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Bodard S, Guinebert S, Petre EN, Alexander E, Marinelli B, Sarkar D, Cornelis FH. Percutaneous Lung Biopsies With Robotic Systems: A Systematic Review of Available Clinical Solutions. Can Assoc Radiol J 2024:8465371241242758. [PMID: 38581355 DOI: 10.1177/08465371241242758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024] Open
Abstract
Objectives: This systematic review aims to assess existing research concerning the use of robotic systems to execute percutaneous lung biopsy. Methods: A systematic review was performed and identified 4 studies involving robotic systems used for lung biopsy. Outcomes assessed were operation time, radiation dose to patients and operators, technical success rate, diagnostic yield, and complication rate. Results: One hundred and thirteen robot-guided percutaneous lung biopsies were included. Technical success and diagnostic yield were close to 100%, comparable to manual procedures. Technical accuracy, illustrated by needle positioning, showed less frequent needle adjustments in robotic guidance than in manual guidance (P < .001): 2.7 ± 2.6 (range 1-4) versus 6 ± 4 (range 2-12). Procedure time ranged from comparable to reduced by 35% on average (20.1 ± 11.3 minutes vs 31.4 ± 10.2 minutes, P = .001) compared to manual procedures. Patient irradiation ranged from comparable to reduced by an average of 40% (324 ± 114.5 mGy vs 541.2 ± 446.8 mGy, P = .001). There was no significant difference in reported complications between manual biopsy and biopsies that utilized robotic guidance. Conclusion: Robotic systems demonstrate promising results for percutaneous lung biopsy. These devices provide adequate accuracy in probe placement and could both reduce procedural duration and mitigate radiation exposure to patients and practitioners. However, this review underscores the need for larger, controlled trials to validate and extend these findings.
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Affiliation(s)
- Sylvain Bodard
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiology, University of Paris Cité, Necker Hospital, Paris, France
- Laboratoire d'Imagerie Biomédicale, Sorbonne University, CNRS UMR 7371, INSERM U 1146, Paris, France
| | - Sylvain Guinebert
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elena N Petre
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Erica Alexander
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Brett Marinelli
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Debkumar Sarkar
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Francois H Cornelis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiology, Sorbonne University, Tenon Hospital, Paris, France
- Weill Cornell Medical College, New York, NY, USA
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2
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Piccinelli M, Cheng Z, Dall'Alba D, Schmidt MK, Savarimuthu TR, Fiorini P. 3D Vision Based Robot Assisted Electrical Impedance Scanning for Soft Tissue Conductivity Sensing. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3150481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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3
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de Baere T, Roux C, Noel G, Delpla A, Deschamps F, Varin E, Tselikas L. Robotic assistance for percutaneous needle insertion in the kidney: preclinical proof on a swine animal model. Eur Radiol Exp 2022; 6:13. [PMID: 35257224 PMCID: PMC8901810 DOI: 10.1186/s41747-022-00265-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/17/2022] [Indexed: 01/04/2023] Open
Abstract
Abstract
Background
We evaluated the accuracy, safety, and feasibility of a computed tomography (CT)-guided robotic assistance system for percutaneous needle placement in the kidney.
Methods
Fiducials surgically implanted into the kidneys of two pigs were used as targets for subsequent robotically-assisted needle insertion. Robotically-assisted needle insertions and CT acquisitions were coordinated using respiratory monitoring. An initial scan volume data set was used for needle insertion planning defining skin entry and target point. Then, needle insertion was performed according to robot positioning. The accuracy of needle placement was evaluated upon the distance between the needle tip and the predefined target on a post needle insertion scan. A delayed contrast-enhanced CT scan was acquired to assess safety.
Results
Eight needle trajectories were performed with a median procedural time measured from turning on the robotic system to post needle insertion CT scan of 21 min (interquartile range 15.5−26.5 min). Blind review of needle placement accuracy was 2.3 ± 1.2 mm (mean ± standard deviation) in lateral deviation, 0.7 ± 1.7 mm in depth deviation, and 2.8 ± 1.3 mm in three-dimensional Euclidian deviation. All needles were inserted on the first attempt, which determined 100% feasibility, without needle readjustment. The angulation and length of the trajectory did not impact on the needle placement accuracy. Two minor procedure-related complications were encountered: 2 subcapsular haematomas (13 × 6 mm and 35 × 6 mm) in the same animal.
Conclusions
Robotically-assisted needle insertion was shown feasible, safe and accurate in a swine kidney model. Further larger studies are needed.
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Zhang W, Xia P, Liu S, Huang X, Zhao X, Liu Z, Dang H, Li X, Niu G. A coordinate positioning puncture method under robot-assisted CT-guidance: phantom and animal experiments. MINIM INVASIV THER 2022; 31:206-215. [PMID: 32633586 DOI: 10.1080/13645706.2020.1787451] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the accuracy of the robot-assisted computed tomography (CT)-guided coordinate positioning puncture method by phantom and animal experiments. MATERIAL AND METHODS In the phantom experiment, seven robot-assisted punctures were made to evaluate the accuracy of the method. In the animal experiment, 18 punctures (nine robotic and nine manual) were made in the livers of nine rabbits. The indicators, such as needle-tract length, angle deviation, puncture accuracy, number of scans required, and radiation exposure dose were compared between manual and robotic punctures. The paired-samples t-test was used for analysis. RESULTS In the phantom experiment, the mean accuracy of seven punctures was 2.67 mm. In the animal experiment, there was no significant difference in needle-tract length (32.58 mm vs. 34.04 mm, p = .606), angle deviation (17.21° vs. 21.23° p = .557) and puncture accuracy (8.42 vs. 8.77 mm, p = .851) between the two groups. However, the number CT scans required (2.44 vs. 3.33, p = .002), and the radiation exposure dose (772.98 vs. 1077.89 mGy/cm, p = .003) were lower in the robot group than in the manual group. CONCLUSIONS The coordinate positioning puncture method under robot-assisted CT-guidance can reach an accuracy that is comparable to that of the traditional manual CT-guided puncture method and with fewer CT scanning times accompanied with a lower radiation dosage.
