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.