Shiran Levy1, S Nahum Goldberg2, Ido Roth3, Moran Shochat3, Jacob Sosna2, Isaac Leichter2, Sebastian Flacke4. 1. Department of Radiology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. Shiran.h2@gmail.com. 2. Department of Radiology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. 3. Department of Research & Development, XACT Robotics, Caesarea, Israel. 4. Department of Radiology, Lahey Clinic, Tufts University Medical School, Burlington, MA, USA.
Abstract
PURPOSE: To assess accuracy and compare protocols for CT-guided needle insertion for clinical biopsies using a hands-free robotic system, balancing system accuracy with duration of procedure and radiation dose. METHODS: Thirty-two percutaneous abdominal and pelvic biopsies were performed and analyzed at two centers (Center 1 n = 11; Center 2 n = 21) as part of an ongoing prospective, multi-center study. CT datasets were obtained for planning and controlled placement of 17 g needles using a patient-mounted, CT-guided robotic system. Planning included target selection, skin entry point, and predetermined checkpoints. Additional CT imaging was performed at checkpoints to confirm needle location and permit stepwise correction of the trajectory. Center 1 used a more conservative approach with multiple checkpoints, whereas Center 2 used fewer checkpoints. Scanning and needle advancement were performed under respiratory gating. Accuracy, radiation dose, and steering duration were compared. RESULTS: Overall accuracy was 1.6 ± 1.5 mm (1.9 ± 1.2 mm Center 1; 1.5 ± 1.6 mm Center 2; p = 0.55). Mean distance to target was 86.2 ± 27.1 mm (p = 0.18 between centers). Center 1 used 4.6 ± 0.8 checkpoints, whereas Center 2 used 1.8 ± 0.6 checkpoints (p < 0.001). Effective radiation doses were lower for Center 1 than for Center 2 (22.2 ± 12.6 mSv vs. 11.7 ± 4.3 mSv; p = 0.002). Likewise, steering duration (from planning to target) was significantly reduced in relation to the number of checkpoints from 43.8 ± 15.9 min for Center 1 to 30.5 ± 10.2 min for Center 2 (p = 0.008). CONCLUSIONS: Accurate needle targeting with < 2 mm error can be achieved in patients when using a CT-guided robotic system. Judicious selection of the number of checkpoints may substantially reduce procedure time and radiation dose without sacrificing accuracy.
PURPOSE: To assess accuracy and compare protocols for CT-guided needle insertion for clinical biopsies using a hands-free robotic system, balancing system accuracy with duration of procedure and radiation dose. METHODS: Thirty-two percutaneous abdominal and pelvic biopsies were performed and analyzed at two centers (Center 1 n = 11; Center 2 n = 21) as part of an ongoing prospective, multi-center study. CT datasets were obtained for planning and controlled placement of 17 g needles using a patient-mounted, CT-guided robotic system. Planning included target selection, skin entry point, and predetermined checkpoints. Additional CT imaging was performed at checkpoints to confirm needle location and permit stepwise correction of the trajectory. Center 1 used a more conservative approach with multiple checkpoints, whereas Center 2 used fewer checkpoints. Scanning and needle advancement were performed under respiratory gating. Accuracy, radiation dose, and steering duration were compared. RESULTS: Overall accuracy was 1.6 ± 1.5 mm (1.9 ± 1.2 mm Center 1; 1.5 ± 1.6 mm Center 2; p = 0.55). Mean distance to target was 86.2 ± 27.1 mm (p = 0.18 between centers). Center 1 used 4.6 ± 0.8 checkpoints, whereas Center 2 used 1.8 ± 0.6 checkpoints (p < 0.001). Effective radiation doses were lower for Center 1 than for Center 2 (22.2 ± 12.6 mSv vs. 11.7 ± 4.3 mSv; p = 0.002). Likewise, steering duration (from planning to target) was significantly reduced in relation to the number of checkpoints from 43.8 ± 15.9 min for Center 1 to 30.5 ± 10.2 min for Center 2 (p = 0.008). CONCLUSIONS: Accurate needle targeting with < 2 mm error can be achieved in patients when using a CT-guided robotic system. Judicious selection of the number of checkpoints may substantially reduce procedure time and radiation dose without sacrificing accuracy.
Authors: Marco Calandri; Giovanni Mauri; Steven Yevich; Carlo Gazzera; Domenico Basile; Marco Gatti; Andrea Veltri; Paolo Fonio Journal: Cardiovasc Intervent Radiol Date: 2019-02-26 Impact factor: 2.740
Authors: Daniel Putzer; Benjamin Henninger; Peter Kovacs; Christian Uprimny; Dorota Kendler; Werner Jaschke; Reto J Bale Journal: Q J Nucl Med Mol Imaging Date: 2016-06 Impact factor: 2.346
Authors: Avinash Kambadakone; Vinit Baliyan; Hamed Kordbacheh; Raul N Uppot; Ashraf Thabet; Debra A Gervais; Ronald S Arellano Journal: World J Hepatol Date: 2017-07-08
Authors: Chow Wei Too; David Wei Wen; Ankur Patel; Abdul Rahman Abdul Syafiq; Jian Liu; Sum Leong; Apoorva Gogna; Richard Hoau Gong Lo; Sonam Tashi; Kristen Alexa Lee; Pradesh Kumar; Sui An Lie; Yoong Chuan Tay; Lai Chee Lee; Moi Lin Ling; Bien Soo Tan; Kiang Hiong Tay Journal: Cardiovasc Intervent Radiol Date: 2020-04-27 Impact factor: 2.740
Authors: Maximilian Neidhardt; Stefan Gerlach; Robin Mieling; Max-Heinrich Laves; Thorben Weib; Martin Gromniak; Antonia Fitzek; Dustin Mobius; Inga Kniep; Alexandra Ron; Julia Schadler; Axel Heinemann; Klaus Puschel; Benjamin Ondruschka; Alexander Schlaefer Journal: IEEE Trans Med Robot Bionics Date: 2022-01-26