Evaluation of the Needle Positioning Accuracy of a Light Puncture Robot Under MRI Guidance: Results of a Clinical Trial on Healthy Volunteers

Ghelfi, Julien; Moreau–Gaudry, Alexandre; Hungr, Nikolai; Fouard, Céline; Veron, Baptiste; Medici, Maud; Chipon, E.; Cinquin, Philippe; Bricault, Ivan

doi:10.1007/s00270-018-2001-5

Cited by 18 publications

(12 citation statements)

References 19 publications

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“…As the thinnest scanning thickness of our CT is 1 mm, the radius of sphere target was set as 1 mm to reduce the influence of scanning. When compared with other equipment[ 21 - 24 ], the results of our research are promising given the same accuracy of the navigation robot. For short- and medium-distance targets, the position errors were 1.7 ± 0.9 mm and 2.4 ± 1.0 mm, respectively.…”

Section: Discussionmentioning

confidence: 64%

Accuracy study of a binocular-stereo-vision-based navigation robot for minimally invasive interventional procedures

Wang¹,

Han²,

Luo³

et al. 2020

WJCC

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BACKGROUND Medical robot is a promising surgical tool, but no specific one has been designed for interventional treatment of chronic pain. We developed a computed tomography-image based navigation robot using a new registration method with binocular vision. This kind of robot is appropriate for minimal invasive interventional procedures and easy to operate. The feasibility, accuracy and stability of this new robot need to be tested. AIM To assess quantitatively the feasibility, accuracy and stability of the binocular-stereo-vision-based navigation robot for minimally invasive interventional procedures. METHODS A box model was designed for assessing the accuracy for targets at different distances. Nine (three sets) lead spheres were embedded in the model as puncture goals. The entry-to-target distances were set 50 mm (short-distance), 100 mm (medium-distance) and 150 mm (long-distance). Puncture procedure was repeated three times for each goal. The Euclidian error of each puncture was calculated and statistically analyzed. Three head phantoms were used to explore the clinical feasibility and stability. Three independent operators conducted foramen ovale placement on head phantoms (both sides) by freehand or under the guidance of robot (18 punctures with each method). The operation time, adjustment time and one-time success rate were recorded, and the two guidance methods were compared. RESULTS On the box model, the mean puncture errors of navigation robot were 1.7 ± 0.9 mm for the short-distance target, 2.4 ± 1.0 mm for the moderate target and 4.4 ± 1.4 mm for the long-distance target. On the head phantom, no obvious differences in operation time and adjustment time were found among the three performers ( P > 0.05). The median adjustment time was significantly less under the guidance of the robot than under free hand. The one-time success rate was significantly higher with the robot ( P < 0.05). There was no obvious difference in operation time between the two methods ( P > 0.05). CONCLUSION In the laboratory environment, accuracy of binocular-stereo-vision-based navigation robot is acceptable for target at 100 mm depth or less. Compared with freehand, foramen ovale placement accuracy can be improved with robot guidance.

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Section: Discussionmentioning

confidence: 64%

Accuracy study of a binocular-stereo-vision-based navigation robot for minimally invasive interventional procedures

Wang¹,

Han²,

Luo³

et al. 2020

WJCC

View full text Add to dashboard Cite

show abstract

“…The cadaver study showed the feasibility of using the robotic device for accurate needle placement under intraoperative MRI guidance. Achieved needle placement accuracy of 2.07 mm with the robotic assistance is better than previously reported manual (3.1 ± 1.2 mm) (Fritz et al, 2012), robot-assisted abdominal interventions (4.1 mm) (Ghelfi et al, 2018) and liver interventions (4.1 ± 3.1 mm) (Hata et al, 2016). Though the accuracy improvement is not huge, robotic system can deliver this performance irrespective of the surgeon's experience.…”

Section: Discussionmentioning

confidence: 66%

Body-Mounted Robotic System for MRI-Guided Shoulder Arthrography: Cadaver and Clinical Workflow Studies

