• Joseph R England, Tucker Fischbeck, and Hisham Tchelepi.
• Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles, California USA.
• J Ultrasound Med. 2019 Feb 1; 38 (2): 399-405.

ObjectivesRadiology residents typically learn ultrasound-guided procedures by performing supervised procedures on patients who may experience longer procedure times and higher complication rates. The purpose of this study was to determine if existing technologies, such as in-plane, fixed-angle guidance (IPFA) and electromagnetic needle tracking (ENT), can improve resident procedure time and accuracy.MethodsRadiology residents (18 total) were randomized to 1 of 3 ultrasound-guidance technique groups-freehand, IPFA, or ENT-and instructed to place a needle into 4 liver lesions in a humanoid phantom, each increasing in difficulty. For each lesion, residents were timed from skin puncture to needle placement, and the number of times the needle was pulled back and redirected (pullbacks) was recorded. Primary outcomes were total time and total number of pullbacks for all 4 lesions. Secondary outcomes were individual time and number of pullbacks for each lesion.ResultsCompared to the freehand group, the IPFA and ENT groups demonstrated lower procedural time and number of pullbacks both in total and for each individual lesion. Differences in total time and total number of pullbacks were significant (P < .001), as were differences for lesion 3 (P = .002-.02) and lesion 4 (P < .001). Differences for lesions 1 and 2 were not statistically significant.ConclusionsRadiology resident procedure time and procedure accuracy (as judged by number of pullbacks) are significantly improved by the use IPFA and ENT guidance technologies.© 2018 by the American Institute of Ultrasound in Medicine.

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