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Affiliation(s)
- Weifan Zhang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Peng Xia
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Shijie Liu
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, PR China
| | - Xiaowei Huang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, PR China
| | - Xinhui Zhao
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Zhao Liu
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Hui Dang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Xiaohu Li
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, PR China
| | - Gang Niu
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
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5
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Shaaban AS, Ali AS, Mostafa R, El-Samie FEA. Design and Implementation of Needle Steering System. 2021 11TH IEEE INTERNATIONAL CONFERENCE ON CONTROL SYSTEM, COMPUTING AND ENGINEERING (ICCSCE) 2021. [DOI: 10.1109/iccsce52189.2021.9530973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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6
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Pfeil A, Barbé L, Geiskopf F, Cazzato RL, Renaud P. Workflow-Based Design and Evaluation of a Device for CBCT-Guided Biopsy. J Med Device 2021. [DOI: 10.1115/1.4050660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Biopsies for personalized cancer care can be performed with cone beam computed tomography (CBCT) guidance, but manual needle manipulation remains an issue due to X-ray exposure to physicians. Modern CBCT scanners integrate today real-time imaging and software assistance for needle planning. In this paper, these available features are exploited to design a novel device offering an intermediate level of assistance between simple passive mechanical devices of limited efficiency, and advanced robotic devices requiring adapted procedure workflows. Our resulting system is built to limit its impact on the current manual practice. It is patient-mounted and provides remote control of needle orientation and insertion. A multilayer phantom is specifically developed to reproduce interactions between the needle and soft abdominal tissues. It is used to experimentally evaluate the device added value by comparing assisted versus manual needle insertions. The device is shown to help reducing X-ray exposure by a factor 4, without impacting the accuracy obtained manually.
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Affiliation(s)
- A. Pfeil
- ICube Laboratory, University of Strasbourg, CNRS INSA, Strasbourg 67000, France
| | - L. Barbé
- ICube Laboratory, University of Strasbourg, CNRS, Strasbourg 67000, France
| | - F. Geiskopf
- ICube Laboratory, University of Strasbourg, CNRS INSA, Strasbourg 67000, France
| | - R. L. Cazzato
- ICube Laboratory, University Hospital of Strasbourg, Strasbourg 67000, France
| | - P. Renaud
- ICube Laboratory, University of Strasbourg, CNRS INSA, Strasbourg 67000, France
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Švaco M, Stiperski I, Dlaka D, Šuligoj F, Jerbić B, Chudy D, Raguž M. Stereotactic Neuro-Navigation Phantom Designs: A Systematic Review. Front Neurorobot 2020; 14:549603. [PMID: 33192433 PMCID: PMC7644893 DOI: 10.3389/fnbot.2020.549603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/16/2020] [Indexed: 11/28/2022] Open
Abstract
Diverse stereotactic neuro-navigation systems are used daily in neurosurgery and novel systems are continuously being developed. Prior to clinical implementation of new surgical tools, methods or instruments, in vitro experiments on phantoms should be conducted. A stereotactic neuro-navigation phantom denotes a rigid or deformable structure resembling the cranium with the intracranial area. The use of phantoms is essential for the testing of complete procedures and their workflows, as well as for the final validation of the application accuracy. The aim of this study is to provide a systematic review of stereotactic neuro-navigation phantom designs, to identify their most relevant features, and to identify methodologies for measuring the target point error, the entry point error, and the angular error (α). The literature on phantom designs used for evaluating the accuracy of stereotactic neuro-navigation systems, i.e., robotic navigation systems, stereotactic frames, frameless navigation systems, and aiming devices, was searched. Eligible articles among the articles written in English in the period 2000–2020 were identified through the electronic databases PubMed, IEEE, Web of Science, and Scopus. The majority of phantom designs presented in those articles provide a suitable methodology for measuring the target point error, while there is a lack of objective measurements of the entry point error and angular error. We identified the need for a universal phantom design, which would be compatible with most common imaging techniques (e.g., computed tomography and magnetic resonance imaging) and suitable for simultaneous measurement of the target point, entry point, and angular errors.
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Affiliation(s)
- Marko Švaco
- Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia.,Department of Neurosurgery, University Hospital Dubrava, Zagreb, Croatia
| | - Ivan Stiperski
- Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia
| | - Domagoj Dlaka
- Department of Neurosurgery, University Hospital Dubrava, Zagreb, Croatia
| | - Filip Šuligoj
- Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia.,Department of Neurosurgery, University Hospital Dubrava, Zagreb, Croatia
| | - Bojan Jerbić
- Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia.,Department of Neurosurgery, University Hospital Dubrava, Zagreb, Croatia
| | - Darko Chudy
- Department of Neurosurgery, University Hospital Dubrava, Zagreb, Croatia.,Croatian Institute for Brain Research, School of Medicine University of Zagreb, Zagreb, Croatia.,Department of Surgery, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Marina Raguž
- Department of Neurosurgery, University Hospital Dubrava, Zagreb, Croatia.,Croatian Institute for Brain Research, School of Medicine University of Zagreb, Zagreb, Croatia.,Department of Anatomy and Clinical Anatomy, School of Medicine University of Zagreb, Zagreb, Croatia
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8
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Ye M, Li W, Chan DTM, Chiu PWY, Li Z. A Semi-Autonomous Stereotactic Brain Biopsy Robot With Enhanced Safety. IEEE Robot Autom Lett 2020. [DOI: 10.1109/lra.2020.2967732] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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9
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Origami Lesion-Targeting Device for CT-Guided Interventions. J Imaging 2019; 5:jimaging5020023. [PMID: 34460471 PMCID: PMC8320902 DOI: 10.3390/jimaging5020023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 11/17/2022] Open
Abstract
The objective of this study is to preliminarily evaluate a lesion-targeting device for CT-guided interventions. The device is created by laser cutting the structure from a sheet of medical grade paperboard, 3D printing two radiocontrast agent grids onto the surface and folding the structure into a rectangular prism with a viewing window. An abdominal imaging phantom was used to evaluate the device through CT imaging and the targeting of lesions for needle insertion. The lesion-targeting trials resulted in a mean targeting error of 2.53 mm (SD 0.59 mm, n = 30). The device is rigid enough to adequately support standard biopsy needles, and it attaches to the patient, reducing the risk of tissue laceration by needles held rigidly in place by an external manipulator. Additional advantages include adequate support for the insertion of multiple surgical tools at once for procedures such as composite ablation and the potential to guide off-axial needle insertion. The low-cost and disposability of the device make it well-suited for the minimally invasive image-guided therapy environment.
