorded. Interobserver reliability was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. The association between synchronization error and needle tip-to-ROI distance was explored using Spearman rank correlation.
RESULTS: Twenty-six target sites in 22 patients were analyzed. Mean CT-US synchronization error was 2.09 ± 1.67 mm, and mean needle tip-to-ROI distance was 2.65 ± 1.05 mm. Interobserver reliability was high (ICC[2,1] = 0.846 and 0.941), with close Bland-Altman agreement. First-attempt technical success and positive RFSS responses were achieved in all procedures. All predefined bony landmarks and vessels were identified, and no procedure-related complications occurred. No evident association was observed between synchronization error and needle tip-to-ROI distance (Spearman's ρ = 0.131, P = 0.522).
CONCLUSION: CTF-USG demonstrated technical feasibility and quantifiable spatial accuracy for PRF-TR in TN. Objective spatial measurements and high interobserver reliability provide a reproducible framework for evaluating fusion-guided needle navigation. Larger comparative studies are warranted to determine its reproducibility and clinical benefit.