Accuracy and efficacy of percutaneous biopsy and ablation using robotic assistance under computed tomography guidance: a phantom study

Koethe, Yilun; Xu, Sheng; Velusamy, Gnanasekar; Wood, Bradford J.; Venkatesan, Aradhana M.

doi:10.1007/s00330-013-3056-y

Cited by 85 publications

(60 citation statements)

References 30 publications

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“…(B) Specialised antennas: designed to selectively heat focal zones presently treated with RF applicators, but in less time and with greater precision [100,101,123]. (C) Navigation with co-registration: technology exists to co-register a treatment target with a treatment device but has not been incorporated into systems that utilise ablation [124,125]. (D) New malignant organ sites: following liver ablation, new tumour sites will be targeted with MW, including more lung, breast, prostate and bone mets (see citations in Section 4.3).…”

Section: Discussionmentioning

confidence: 99%

Interstitial microwave treatment for cancer: historical basis and current techniques in antenna design and performance

Ryan¹,

Brace

2016

International Journal of Hyperthermia

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The use of microwaves (MW) for thermal cancer treatment began in the late 1970s. At first, hyperthermia was induced by using single antennas applied interstitially. This was followed by arrays of multiple interstitial antennas driven synchronously at 915 or 2450 MHz. This early work focused on hyperthermia as an adjuvant therapy, but more recently has evolved into a thermally ablative monotherapy. Increased power required to thermally ablate tissues required additional developments such as internally cooled antennas. Larger tumours have also been ablated with MW antenna arrays activated synchronously or non-synchronously. Numerical modelling has provided clinical treatment planning guidance and device design insight throughout this history. MW thermal therapy systems, treatment planning, navigation and image guidance continue to evolve to provide better tools and options for clinicians and patients in order to provide targeting optimisation with the goal of improved treatment for the patient and durable cancer eradication. This paper reviews the history and related technological developments, including antenna design, of MW heating for both hyperthermia and ablation.

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Section: Discussionmentioning

confidence: 99%

Interstitial microwave treatment for cancer: historical basis and current techniques in antenna design and performance

Ryan¹,

Brace

2016

International Journal of Hyperthermia

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“…The efficacy of robotic assistance for needle placements in the thorax or abdomen has been typically evaluated through experimental placements performed on phantoms [15], animals [29] or patients [26] without comparison to manual placements to similar targets by experienced IR physicians using standard technique. We address this knowledge gap by comparing CT-Fluoroscopy guided manual and CT-guided RPS assisted needle placement by experienced IR physician when targeting small in-vivo targets in liver.…”

Section: Introductionmentioning

confidence: 99%

Comparison of CT Fluoroscopy-Guided Manual and CT-Guided Robotic Positioning System for In Vivo Needle Placements in Swine Liver

Cornelis

Takaki

Laskhmanan³

et al. 2014

Cardiovasc Intervent Radiol

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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 5mm 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 were not statistically different (manual: 4.53 mm; RPS: 4.66 mm; p=0.41), but manual placement resulted in higher total radiation dose (manual: 1075.77mGy/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: 6.12mins; RPS: 9.7mins; 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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“…Maxio's mean tip-to-target distance, which corresponds to overall error of our system, was 6.5±2.5 mm (9). Our system has shown improved accuracy; overall error was 2 mm.…”

Section: Discussionmentioning

confidence: 74%

Validation of a CT-guided intervention robot for biopsy and radiofrequency ablation: experimental study with an abdominal phantom

Won

Kim²,

Kim³

et al. 2017

Diagn Interv Radiol

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C omputed tomography (CT)-guided interventions such as biopsy, catheter drainage, and radiofrequency ablation are widely used as minimally invasive diagnostic and therapeutic procedures. The use of CT fluoroscopy helps to reduce the procedure time, patient radiation dose, and complications, particularly in risky locations near large vessels and the gastrointestinal tract. Reported success rates of conventional CT and CT fluoroscopy-guided biopsies range from 90%-100% and 83%-100%, respectively (1-3). However, CT-guided interventions are time-consuming procedures and should be performed by experienced interventional radiologists. In addition, significant radiation exposures occur to medical personnel when CT fluoroscopic guidance is used.Recently, development of the robotic surgery platform has provided a tool that can overcome many of the limitations of conventional surgery. Augmented dexterity enabled by the endowristed movements, software filtration of the surgeon's movements, and enhanced vision provided by the stereoscopic camera combine to allow steady and careful dissection and prompt and precise suturing (4, 5). These advantages of the robotic system can also enable accurate targeting with diverse angulation of the robotic arm in CT-guided biopsy and tumor ablation. Furthermore, robotic intervention can potentially decrease procedure time and radiation exposure to both patients and doctors (6).We developed a robotic system with path-planning and needle-placement functions under CT guidance. The purpose of this experiment was to assess the stability and accuracy of our CT-guided intervention robot using an abdominal phantom. Methods Robot systemThe interventional robotic system used in this study is a master-slave type robotic system for CT-guided needle intervention jointly developed by our hospital and a manufacturer (Fig. 1). I N T E R V E N T I O N A L R A D I O LO G Y O R I G I N A L A R T I C L E PURPOSEWe aimed to evaluate the accuracy of a needle-placement robot for biopsy and radiofrequency ablation on an abdominal phantom. METHODSA master-slave robotic system has been developed that includes a needle-path planning system and a needle-inserting robot arm with computed tomography (CT) and CT fluoroscopy guidance. For evaluation of its accuracy in needle placement, a commercially available abdominal phantom (Model 057A; CIRS Inc.) was used. The liver part of the phantom contains multiple spherical simulated tumors of three different size spheres. Various needle insertion trials were performed in the transverse plane and caudocranial plane two nodule sizes (10 mm and 20 mm in diameter) to test the reliability of this robot. To assess accuracy, a CT scan was performed after each trial with the needle in situ. RESULTSThe overall error was 2 mm (0-2.6 mm), which was calculated as the distance from the planned trajectory before insertion to the actual needle trajectory after insertion. The standard deviations of the insertions on two nodules (10 mm and 20 mm in diameter) were 0.5 mm and 0.2 mm, respect...

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Accuracy and efficacy of percutaneous biopsy and ablation using robotic assistance under computed tomography guidance: a phantom study

Cited by 85 publications

References 30 publications

Interstitial microwave treatment for cancer: historical basis and current techniques in antenna design and performance

Interstitial microwave treatment for cancer: historical basis and current techniques in antenna design and performance

Comparison of CT Fluoroscopy-Guided Manual and CT-Guided Robotic Positioning System for In Vivo Needle Placements in Swine Liver

Validation of a CT-guided intervention robot for biopsy and radiofrequency ablation: experimental study with an abdominal phantom

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