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10
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Computed Tomography-Assisted Thoracoscopic Surgery: A Novel, Innovative Approach in Patients With Deep Intrapulmonary Lesions of Unknown Malignant Status. Invest Radiol 2018; 52:374-380. [PMID: 28141614 DOI: 10.1097/rli.0000000000000353] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Minimally invasive resection of small, deep intrapulmonary lesions can be challenging due to the difficulty of localizing them during video-assisted thoracoscopic surgery (VATS). We report our preliminary results evaluating the feasibility of an image-guided, minimally invasive, 1-stop-shop approach for the resection of small, deep intrapulmonary lesions in a hybrid operating room (OR). MATERIALS AND METHODS Fifteen patients (5 men, 10 women; mean age, 63 years) with a total of 16 solitary, deep intrapulmonary nodules of unknown malignant status were identified for intraoperative wire marking. Patients were placed on the operating table for resection by VATS. A marking wire was placed within the lesion under 3D laser and fluoroscopic guidance using a cone beam computed tomography system. Then, wedge resection by VATS was performed in the same setting without repositioning the patient. RESULTS Complete resection with adequate safety margins was confirmed for all lesions. Marking wire placement facilitated resection in 15 of 16 lesions. Eleven lesions proved to be malignant, either primary or secondary; 5 were benign. Mean lesion size was 7.7 mm; mean distance to the pleural surface was 15.1 mm (mean lesion depth-diameter ratio, 2.2). Mean procedural time for marking wire placement was 35 minutes; mean VATS duration was 36 minutes. CONCLUSIONS Computed tomography-assisted thoracoscopic surgery is a new, safe, and effective procedure for minimally invasive resection of small, deeply localized intrapulmonary lesions. The benefits of computed tomography-assisted thoracoscopic surgery are 1. One-stop-shop procedure, 2. Lower risk for the patient (no patient relocation, no marking wire loss), and 3. No need to coordinate scheduling between the CT room and OR.
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11
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Arnolli MM, Buijze M, Franken M, de Jong KP, Brouwer DM, Broeders IAMJ. System for CT-guided needle placement in the thorax and abdomen: A design for clinical acceptability, applicability and usability. Int J Med Robot 2017; 14. [PMID: 29205787 DOI: 10.1002/rcs.1877] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND Various systems exist for CT-guided needle placement in the thorax and abdomen, but widespread adoption is lacking. The goal of this work is to develop a system for precise needle placement with a design focus on clinical acceptability, applicability and usability. METHODS A system was outlined incorporating a needle guide on a mechanism with a remote centre of motion, manually placeable around the patient at the desired entry point and lockable by push-button to the CT table. System and patient are scanned for system-to-CT registration and target specification. The needle guide is automatically aimed at the target, for manual needle insertion to specified depth. RESULTS A fully functional prototype was realized, achieving 1.2±0.6 mm placement error at 79.0±8.4 mm depth and 2.1±0.7 mm at 156.0±6.9 mm for 2×12 in- and out-of-plane punctures in a gelatin phantom. CONCLUSIONS The system enables precise needle placement in a single insertion and is ready for its first clinical deployment.
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Affiliation(s)
- Maarten M Arnolli
- DEMCON Advanced Mechatronics, the Netherlands.,Precision Engineering, Science-based Engineering, University of Twente, the Netherlands
| | | | | | - Koert P de Jong
- Department of Hepato-Pancreato-Biliary Surgery & Liver Transplantation, University Medical Center Groningen, the Netherlands
| | - Dannis M Brouwer
- Precision Engineering, Science-based Engineering, University of Twente, the Netherlands
| | - Ivo A M J Broeders
- Minimally Invasive Surgery & Robotics, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, the Netherlands
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12
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Shahriari N, Heerink W, van Katwijk T, Hekman E, Oudkerk M, Misra S. Computed tomography (CT)-compatible remote center of motion needle steering robot: Fusing CT images and electromagnetic sensor data. Med Eng Phys 2017; 45:71-77. [PMID: 28512000 DOI: 10.1016/j.medengphy.2017.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/22/2017] [Accepted: 04/23/2017] [Indexed: 12/29/2022]
Abstract
Lung cancer is the most common cause of cancer-related death, and early detection can reduce the mortality rate. Patients with lung nodules greater than 10 mm usually undergo a computed tomography (CT)-guided biopsy. However, aligning the needle with the target is difficult and the needle tends to deflect from a straight path. In this work, we present a CT-compatible robotic system, which can both position the needle at the puncture point and also insert and rotate the needle. The robot has a remote-center-of-motion arm which is achieved through a parallel mechanism. A new needle steering scheme is also developed where CT images are fused with electromagnetic (EM) sensor data using an unscented Kalman filter. The data fusion allows us to steer the needle using the real-time EM tracker data. The robot design and the steering scheme are validated using three experimental cases. Experimental Case I and II evaluate the accuracy and CT-compatibility of the robot arm, respectively. In experimental Case III, the needle is steered towards 5 real targets embedded in an anthropomorphic gelatin phantom of the thorax. The mean targeting error for the 5 experiments is 1.78 ± 0.70 mm. The proposed robotic system is shown to be CT-compatible with low targeting error. Small nodule size and large needle diameter are two risk factors that can lead to complications in lung biopsy. Our results suggest that nodules larger than 5 mm in diameter can be targeted using our method which may result in lower complication rate.
