title: System for robotically assisted prostate biopsy and therapy with intraoperative CT guidance.
abstract: OBJECTIVE
  The purpose of this study was to assess the work-in-progress prototype of an image-guided, robotic system for accurate and consistent placement of transperineal needles into the prostate with intraoperative image guidance inside the gantry of a computed tomographic (CT) scanner.
  
  
  METHODS
  The coach-mounted system consists of a seven-degrees-of-freedom, passive mounting arm: a remote-center-of-motion robot; and a motorized, radiolucent needle-insertion device to deliver 17-18-gauge implant and biopsy needles into the prostate with the transperineal route. The robot is registered to the image space with a stereotactic adapter. The surgeon plans and controls the intervention in the CT scanner room with a desktop computer that receives DICOM images from the CT scanner. The complete system fits in a carry-on suitcase, does not need calibration, and does not utilize vendor-specific features of the CT scanner.
  
  
  RESULTS
  In open air, the average accuracy was better than 1 mm at a 5-8-cm depth. In various phantoms, the average orientation error was 1.3 degrees, and the average distance between the needle tip and the target was 2 mm.
  
  
  CONCLUSIONS
  Results of preliminary experiments indicate that this robotic system may be suitable for transperineal needle placement into the prostate and shows potential in a variety of other percutaneous clinical applications.
authors.affiliation: Engineering Research Center, Johns Hopkins University, Baltimore, MD 21218-2682, USA.
authors.forename: Gabor
authors.initials: G
authors.lastname: Fichtinger
authors.forename: Theodore L
authors.initials: TL
authors.lastname: DeWeese
authors.forename: Alexandru
authors.initials: A
authors.lastname: Patriciu
authors.forename: Attila
authors.initials: A
authors.lastname: Tanacs
authors.forename: Dumitru
authors.initials: D
authors.lastname: Mazilu
authors.forename: James H
authors.initials: JH
authors.lastname: Anderson
authors.forename: Ken
authors.initials: K
authors.lastname: Masamune
authors.forename: Russell H
authors.initials: RH
authors.lastname: Taylor
authors.forename: Dan
authors.initials: D
authors.lastname: Stoianovici
mesh_terms: D001707:Biopsy, Needle / Q000295:instrumentation*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D019047:Phantoms, Imaging; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012371:Robotics / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*