Abstract
Purpose: To investigate a robot assistance device for CT-guided percutan liver biopsy. Materials and Methods: The liver of a corpse was equipped with target dummies. Four radiologists used a 16 G needle to perform biopsy of the target region in standard free hand technique and then used a robot system which allowed planning and aligning the trajectory path. Accuracy in terms of needle tip deviation, and time efficiency and radiation exposure in terms of effective dose for the radiologists were measured. Results: For in plane procedures, there was no significant benefit in accuracy when using the robot versus standard technique (4 mm vs. 5.6 mm, p = 0.11); timely effort was worse (443 sec vs. 405 sec, p = 0.64). For angulated punctures, a needle tip of 3.7 mm was measured by using the robotic device (vs. 10.8 mm, p < 0.01); mean biopsy duration was 490 sec (vs. 900 sec, p < 0.01). Mean radiation exposures in freehand technique were 2.4 μSv (in plane procedures) and 10.8 μSv (oblique procedures); the robotic assisted procedures were performed without additional image guidance. Conclusion: The proposed robotic assistance device may be superior for angulated interventions regarding accuracy and timely effort. Furthermore, the zero radiation exposure is a significant benefit for the interventional radiologist.
Highlights
Percutaneous Computed Tomography (CT)-guided liver biopsies are highly efficient due to the high accuracy and minimally invasive character of the procedure [1]
India) is a guidance robot for percutaneous needle interventions that aligns itself to trajectory paths that were previously planned by the physician
The radiologist used the in plane technique 22 times, and the subcapsular lesion located in segment 8 was punctured in single oblique technique all 8 times
Summary
Percutaneous Computed Tomography (CT)-guided liver biopsies are highly efficient due to the high accuracy and minimally invasive character of the procedure [1]. Radiologists favor in plane access routes which allow a simultaneous view of the biopsy instrument and the target tissue. If a vital or bony structure obstructs the direct access of the instrument, angulated and more difficult approaches in single- or even double-oblique techniques are essential for safe and successful needle placement. Repetitive monitoring of the correct trajectory of the biopsy instrument during the procedure causes the interventional radiologist to be exposed to a significant amount of scattered X-rays [2]. The number of necessary images and radiation dose increase with the complexity of the procedure and the length of the access path. Certain other anatomical areas such as the operator’s hands and head are still exposed to the radiation regularly if not shielded in addition
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