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Affiliation(s)
- Navid Shahriari
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, The Netherlands; Department of Biomechanical Engineering, MIRA-Institute for Biomedical Technology and Technical Medicine, University of Twente, Horstring (HR) Z-140, Drienerlolaan 5, Enschede 7522NB, The Netherlands.
| | - Wout Heerink
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Tim van Katwijk
- Department of Biomechanical Engineering, MIRA-Institute for Biomedical Technology and Technical Medicine, University of Twente, Horstring (HR) Z-140, Drienerlolaan 5, Enschede 7522NB, The Netherlands
| | - Edsko Hekman
- Department of Biomechanical Engineering, MIRA-Institute for Biomedical Technology and Technical Medicine, University of Twente, Horstring (HR) Z-140, Drienerlolaan 5, Enschede 7522NB, The Netherlands
| | - Matthijs Oudkerk
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Sarthak Misra
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, The Netherlands; Department of Biomechanical Engineering, MIRA-Institute for Biomedical Technology and Technical Medicine, University of Twente, Horstring (HR) Z-140, Drienerlolaan 5, Enschede 7522NB, The Netherlands; Department of Biomedical Engineering, University of Groningen, University Medical Center Groningen, The Netherlands
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Avgousti S, Christoforou EG, Panayides AS, Voskarides S, Novales C, Nouaille L, Pattichis CS, Vieyres P. Medical telerobotic systems: current status and future trends. Biomed Eng Online 2016; 15:96. [PMID: 27520552 PMCID: PMC4983067 DOI: 10.1186/s12938-016-0217-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 08/02/2016] [Indexed: 01/27/2023] Open
Abstract
Teleoperated medical robotic systems allow procedures such as surgeries, treatments, and diagnoses to be conducted across short or long distances while utilizing wired and/or wireless communication networks. This study presents a systematic review of the relevant literature between the years 2004 and 2015, focusing on medical teleoperated robotic systems which have witnessed tremendous growth over the examined period. A thorough insight of telerobotics systems discussing design concepts, enabling technologies (namely robotic manipulation, telecommunications, and vision systems), and potential applications in clinical practice is provided, while existing limitations and future trends are also highlighted. A representative paradigm of the short-distance case is the da Vinci Surgical System which is described in order to highlight relevant issues. The long-distance telerobotics concept is exemplified through a case study on diagnostic ultrasound scanning. Moreover, the present review provides a classification into short- and long-distance telerobotic systems, depending on the distance from which they are operated. Telerobotic systems are further categorized with respect to their application field. For the reviewed systems are also examined their engineering characteristics and the employed robotics technology. The current status of the field, its significance, the potential, as well as the challenges that lie ahead are thoroughly discussed.
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Affiliation(s)
- Sotiris Avgousti
- Nursing Department, School of Health and Science, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036 Limassol, Cyprus
| | - Eftychios G. Christoforou
- Department of Electrical and Computer Engineering, University of Cyprus, 75 Kalipoleos Street, P.O.BOX 20537, 1678 Nicosia, Cyprus
| | - Andreas S. Panayides
- Department of Electrical and Electronic Engineering, Imperial College, South Kensington Campus, London, SW7 2AZ UK
- Department of Computer Science, University of Cyprus, 75 Kalipoleos Street, P.O.BOX 20537, 1678 Nicosia, Cyprus
| | - Sotos Voskarides
- Department of Electrical Engineering, Computer Engineering and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036 Lemesos, Cyprus
| | - Cyril Novales
- Laboratoire PRISME-Universite d’Orleans, 63 Avenue de Lattre de Tassigny, 18020 Bourges, France
| | - Laurence Nouaille
- Laboratoire PRISME-Universite d’Orleans, 63 Avenue de Lattre de Tassigny, 18020 Bourges, France
| | - Constantinos S. Pattichis
- Department of Computer Science, University of Cyprus, 75 Kalipoleos Street, P.O.BOX 20537, 1678 Nicosia, Cyprus
| | - Pierre Vieyres
- Laboratoire PRISME-Universite d’Orleans, 63 Avenue de Lattre de Tassigny, 18020 Bourges, France
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14
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Fischer S, Vogl TJ, Kresing M, Marzi I, Zangos S, Mack MG, Eichler K. Minimally invasive screw fixation of fractures in the thoracic spine: CT-controlled pre-surgical guidewire implantation in routine clinical practice. Clin Radiol 2016; 71:997-1004. [PMID: 27426675 DOI: 10.1016/j.crad.2016.06.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/24/2016] [Accepted: 06/14/2016] [Indexed: 11/24/2022]
Abstract
AIM To evaluate the feasibility and accuracy of minimally invasive, transpedicular screw placement in cervicothoracic fractures with the help of computed tomography (CT)-controlled guidewires. MATERIALS AND METHODS Two hundred and ninety-three guidewires were inserted in 35 patients (42.9±21.2 years) under CT fluoroscopy (286 thoracic, seven cervical). There were 28 traumatic cases, three pathological fractures, three fractures due to infectious infiltrations, and one osteoporotic fracture. In 151 pedicles, screw placement was performed in the CT room. CT images were reviewed regarding accuracy and cortical violations using the popular 2 mm increment deviation classification of Gertzbein and Robbins. RESULTS Guidewire implantation resulted in only 28 cortical contacts. Minor encroachments of the pedicle wall by inserted screws occurred in 39.1% (59 of 151) and in 23.8% if taking unavoidable encroachments into account (30 of 59). Pedicular isthmus width correlated to cortical guidewire contacts (r=-0.449; p=0.077) and pedicle violations (all graded "A") by the inserted screws (r=-0.581; p=0.049). Total procedural duration was 138.6±44.2 minutes, representing 14.5±11.6 minutes for each pedicle, while showing a significant correlation against higher vertebral levels (r=-0.849; p=0.0002) and the occurrence of pedicle violations (r=-0.641; p=0.027). CONCLUSIONS The treatment of vertebral fractures with a guidewire-based pedicle screw insertion technique under CT imaging results in very high accuracy and a low complication rate.
