Accuracy and efficacy of percutaneous biopsy and ablation using robotic assistance under computed tomography guidance: a phantom study.
OBJECTIVE
To compare the accuracy of a robotic interventional radiologist (IR) assistance platform with a standard freehand technique for computed-tomography (CT)-guided biopsy and simulated radiofrequency ablation (RFA).


METHODS
The accuracy of freehand single-pass needle insertions into abdominal phantoms was compared with insertions facilitated with the use of a robotic assistance platform (n = 20 each). Post-procedural CTs were analysed for needle placement error. Percutaneous RFA was simulated by sequentially placing five 17-gauge needle introducers into 5-cm diameter masses (n = 5) embedded within an abdominal phantom. Simulated ablations were planned based on pre-procedural CT, before multi-probe placement was executed freehand. Multi-probe placement was then performed on the same 5-cm mass using the ablation planning software and robotic assistance. Post-procedural CTs were analysed to determine the percentage of untreated residual target.


RESULTS
Mean needle tip-to-target errors were reduced with use of the IR assistance platform (both P < 0.0001). Reduced percentage residual tumour was observed with treatment planning (P = 0.02).


CONCLUSIONS
Improved needle accuracy and optimised probe geometry are observed during simulated CT-guided biopsy and percutaneous ablation with use of a robotic IR assistance platform. This technology may be useful for clinical CT-guided biopsy and RFA, when accuracy may have an impact on outcome.


CONCLUSIONS
• A recently developed robotic intervention radiology assistance platform facilitates CT-guided interventions. • Improved accuracy of complex needle insertions is achievable. • IR assistance platform use can improve target ablation coverage.
Center for Interventional Oncology, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Yilun
Y
Koethe
Sheng
S
Xu
Gnanasekar
G
Velusamy
Bradford J
BJ
Wood
Aradhana M
AM
Venkatesan
D001707:Biopsy, Needle; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D061705:Image-Guided Biopsy / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D019047:Phantoms, Imaging / Q000592:standards*; D015203:Reproducibility of Results; D012371:Robotics / Q000379:methods / Q000592:standards*; D012984:Software; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods / Q000592:standards*