Patel

Yan

et al. 2021

Front. Robot. AI

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This paper presents an intraoperative MRI-guided, patient-mounted robotic system for shoulder arthrography procedures in pediatric patients. The robot is designed to be compact and lightweight and is constructed with nonmagnetic materials for MRI safety. Our goal is to transform the current two-step arthrography procedure (CT/x-ray-guided needle insertion followed by diagnostic MRI) into a streamlined single-step ionizing radiation-free procedure under MRI guidance. The MR-conditional robot was evaluated in a Thiel embalmed cadaver study and healthy volunteer studies. The robot was attached to the shoulder using straps and ten locations in the shoulder joint space were selected as targets. For the first target, contrast agent (saline) was injected to complete the clinical workflow. After each targeting attempt, a confirmation scan was acquired to analyze the needle placement accuracy. During the volunteer studies, a more comfortable and ergonomic shoulder brace was used, and the complete clinical workflow was followed to measure the total procedure time. In the cadaver study, the needle was successfully placed in the shoulder joint space in all the targeting attempts with translational and rotational accuracy of 2.07 ± 1.22 mm and 1.46 ± 1.06 degrees, respectively. The total time for the entire procedure was 94 min and the average time for each targeting attempt was 20 min in the cadaver study, while the average time for the entire workflow for the volunteer studies was 36 min. No image quality degradation due to the presence of the robot was detected. This Thiel-embalmed cadaver study along with the clinical workflow studies on human volunteers demonstrated the feasibility of using an MR-conditional, patient-mounted robotic system for MRI-guided shoulder arthrography procedure. Future work will be focused on moving the technology to clinical practice.

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“…Thus, Passive guidance systems lack accuracy and are sensitive to artifacts. Considering the work of robotic system other than prostate for in-bore needle intervention with the aid of passive markers under 3 T MRI for clinical testing, resulted in <5 accuracy with T1−w sequences, targeting 10 deep lesion sites of ≥5 size [141]. 2) Active guidance systems require integration of the RF-coil interventional tool, e.g., needle tip, which does not require any space co-ordinate registration.…”

Section: Needle Guidance Systemmentioning

confidence: 99%

Review of Clinical and Technological Consideration for MRI-Guided Robotic Prostate Brachytherapy

Dhaliwal

Chettibi

Wilby

et al. 2021

IEEE Trans. Med. Robot. Bionics

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Low Dose Rate Brachytherapy (LDR-BT) is a technique for treating localized prostate cancer by implanting radioactive seeds. In conventional practice, the delivery of seeds is performed using transrectal ultrasonography (TRUS) imaging for implant guidance and checked using computed-tomography for post-implant dosimetry. In the case of TRUS, accuracy can be compromised due to sub-optimal imaging. Magnetic Resonance Imaging (MRI), however, is known to provide better soft-tissue contrast, therefore, increasing the ability to detect small lesions; for that reason, the integration of intraoperative MRI in BT workflows has been investigated over the last two decades. The fusion of preoperative MR-images during TRUS-brachytherapy is possible. However, the image registration process introduces a source of uncertainty. Manual, real-time intra-operative LDR-BT is challenging under MRI due to confined space and procedural workflows. This motivates the development of MRI-compatible robots for prostate BT, with potential advantages of improved source placement accuracy and final dosimetry. In this paper, the state-of-art of technological components in MRI compatible robots, especially for LDR-BT, has been presented. This systematic review helps us to position an ongoing Cooperative Brachytherapy project, developing a real-time MRI-guided robot for adaptive LDR-BT. The design approach includes integrating separate modules: imaging, dose planning, needles, and robot.

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Evaluation of the Needle Positioning Accuracy of a Light Puncture Robot Under MRI Guidance: Results of a Clinical Trial on Healthy Volunteers

Abstract: LPR accuracy in the deployment of a sham needle inside the MRI tunnel and its setup time are promising. Further studies need to be conducted to confirm these results before clinical trials.

Cited by 18 publications

References 19 publications

Accuracy study of a binocular-stereo-vision-based navigation robot for minimally invasive interventional procedures

Accuracy study of a binocular-stereo-vision-based navigation robot for minimally invasive interventional procedures

Body-Mounted Robotic System for MRI-Guided Shoulder Arthrography: Cadaver and Clinical Workflow Studies

Review of Clinical and Technological Consideration for MRI-Guided Robotic Prostate Brachytherapy

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