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Affiliation(s)
- S Fischer
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
| | - T J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - M Kresing
- Dr. Mohr and Colleagues, Carl-Ulrich Street 2, 63263 Neu-Isenburg, Germany
| | - I Marzi
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - S Zangos
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - M G Mack
- Radiology Munich, Burgstraße 7, 80331 Munich, Germany
| | - K Eichler
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
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Kroes MW, van Strijen MJL, Braak SJ, Hoogeveen YL, de Lange F, Schultze Kool LJ. The Use of Laser Guidance Reduces Fluoroscopy Time for C-Arm Cone-Beam Computed Tomography-Guided Biopsies. Cardiovasc Intervent Radiol 2016; 39:1322-6. [PMID: 27094692 PMCID: PMC4963440 DOI: 10.1007/s00270-016-1345-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 03/30/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE When using laser guidance for cone-beam computed tomography (CBCT)-guided needle interventions, planned needle paths are visualized to the operator without the need to switch between entry- and progress-view during needle placement. The current study assesses the effect of laser guidance during CBCT-guided biopsies on fluoroscopy and procedure times. MATERIALS AND METHODS Prospective data from 15 CBCT-guided biopsies of 8-65 mm thoracic and abdominal lesions assisted by a ceiling-mounted laser guidance technique were compared to retrospective data of 36 performed CBCT-guided biopsies of lesions >20 mm using the freehand technique. Fluoroscopy time, procedure time, and number of CBCT-scans were recorded. All data are presented as median (ranges). RESULTS For biopsies using the freehand technique, more fluoroscopy time was necessary to guide the needle onto the target, 165 s (83-333 s) compared to 87 s (44-190 s) for laser guidance (p < 0.001). Procedure times were shorter for freehand-guided biopsies, 24 min versus 30 min for laser guidance (p < 0.001). CONCLUSION The use of laser guidance during CBCT-guided biopsies significantly reduces fluoroscopy time.
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Affiliation(s)
- Maarten W Kroes
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Marco J L van Strijen
- Department of Radiology, St. Antonius Hospital, P.O. Box 2500, 3430 EM, Nieuwegein, The Netherlands
| | - Sicco J Braak
- Department of Radiology, St. Antonius Hospital, P.O. Box 2500, 3430 EM, Nieuwegein, The Netherlands
| | - Yvonne L Hoogeveen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Frank de Lange
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Leo J Schultze Kool
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
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Accuracy of percutaneous soft-tissue interventions using a multi-axis, C-arm CT system and 3D laser guidance. Eur J Radiol 2015; 84:1970-5. [DOI: 10.1016/j.ejrad.2015.06.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 06/08/2015] [Accepted: 06/26/2015] [Indexed: 11/19/2022]
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Gruber-Rouh T, Lee C, Bolck J, Naguib NNN, Schulz B, Eichler K, Aschenbach R, Wichmann JL, Vogl TJ, Zangos S. Intervention Planning Using a Laser Navigation System for CT-Guided Interventions: A Phantom and Patient Study. Korean J Radiol 2015; 16:729-35. [PMID: 26175571 PMCID: PMC4499536 DOI: 10.3348/kjr.2015.16.4.729] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 05/13/2015] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the accuracy, efficiency and radiation dose of a novel laser navigation system (LNS) compared to those of free-handed punctures on computed tomography (CT). Materials and Methods Sixty punctures were performed using a phantom body to compare accuracy, timely effort, and radiation dose of the conventional free-handed procedure to those of the LNS-guided method. An additional 20 LNS-guided interventions were performed on another phantom to confirm accuracy. Ten patients subsequently underwent LNS-guided punctures. Results The phantom 1-LNS group showed a target point accuracy of 4.0 ± 2.7 mm (freehand, 6.3 ± 3.6 mm; p = 0.008), entrance point accuracy of 0.8 ± 0.6 mm (freehand, 6.1 ± 4.7 mm), needle angulation accuracy of 1.3 ± 0.9° (freehand, 3.4 ± 3.1°; p < 0.001), intervention time of 7.03 ± 5.18 minutes (freehand, 8.38 ± 4.09 minutes; p = 0.006), and 4.2 ± 3.6 CT images (freehand, 7.9 ± 5.1; p < 0.001). These results show significant improvement in 60 punctures compared to freehand. The phantom 2-LNS group showed a target point accuracy of 3.6 ± 2.5 mm, entrance point accuracy of 1.4 ± 2.0 mm, needle angulation accuracy of 1.0 ± 1.2°, intervention time of 1.44 ± 0.22 minutes, and 3.4 ± 1.7 CT images. The LNS group achieved target point accuracy of 5.0 ± 1.2 mm, entrance point accuracy of 2.0 ± 1.5 mm, needle angulation accuracy of 1.5 ± 0.3°, intervention time of 12.08 ± 3.07 minutes, and used 5.7 ± 1.6 CT-images for the first experience with patients. Conclusion Laser navigation system improved accuracy, duration of intervention, and radiation dose of CT-guided interventions.
