Brachytherapy next generation: robotic systems

Abstract

In a field dominated by external beam radiation therapy (EBRT), both the therapeutic and technical possibilities of brachytherapy (BT) are underrated, shadowed by protons and intensity modulated radiotherapy. Decreasing expertise and indications, as well as increasing lack of specific BT training for radiation therapy (RT) residents led to the real need of shortening its learning curve and making it more popular. Developing robotic BT devices can be a way to mitigate the above issues. There are many teams working at custom-made robotic BT platforms to perfect and overcome the limitations of the existing systems. This paper provides a picture of the current state-of-the-art in robotic assisted BT, as it also conveys the author's solution to the problem, a parallel robot that uses CT-guidance.

Design and validation of a CT‐guided robotic system for lung cancer brachytherapy

“…Robotic-assisted surgery with image-guidance has made significant progress in recent years and many robotic-assisted systems for percutaneous puncture have been developed for lung, prostate, or other organs. 12,13 Currently, ROBIO EX is used as the only clinical robotic system for lung percutaneous puncture, which assists lung biopsy with CT-guidance to accurately locate the biopsy needle by manual insertion. Anzidei et al 14 compared the performance of the ROBIO EX system with manual technique and reported that the system has advantages in accurate positioning, time-saving, and satisfied pathological result.…”

“…This relies on accurate positioning of the template to guarantee insertion accuracy and radioactive seed implantation accuracy according to the treatment plan. In current clinical manual procedure, the template is guided by repeated CT scans and the positioning of template is time‐consuming, leading the whole operation to last almost 2 h. Robotic‐assisted brachytherapy devices can be a way to simplify this procedure and improve the manual positioning accuracy …”

“…Robotic‐assisted surgery with image‐guidance has made significant progress in recent years and many robotic‐assisted systems for percutaneous puncture have been developed for lung, prostate, or other organs …”

“…In current clinical manual procedure, the template is guided by repeated CT scans and the positioning of template is time-consuming, leading the whole operation to last almost 2 h. Robotic-assisted brachytherapy devices can be a way to simplify this procedure and improve the manual positioning accuracy. 7,12,13…”

A novel auto‐positioning method in Iodine‐125 seed brachytherapy driven by preoperative planning

“…1. [9][10][11] To adjust the template, the initial position and target position of the template must be determined. The process is completed manually, which is associated with long treatment time and poor accuracy.…”