title: Prospects in percutaneous ablative targeting: comparison of a computer-assisted navigation system and the AcuBot Robotic System.
abstract: OBJECTIVE
  Precise targeting is essential for adequate treatment of lesions during image-guided therapy. The aim of this study was to compare the performance of two emerging image-guided targeting technologies in a phantom model.
  
  
  METHODS
  A computer-assisted navigation system and AcuBot were tested using three operators: an interventional radiologist and two endourologists. Fiducials were placed in an anatomic gelatin phantom and targeted by both systems. The images were reconstructed and analyzed using a specialized software package (Amira; Visage Imaging, Carlsbad, CA). Accuracy was assessed by measuring proximity of the tip of the needle to the fiducial on computed-tomography-guided imaging. Accuracy and time to target were quantified and compared.
  
  
  RESULTS
  The mean distance from the desired target for AcuBot was 1.2 mm (range: 0.39-2.82). The mean distance from the desired target for the navigation system was 5.8 mm (range: 1.8-11.9). The AcuBot was significantly more accurate than the navigation system (p < 0.0001). The mean time from target acquisition to needle placement was 37 seconds (range: 15-75) for the AcuBot and 108 seconds (range: 45-315) for the navigation system (p = 0.001).
  
  
  CONCLUSIONS
  Emerging technologies hold promise for increased accuracy during percutaneous targeted procedures. Both the AcuBot and the computer-assisted navigation system were accurate and efficient in a phantom targeting model. AcuBot was significantly more accurate, faster, and less user dependent than the navigation system. Further studies in animal and clinical studies are warranted to further advance this promising technology.
authors.affiliation: The James Buchanan Urologic Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Pollock
authors.forename: Pierre
authors.initials: P
authors.lastname: Mozer
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Guzzo
authors.forename: Jonathan
authors.initials: J
authors.lastname: Marx
authors.forename: Brian
authors.initials: B
authors.lastname: Matlaga
authors.forename: Doru
authors.initials: D
authors.lastname: Petrisor
authors.forename: Bogdan
authors.initials: B
authors.lastname: Vigaru
authors.forename: Shadie
authors.initials: S
authors.lastname: Badaan
authors.forename: Dan
authors.initials: D
authors.lastname: Stoianovici
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Allaf
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D012371:Robotics / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*