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Affiliation(s)
- Tatjana Gruber-Rouh
- Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany
| | - Clara Lee
- Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany
| | - Jan Bolck
- Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany
| | - Nagy N N Naguib
- Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany. ; Department of Radiology, Faculty of Medicine, Alexandria University, Alexandria 21514, Egypt
| | - Boris Schulz
- Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany
| | - Katrin Eichler
- Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany
| | - Rene Aschenbach
- Department of Radiology, HELIOS Klinikum Erfurt, Erfurt 99089, Germany
| | - Julian L Wichmann
- Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany
| | - Thomas J Vogl
- Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany
| | - Stephan Zangos
- Institute for Diagnostic and Interventional Radiology, J. W. Goethe University of Frankfurt, Frankfurt 60590, Germany
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Design and evaluation of a computed tomography (CT)-compatible needle insertion device using an electromagnetic tracking system and CT images. Int J Comput Assist Radiol Surg 2015; 10:1845-52. [PMID: 25843947 PMCID: PMC4617842 DOI: 10.1007/s11548-015-1176-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/10/2015] [Indexed: 12/31/2022]
Abstract
Purpose Percutaneous needle insertion procedures are commonly used for diagnostic and therapeutic purposes. Although current technology allows accurate localization of lesions, they cannot yet be precisely targeted. Lung cancer is the most common cause of cancer-related death, and early detection reduces the mortality rate. Therefore, suspicious lesions are tested for diagnosis by performing needle biopsy. Methods In this paper, we have presented a novel computed tomography (CT)-compatible needle insertion device (NID). The NID is used to steer a flexible needle (\documentclass[12pt]{minimal}
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\begin{document}$${\phi }0.55\,\hbox {mm}$$\end{document}ϕ0.55mm) with a bevel at the tip in biological tissue. CT images and an electromagnetic (EM) tracking system are used in two separate scenarios to track the needle tip in three-dimensional space during the procedure. Our system uses a control algorithm to steer the needle through a combination of insertion and minimal number of rotations. Results Noise analysis of CT images has demonstrated the compatibility of the device. The results for three experimental cases (case 1: open-loop control, case 2: closed-loop control using EM tracking system and case 3: closed-loop control using CT images) are presented. Each experimental case is performed five times, and average targeting errors are \documentclass[12pt]{minimal}
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\begin{document}$$2.86\pm 1.14$$\end{document}2.86±1.14, \documentclass[12pt]{minimal}
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\begin{document}$$1.11\pm 0.14$$\end{document}1.11±0.14 and \documentclass[12pt]{minimal}
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\begin{document}$$1.94\pm 0.63\,\hbox {mm}$$\end{document}1.94±0.63mm for case 1, case 2 and case 3, respectively. Conclusions The achieved results show that our device is CT-compatible and it is able to steer a bevel-tipped needle toward a target. We are able to use intermittent CT images and EM tracking data to control the needle path in a closed-loop manner. These results are promising and suggest that it is possible to accurately target the lesions in real clinical procedures in the future.
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Niccolini M, Castelli V, Diversi C, Kang B, Mussa F, Sinibaldi E. Development and preliminary assessment of a robotic platform for neuroendoscopy based on a lightweight robot. Int J Med Robot 2015; 12:4-17. [PMID: 25600885 DOI: 10.1002/rcs.1638] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 12/11/2014] [Accepted: 12/12/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND Ventriculostomy is a widely performed neurosurgical procedure; some risk factors can be mitigated by computer/robot-assisted approaches. Platforms fostering synergistic robot-surgeon integration are pursued, for which lightweight robots with compliant controlled joints must be assessed (because compliance hampers accuracy). METHODS We developed a platform encompassing, in particular, a lightweight robot and an optical tracker also used to enhance robot accuracy. Based on specifications by neurosurgeons, we designed a neuroendoscope-handling interface and assessed targeting accuracy in a model ventriculostomy where the robot was operated both autonomously and in hands-on (i.e. co-operative) mode. RESULTS Targeting errors were systematically below the procedure accuracy threshold (1 mm); the rms targeting errors were 0.51 and 0.54 mm for autonomous and hands-on control, respectively. No significant difference was observed between the considered control modes. Very positive feedback was gathered from neurosurgeons. CONCLUSIONS Accurate tool targeting under both autonomous and hands-on control was achieved.
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Affiliation(s)
- Marta Niccolini
- Center for Micro-BioRobotics@SSSA, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025, Pontedera, Italy
| | - Virginia Castelli
- Center for Micro-BioRobotics@SSSA, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025, Pontedera, Italy
| | - Costanza Diversi
- Center for Micro-BioRobotics@SSSA, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025, Pontedera, Italy
| | - Byungjeon Kang
- Center for Micro-BioRobotics@SSSA, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025, Pontedera, Italy.,The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34, 56025, Pontedera, Italy
| | - Federico Mussa
- Neurosurgery Department, Meyer Pediatric Hospital, Viale Pieraccini 24, 50139, Firenze, Italy
| | - Edoardo Sinibaldi
- Center for Micro-BioRobotics@SSSA, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025, Pontedera, Italy
