Freehand Three‐Dimensional Ultrasound Image‐Guided Needle Targeting for Percutaneous Abdominal Puncture

BACKGROUND: Percutaneous abdominal interventions require precise and real-time guidance for safe needle placement. Conventional CT or fluoroscopy provides accurate localisation but involves radiation, while ultrasound (US) offers a radiation-free alternative but suffers from limited 3D visualisation. METHODS: We developed a guidance system integrating a needle-guide mechanism with a tracked US probe to achieve real-time radiation-free targeting. The approach reconstructs freehand 3D US volumes at 25 frames per second, enabling path planning and augmenting the needle trajectory onto live B-scan images. Validation was conducted using a mockup, two phantoms, a pig model, and a human volunteer. RESULTS: The system completed 3D US acquisition within 10 s and achieved high accuracy, with mean calibration errors of 0.62 mm and 0.22°. Needle tracking yielded angular and positional errors of 0.84 ± 0.40° and 0.76 ± 0.38 mm. CONCLUSIONS: This method enables accurate, rapid, and radiation-free guidance, demonstrating strong potential for clinical application.