Feasibility, safety and accuracy of a CT-guided robotic assistance for percutaneous needle placement in a swine liver model

Sci Rep. 2021 Mar 4;11(1):5218. doi: 10.1038/s41598-021-84878-3.

Abstract

Evaluate the feasibility, safety and accuracy of a CT-guided robotic assistance for percutaneous needle placement in the liver. Sixty-six fiducials were surgically inserted into the liver of ten swine and used as targets for needle insertions. All CT-scan acquisitions and robotically-assisted needle insertions were coordinated with breath motion using respiratory monitoring. Skin entry and target points were defined on planning CT-scan. Then, robotically-assisted insertions of 17G needles were performed either by experienced interventional radiologists or by a novice. Post-needle insertion CT-scans were acquired to assess accuracy (3D deviation, ie. distance from needle tip to predefined target) and safety. All needle insertions (43/43; median trajectory length = 83 mm (interquartile range [IQR] 72-105 mm) could be performed in one (n = 36) or two (n = 7) attempts (100% feasibility). Blinded evaluation showed an accuracy of 3.5 ± 1.3 mm. Accuracy did not differ between novice and experienced operators (3.7 ± 1.3 versus 3.4 ± 1.2 mm, P = 0.44). Neither trajectory angulation nor trajectory length significantly impacted accuracy. No complications were encountered. Needle insertion using the robotic device was shown feasible, safe and accurate in a swine liver model. Accuracy was influenced neither by the trajectory length nor by trajectory angulations nor by operator's experience. A prospective human clinical trial is recruiting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Humans
  • Image-Guided Biopsy / methods*
  • Liver / diagnostic imaging*
  • Liver / pathology
  • Needles
  • Phantoms, Imaging
  • Radiography, Interventional
  • Robotic Surgical Procedures / methods*
  • Swine
  • Tomography, X-Ray Computed / methods*