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Arnolli MM, Hanumara NC, Franken M, Brouwer DM, Broeders IAMJ. An overview of systems for CT- and MRI-guided percutaneous needle placement in the thorax and abdomen. Int J Med Robot 2014; 11:458-75. [DOI: 10.1002/rcs.1630] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 09/17/2014] [Accepted: 09/22/2014] [Indexed: 11/11/2022]
Affiliation(s)
| | - Nevan C. Hanumara
- Mechanical Engineering Department; Massachusetts Institute of Technology; MA USA
| | | | - Dannis M. Brouwer
- Laboratory of Mechanical Automation and Mechatronics, Faculty of Engineering Technology; University of Twente; The Netherlands
| | - Ivo A. M. J. Broeders
- Robotics and Mechatronics, MIRA Institute for Biomedical Technology and Technical Medicine; University of Twente; The Netherlands
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21
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Kettenbach J, Kronreif G. Robotic systems for percutaneous needle-guided interventions. MINIM INVASIV THER 2014; 24:45-53. [DOI: 10.3109/13645706.2014.977299] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Preliminary clinical experience with a dedicated interventional robotic system for CT-guided biopsies of lung lesions: a comparison with the conventional manual technique. Eur Radiol 2014; 25:1310-6. [DOI: 10.1007/s00330-014-3508-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 09/24/2014] [Accepted: 11/14/2014] [Indexed: 12/21/2022]
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Cornelis F, Takaki H, Laskhmanan M, Durack JC, Erinjeri JP, Getrajdman GI, Maybody M, Sofocleous CT, Solomon SB, Srimathveeravalli G. Comparison of CT Fluoroscopy-Guided Manual and CT-Guided Robotic Positioning System for In Vivo Needle Placements in Swine Liver. Cardiovasc Intervent Radiol 2014; 38:1252-60. [PMID: 25376924 DOI: 10.1007/s00270-014-1016-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 09/08/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE To compare CT fluoroscopy-guided manual and CT-guided robotic positioning system (RPS)-assisted needle placement by experienced IR physicians to targets in swine liver. MATERIALS AND METHODS Manual and RPS-assisted needle placement was performed by six experienced IR physicians to four 5 mm fiducial seeds placed in swine liver (n = 6). Placement performance was assessed for placement accuracy, procedure time, number of confirmatory scans, needle manipulations, and procedure radiation dose. Intra-modality difference in performance for each physician was assessed using paired t test. Inter-physician performance variation for each modality was analyzed using Kruskal-Wallis test. RESULTS Paired comparison of manual and RPS-assisted placements to a target by the same physician indicated accuracy outcomes was not statistically different (manual: 4.53 mm; RPS: 4.66 mm; p = 0.41), but manual placement resulted in higher total radiation dose (manual: 1075.77 mGy/cm; RPS: 636.4 mGy/cm; p = 0.03), required more confirmation scans (manual: 6.6; RPS: 1.6; p < 0.0001) and needle manipulations (manual: 4.6; RPS: 0.4; p < 0.0001). Procedure time for RPS was longer than manual placement (manual: 6.12 min; RPS: 9.7 min; p = 0.0003). Comparison of inter-physician performance during manual placement indicated significant differences in the time taken to complete placements (p = 0.008) and number of repositions (p = 0.04) but not in other study measures (p > 0.05). Comparison of inter-physician performance during RPS-assisted placement suggested statistically significant differences in procedure time (p = 0.02) and not in other study measures (p > 0.05). CONCLUSIONS CT-guided RPS-assisted needle placement reduced radiation dose, number of confirmatory scans, and needle manipulations when compared to manual needle placement by experienced IR physicians, with equivalent accuracy.
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Affiliation(s)
- F Cornelis
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.,Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - H Takaki
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - M Laskhmanan
- Perfint Healthcare Inc, Chennai, Tamil Nadu, India
| | - J C Durack
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - J P Erinjeri
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - G I Getrajdman
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - M Maybody
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - C T Sofocleous
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - S B Solomon
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - G Srimathveeravalli
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
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Kettenbach J, Kara L, Toporek G, Fuerst M, Kronreif G. A robotic needle-positioning and guidance system for CT-guided puncture: Ex vivo results. MINIM INVASIV THER 2014; 23:271-8. [PMID: 24953817 DOI: 10.3109/13645706.2014.928641] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To test the feasibility of a robotic needle-guidance platform during CT-guided puncture ex vivo. MATERIAL AND METHODS Thin copper wires inserted into a torso phantom served as targets. The phantom was placed on a carbon plate and the robot-positioning unit (RPU) of the guidance platform (iSYS Medizintechnik GmbH, Kitzbuehel, Austria) was attached. Following CT imaging and automatic registration a double oblique trajectory was planned and the RPU was remotely moved into appropriate position and angulation. A 17G-puncture needle was then manually inserted until the preplanned depth, permanently guided by the RPU. The CT scan was repeated and the distance between the actual needle tip and the target was evaluated. RESULTS Automatic registration was successful in ten experiments and the median duration of an experiment was 9.6 (6.4-46.0) minutes. The angulation of the needle path in x-y and z-axis was within 15.6° to 32.6°, and -32.8° to 3.2°, respectively and the needle insertion depth was 92.8 ± 14.4 mm. The Euclidean distance between the actual needle tip and the target was 2.3 ± 0.8 (range, 0.9-3.7) mm. CONCLUSION Automatic registration and accurate needle placement close to small targets was demonstrated. Study settings and torso phantom were very close to the clinical reality.
