Intro

Uncharacterized malignant masses typically require percutaneous biopsy, guided by either ultrasound or CT imaging. For this purpose, patients are admitted to the hospital, undergo imaging-guided needle insertion, and remain under observation to manage potential complications.

The likelihood of complications often depends on the location, size, and imaging clarity of the targeted masses. Common complications include pneumothorax (especially in lung lesion biopsies) and bleeding or injury to adjacent organs in the abdomen or thorax. With the rising number of biopsies, additional therapeutic interventions like ablation are increasingly performed to destroy these lesions. Techniques such as thermal ablation and cryotherapy require precise needle placement in or near the lesion for successful "ablation."

Precision is key in positioning the diagnostic or therapeutic needle. Ultrasound offers direct, safer needle guidance but is limited for deep abdominal or lung lesions, where CT imaging is preferable. For CT-guided placements, prior imaging is reviewed to determine the percutaneous approach. The area of interest is re-scanned to locate the lesion and determine the needle’s entry path and angle. After sterilization and local anesthesia, the needle is gradually advanced while re-scanning to monitor its course toward the target. Adjustments are made as necessary to avoid other anatomical structures until the needle reaches the target safely. Depending on the case, this process may require multiple attempts (up to 20–25), and the patient's cooperation in remaining still and holding their breath is crucial.

Technological Support
New technologies, including robotic arms operating with 3D imaging, have emerged to improve both speed and safety in needle placement (see Images 1-3). These robotic systems, however, entail significant costs for consumable materials, with the central planning unit ranging from approximately €300,000 to €900,000.

New Technology: Virtual Reality and Advanced 3D Guidance
Our scientific team has contributed to developing an advanced technology for biopsy guidance utilizing 3D Reconstruction (3D Reformat) and Virtual Reality (VR). This method employs specialized software that, after processing a CT scan with contrast, represents the target lesions spatially and superimposes them onto the patient’s body through VR glasses. This innovative approach significantly enhances the operator’s spatial orientation, facilitating more accurate and efficient needle placement.

 

Game Changer: Apple Vision Pro for Ablation Procedures
The introduction of the Apple Vision Pro offers a transformative opportunity in medical ablation and biopsy procedures. Combining the device’s high-resolution augmented reality (AR) and VR capabilities, clinicians can visualize 3D imaging data directly within the patient's environment, seamlessly overlaying critical anatomical structures for precise targeting. Apple Vision Pro could enable physicians to better align with real-time imaging feedback, minimizing repositioning attempts and enhancing patient safety by reducing exposure to imaging radiation. Furthermore, the device’s ergonomic design and powerful processing could streamline workflow by integrating imaging, navigation, and patient data into a single, immersive environment. This could lead to reduced procedure times and improved outcomes, positioning AR-enhanced ablation with Apple Vision Pro as a potential game changer in interventional radiology and oncology. Publication is pending 

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Disclaimer.

Regarding its plausibility app offers no diagnosis or treatment. App provide an early indication that further evaluation may be warranted by Speciality Doctor.  Explicitly is announced that the apps are not for diagnosis. Clinical judgment and experience are required to properly use the software. App alone do not replace an M.D. or specialist. All information received from the App output must be reviewed before any attempted treatment. The software is not for primary image interpretation. Any influence to the operators in making decisions remains user own responsibility and experience. App does not dispense medical advice. Patient should seek a doctor’s advice in addition using the app and /or before making any medical decisions for themself. Never substitute or replace doctor's advice or change treatment modalities based on any measured outcome. App indicated for assisting healthcare professionals for scientific and research reason. Clinical judgment and experience are required to properly use the app and further research and validation is pending in coming future.The app is not a substitute for professional medical advice.Any medical information provided by the app should be used with caution and not relied upon exclusively for medical decision-making.

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