Robotically Assisted CBCT-Guided Needle Insertions: Preliminary Results in a Phantom Model.

AIM: To compare robotic-assisted needle insertions performed under CBCT guidance to standard manual needle insertions. MATERIALS AND METHODS: A homemade robotic prototype was used by two operators to perform robotic and manual needle insertions on a custom-made phantom. Both the operators had no experience with the prototype before starting the trial. The primary endpoint was accuracy (i.e., the minimal distance between the needle tip and the center of the target) between robotic and manual insertions. Secondary endpoints included total procedure time and operators' radiation exposure. The Wilcoxon test was used. A p value less than 0.05 was considered statistically significant. RESULTS: Thirty-three (17 manual, 16 robotic) needle insertions were performed. Mean accuracy for robotic insertion was 2.3 ± 0.9 mm (median 2.1; range 0.8-4.2) versus 2.3 ± 1 mm (median 2.1; range 0.7-4.4) for manual insertion (p = 0.84). Mean procedure time was 683 ± 57 s (median 670; range 611-849) for the robotic group versus 552 ± 40 s (median 548; range 486-621) for the manual group (p = 0.0002). Mean radiation exposure was 3.25 times less for the robotic insertion on comparison to manual insertion for the operator 1 (0.4 vs 1.3 µGy); and 4.15 times less for the operator 2 (1.9 vs 7.9 µGy). CONCLUSION: The tested robotic prototype showed accuracy comparable to that achieved with manual punctures coupled to a significant reduction of operators' radiation exposure. Further, in vivo studies are necessary to confirm the efficiency of the system.

Observations And Experiments For The Definition Of A New Robotic Device Dedicated To CT, CBCT And MRI-Guided Percutaneous Procedures.

In this paper, we present the work achieved to define the robotic functionalities of interest for percutaneous procedures as performed in interventional radiology. Our contributions are twofold. First, a detailed task analysis is performed with workflow analysis of biopsies, one of the most frequent tasks, under three imaging modalities, namely CT, CBCT and MRI. Second, the functionalities of a robotic assistant are identified, and we analyze whether a single device can bring an added value during procedures in the three modalities while keeping the robotized workflow close to manual tasks, to minimize learning time and difficulty of use. Experimental analysis on CBCT is notably used to confirm the interest of the determined robotic functionalities.