Purpose

The study aimed to evaluate a new robotic assistance system (RAS) for needle placement in combination with a multi-axis C-arm angiography system for cone-beam computed tomography (CBCT) in a phantom setting.

Materials and Methods

The RAS consisted of a tool holder, dedicated planning software, and a mobile platform with a lightweight robotic arm to enable image-guided needle placement in conjunction with CBCT imaging. A CBCT scan of the phantom was performed to calibrate the robotic arm in the scan volume and to plan the different needle trajectories. The trajectory data were sent to the robot, which then positioned the tool holder along the trajectory. A 19G needle was then manually inserted into the phantom. During the control CBCT scan, the exact needle position was evaluated and any possible deviation from the target lesion measured.

Results

In total, 16 needle insertions targeting eight in- and out-of-plane sites were performed. Mean angular deviation from planned trajectory to actual needle trajectory was 1.12°. Mean deviation from target point and actual needle tip position was 2.74 mm, and mean deviation depth from the target lesion to the actual needle tip position was 2.14 mm. Mean time for needle placement was 361 s. Only differences in time required for needle placement between in- and out-of-plane trajectories (337 s vs. 380 s) were statistically significant (p = 0.0214).

Conclusion

Using this RAS for image-guided percutaneous needle placement with CBCT was precise and efficient in the phantom setting.

中文翻译：

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用于锥形束计算机断层扫描引导的经皮置针的机器人辅助系统

目的

该研究旨在评估一种新的用于针放置的机器人辅助系统 (RAS) 与多轴 C 臂血管造影系统相结合，用于在幻影设置中进行锥形束计算机断层扫描 (CBCT)。

材料和方法

RAS 由一个工具架、专用规划软件和一个带有轻型机械臂的移动平台组成，以实现图像引导的针放置和 CBCT 成像。对模型进行 CBCT 扫描以校准扫描体积中的机械臂并规划不同的针轨迹。轨迹数据被发送到机器人，然后机器人沿着轨迹定位工具架。然后将 19G 针手动插入体模中。在对照 CBCT 扫描期间，评估了准确的针头位置，并测量了与目标病变的任何可能偏差。

结果

总共进行了 16 次针对 8 个平面内和平面外位置的针头插入。从计划轨迹到实际针轨迹的平均角度偏差为 1.12°。目标点与实际针尖位置的平均偏差为2.74 mm，目标病灶与实际针尖位置的平均偏差深度为2.14 mm。针放置的平均时间为 361 秒。只有平面内和平面外轨迹（337 s vs. 380 s）之间的针放置时间差异具有统计学意义（p  = 0.0214）。

结论

使用这种 RAS 进行图像引导下的 CBCT 经皮穿刺针放置在体模设置中是精确且有效的。