Abstract
Ultrasound guidance plays a central role in numerous minimally invasive procedures involving percutaneous needle insertion, ensuring safe and accurate needle placement. However, it encounters two primary challenges: (1) aligning the needle with the ultrasound beam and (2) visualizing the needle even when correctly aligned. In this review, we offer a concise overview of the physics foundation underlying these challenges and explore various approaches addressing specific challenges, with a focus on software-based solutions. We further distinguish between hardware-based and software-based solutions, placing a stronger emphasis on the latter. The incorporation of artificial intelligence into these methods to enhance needle visualization and localization is briefly discussed. We identify state-of-the-art needle detection methods, showcasing submillimeter precision in tip localization and orientation. Additionally, we provide insights into potential future directions, aiming to facilitate the translation of these advanced methods into the clinic. This article serves as a comprehensive guide, offering insights into challenges, evolving solutions, and prospective research directions to effectively address these issues.