System for robotically assisted prostate biopsy and therapy with intraoperative CT guidance.
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.
Fichtinger
Gabor
G
Engineering Research Center, Johns Hopkins University, Baltimore, MD 21218-2682, USA.
DeWeese
Theodore L
TL
Patriciu
Alexandru
A
Tanacs
Attila
A
Mazilu
Dumitru
D
Anderson
James H
JH
Masamune
Ken
K
Taylor
Russell H
RH
Stoianovici
Dan
D
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*