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Affiliation(s)
- Joachim Kettenbach
- ARTORG Center for Biomedical Engineering, University of Bern , Switzerland
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Robot-assisted radiofrequency ablation of primary and secondary liver tumours: early experience. Eur Radiol 2013; 24:79-85. [PMID: 23928933 PMCID: PMC3889281 DOI: 10.1007/s00330-013-2979-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/01/2013] [Accepted: 07/10/2013] [Indexed: 12/19/2022]
Abstract
Objective Computed tomography (CT)-compatible robots, both commercial and research-based, have been developed with the intention of increasing the accuracy of needle placement and potentially improving the outcomes of therapies in addition to reducing clinical staff and patient exposure to radiation during CT fluoroscopy. In the case of highly inaccessible lesions that require multiple plane angulations, robotically assisted needles may improve biopsy access and targeted drug delivery therapy by avoidance of the straight line path of normal linear needles. Methods We report our preliminary experience of performing radiofrequency ablation of the liver using a robotic-assisted CT guidance system on 11 patients (17 lesions). Results/Conclusion Robotic-assisted planning and needle placement appears to have high accuracy, is technically easier than the non-robotic-assisted procedure, and involves a significantly lower radiation dose to both patient and support staff. Key Points • An early experience of robotic-assisted radiofrequency ablation is reported • Robotic-assisted RFA improves accuracy of hepatic lesion targeting • Robotic-assisted RFA makes the procedure technically easier with significant lower radiation dose
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Bertelsen A, Melo J, Sánchez E, Borro D. A review of surgical robots for spinal interventions. Int J Med Robot 2012; 9:407-22. [DOI: 10.1002/rcs.1469] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2012] [Indexed: 11/11/2022]
Affiliation(s)
- Alvaro Bertelsen
- Applied Mechanics Department CEIT and Tecnun; University of Navarra; San Sebastián Spain
| | - Javier Melo
- Applied Mechanics Department CEIT and Tecnun; University of Navarra; San Sebastián Spain
| | - Emilio Sánchez
- Applied Mechanics Department CEIT and Tecnun; University of Navarra; San Sebastián Spain
| | - Diego Borro
- Applied Mechanics Department CEIT and Tecnun; University of Navarra; San Sebastián Spain
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Kagadis GC, Katsanos K, Karnabatidis D, Loudos G, Nikiforidis GC, Hendee WR. Emerging technologies for image guidance and device navigation in interventional radiology. Med Phys 2012; 39:5768-81. [PMID: 22957641 DOI: 10.1118/1.4747343] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Recent developments in image-guidance and device navigation, along with emerging robotic technologies, are rapidly transforming the landscape of interventional radiology (IR). Future state-of-the-art IR procedures may include real-time three-dimensional imaging that is capable of visualizing the target organ, interventional tools, and surrounding anatomy with high spatial and temporal resolution. Remote device actuation is becoming a reality with the introduction of novel magnetic-field enabled instruments and remote robotic steering systems. Robots offer several degrees of freedom and unprecedented accuracy, stability, and dexterity during device navigation, propulsion, and actuation. Optimization of tracking and navigation of interventional tools inside the human body will be critical in converting IR suites into the minimally invasive operating theaters of the future with increased safety and unsurpassed therapeutic efficacy. In the not too distant future, individual image guidance modalities and device tracking methods could merge into autonomous, multimodality, multiparametric platforms that offer real-time data of anatomy, morphology, function, and metabolism along with on-the-fly computational modeling and remote robotic actuation. The authors provide a concise overview of the latest developments in image guidance and device navigation, while critically envisioning what the future might hold for 2020 IR procedures.
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Affiliation(s)
- George C Kagadis
- Department of Medical Physics, School of Medicine, University of Patras, Rion, Greece.
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28
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Accuracy and speed of robotic assisted needle interventions using a modern cone beam computed tomography intervention suite: a phantom study. Eur Radiol 2012; 23:198-204. [DOI: 10.1007/s00330-012-2585-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 06/22/2012] [Indexed: 12/18/2022]
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A fully sensorized cooperative robotic system for surgical interventions. SENSORS 2012; 12:9423-47. [PMID: 23012551 PMCID: PMC3444109 DOI: 10.3390/s120709423] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 07/03/2012] [Accepted: 07/03/2012] [Indexed: 11/24/2022]
Abstract
In this research a fully sensorized cooperative robot system for manipulation of needles is presented. The setup consists of a DLR/KUKA Light Weight Robot III especially designed for safe human/robot interaction, a FD-CT robot-driven angiographic C-arm system, and a navigation camera. Also, new control strategies for robot manipulation in the clinical environment are introduced. A method for fast calibration of the involved components and the preliminary accuracy tests of the whole possible errors chain are presented. Calibration of the robot with the navigation system has a residual error of 0.81 mm (rms) with a standard deviation of ±0.41 mm. The accuracy of the robotic system while targeting fixed points at different positions within the workspace is of 1.2 mm (rms) with a standard deviation of ±0.4 mm. After calibration, and due to close loop control, the absolute positioning accuracy was reduced to the navigation camera accuracy which is of 0.35 mm (rms). The implemented control allows the robot to compensate for small patient movements.
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Nelson TR, Tran A, Fakourfar H, Nebeker J. Positional calibration of an ultrasound image-guided robotic breast biopsy system. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:351-359. [PMID: 22368125 DOI: 10.7863/jum.2012.31.3.351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Precision biopsy of small lesions is essential in providing high-quality patient diagnosis and management. Localization depends on high-quality imaging. We have developed a dedicated, fully automatic volume breast ultrasound (US) imaging system for early breast cancer detection. This work focuses on development of an image-guided robotic biopsy system that is integrated with the volume breast US system for performing minimally invasive breast biopsies. The objective of this work was to assess the positional accuracy of the robotic system for breast biopsy. METHODS We have adapted a compact robotic arm for performing breast biopsy. The arm incorporates a force torque sensor and is modified to accommodate breast biopsy sampling needles mounted on the robot end effector. Volume breast US images are used as input to a targeting algorithm that provides the physician with control of biopsy device guidance and trajectory optimization. In this work, the positional accuracy was evaluated using (1) a light-emitting diode (LED) mounted on the end effector and (2) a LED mounted on the end of a biopsy needle, each of which was imaged for each robot controller position as part of mapping the positional accuracy throughout a volume that would contain the breast. We measured the error in each location and the cumulative error. RESULTS Robotic device performance over the volume provided mean accuracy ± SD of 0.76 ± 0.13 mm (end effector) and 0.55 ± 0.13 mm (needle sample location), sufficient for a targeting accuracy within ±1 mm, which is suitable for clinical use. Depth positioning error also was small: 0.38 ± 0.03 mm. Reproducibility was excellent with less than 0.5% variation. CONCLUSIONS Overall accuracy and reproducibility of the compact robotic device were excellent, well within clinical biopsy performance requirements. Volume breast US data provide high-quality input to a biopsy sampling algorithm under physician control. Robotic devices may provide more precise device placement, assisting physicians with biopsy procedures.
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Affiliation(s)
- Thomas R Nelson
- Department of Radiology, University of California, San Diego, 9500 Gilman Dr, Room 113, La Jolla, CA 92037-0610, USA.
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