Human vs. robot operator error in a needle-based navigation system for percutaneous liver interventions

Maier-Hein, Lena; Walsh, Conor J.; Seitel, Alexander; Hanumara, Nevan C.; Shepard, Jo-Anne O.; Franz, Alfred M.; Pianka, Frank; Müller, Sascha; Schmied, Bruno M.; Slocum, Alexander H.; Gupta, Rajiv; Meinzer, Hans-Peter

doi:10.1117/12.811334

Cited by 9 publications

(8 citation statements)

References 33 publications

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“…The measured targeting errors, 2.0 mm ± 1.5 mm, are larger than the previously calculated 2.2 mm, which may be caused by insertion depth error and needle's bending in gelatin. A CT-compatible spherical mechanism for positioning a single probe also reported similar results (2.3 mm ± 1.3 mm) [28].…”

Section: Prototyping and Control Implementationsupporting

confidence: 56%

An MRI Coil-Mounted Multi-Probe Robotic Positioner for Cryoablation

Torabi

Yamada

et al. 2013

Volume 6A: 37th Mechanisms and Robotics Conference

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Cryoablation is a percutaneous procedure for treating solid tumors using needle-like instruments. This paper presents an interventional guidance device for faster and more accurate alignment and insertion of multiple probes during cryoablation performed in closed bore magnetic resonance (MR) imaging systems. The device is compact and is intended to be mounted onto a Siemens 110 mm MR loop coil. A cable-driven two-degrees-of-freedom spherical mechanism mimics the wrist motion as it orients the intervention probes about a remote center of motion located 15 mm above the skin. A carriage interfaces with the probes via a thumbscrew-fastened latch to passively release the probes from their tracks, enabling them to be inserted sequentially and freeing them to move with respiration. Small actuator modules containing piezoelectric encoder-based motors are designed to be snap-fit into the device for ease of replacement and sterilization. The robot MRI compatibility was validated with standard cryoablation imaging sequences in 3T MR environment, yielding a maximum of 4% signal to noise ratio during actuator motion. Bench-level device characterization demonstrated a maximum error of 0.78° in the carriage movement. Needle-tip placement experiments for multiple targets in gelatin were performed using our image-guided navigation software, measuring an average targeting error of 2.0 mm.

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Section: Prototyping and Control Implementationsupporting

confidence: 56%

An MRI Coil-Mounted Multi-Probe Robotic Positioner for Cryoablation

Torabi

Yamada

et al. 2013

Volume 6A: 37th Mechanisms and Robotics Conference

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“…For example, one of the brachytherapy robots described in this report has been used for lung cancer, and clinical investigations are under consideration for other sites such as liver. [5][6][7][8] In the last decade, there have been significant increases in the use of robotic systems and automation tools in brachytherapy. Several groups have adapted and integrated such systems and tools into conventional brachytherapy procedures, with the shared goals of achieving higher precision and accuracy in seed placement, improving dose distributions, minimizing surgical trauma, and further reducing radiation exposure to staffs.…”

Section: Introductionmentioning

confidence: 99%

AAPM and GEC‐ESTRO guidelines for image‐guided robotic brachytherapy: Report of Task Group 192

et al. 2014

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In the last decade, there have been significant developments into integration of robots and automation tools with brachytherapy delivery systems. These systems aim to improve the current paradigm by executing higher precision and accuracy in seed placement, improving calculation of optimal seed locations, minimizing surgical trauma, and reducing radiation exposure to medical staff. Most of the applications of this technology have been in the implantation of seeds in patients with early-stage prostate cancer. Nevertheless, the techniques apply to any clinical site where interstitial brachytherapy is appropriate. In consideration of the rapid developments in this area, the American Association of Physicists in Medicine (AAPM) commissioned Task Group 192 to review the state-of-the-art in the field of robotic interstitial brachytherapy. This is a joint Task Group with the Groupe Européen de Curiethérapie-European Society for Radiotherapy & Oncology (GEC-ESTRO). All developed and reported robotic brachytherapy systems were reviewed. Commissioning and quality assurance procedures for the safe and consistent use of these systems are also provided. Manual seed placement techniques with a rigid template have an estimated in vivo accuracy of 3-6 mm. In addition to the placement accuracy, factors such as tissue deformation, needle deviation, and edema may result in a delivered dose distribution that differs from the preimplant or intraoperative plan. However, real-time needle tracking and seed identification for dynamic updating of dosimetry may improve the quality of seed implantation. The AAPM and GEC-ESTRO recommend that robotic systems should demonstrate a spatial accuracy of seed placement ≤1.0 mm in a phantom. This recommendation is based on the current performance of existing robotic brachytherapy systems and propagation of uncertainties. During clinical commissioning, tests should be conducted to ensure that this level of accuracy is achieved. These tests should mimic the real operating procedure as closely as possible. Additional recommendations on robotic brachytherapy systems include display of the operational state; capability of manual override; documented policies for independent check and data verification; intuitive interface displaying the implantation plan and visualization of needle positions and seed locations relative to the target anatomy; needle insertion in a sequential order; robot-clinician and robot-patient interactions robustness, reliability, and safety while delivering the correct dose at the correct site for the correct patient; avoidance of excessive force on radioactive sources; delivery confirmation of the required number or position of seeds; incorporation of a collision avoidance system; system cleaning, decontamination, and sterilization procedures. These recommendations are applicable to end users and manufacturers of robotic brachytherapy systems. C 2014 American Association of Physicists in Medicine.[http://dx

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“…Several experiences on robot-assisted percutaneous procedures have been reported in the literature in recent years. Good results have been obtained in terms of accuracy [17, 18], number of access attempts, time to successful access, and estimated blood loss and complications, compared to standard procedures where the radiologist has to rely on his/her experience [19]. The standard procedure usually requires several CT scans during the needle insertion to assess its actual position, exposing the patient to a considerable amount of radiation [20].…”

Section: Medical Backgroundmentioning

confidence: 99%

Development of a Cognitive Robotic System for Simple Surgical Tasks

Muradore

Fiorini

Akgun

et al. 2015

International Journal of Advanced Robotic Systems

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The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded project Intelligent Surgical Robotics (I-SUR). The main goal of the project is to demonstrate that autonomous robotic surgical systems can carry out simple surgical tasks effectively and without major intervention by surgeons. To fulfil this goal, we have developed innovative solutions (both in terms of technologies and algorithms) for the following aspects: fabrication of soft organ models starting from CT images, surgical planning and execution of movement of robot arms in contact with a deformable environment, designing a surgical interface minimizing the cognitive load of the surgeon supervising the actions, intra-operative sensing and reasoning to detect normal transitions and unexpected events. All these technologies have been integrated using a component-based software architecture to control a novel robot designed to perform the surgical actions under study. In this work we provide an overview of our system and report on preliminary results of the automatic execution of needle insertion for the cryoablation of kidney tumours.

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Human vs. robot operator error in a needle-based navigation system for percutaneous liver interventions

Cited by 9 publications

References 33 publications

An MRI Coil-Mounted Multi-Probe Robotic Positioner for Cryoablation

An MRI Coil-Mounted Multi-Probe Robotic Positioner for Cryoablation

AAPM and GEC‐ESTRO guidelines for image‐guided robotic brachytherapy: Report of Task Group 192

Development of a Cognitive Robotic System for Simple Surgical Tasks

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