System for robotically assisted percutaneous procedures with computed tomography guidance.

Area of Science:

• Medical Robotics
• Image-Guided Interventions
• Surgical Navigation

Background:

• Percutaneous needle placement is crucial for soft-tissue biopsies and interventions.
• Existing methods can face challenges in accuracy and consistency.
• Image guidance, particularly CT, offers precise visualization but requires robust targeting systems.

Purpose of the Study:

• To develop and evaluate a prototype image-guided robotic system for accurate percutaneous needle insertion under CT guidance.
• To assess the system's accuracy, consistency, and ease of use within the CT scanner environment.
• To demonstrate the system's potential for various clinical percutaneous applications.

Main Methods:

• A couch-mounted robotic system featuring a seven-degrees-of-freedom passive arm, a remote center-of-motion robot, and a motorized needle inserter was developed.
• Stereotactic localization using a miniature BRW head frame enabled single-image-based coregistration of robot and image space.
• Surgeon control was facilitated via a desktop computer receiving DICOM images, with no reliance on vendor-specific hardware or calibration.

Main Results:

• In open-air tests, target accuracy better than 1 mm was achieved at distances of 5-8 cm from the fulcrum.
• In phantom studies, orientation accuracy was 0.6 degrees.
• The needle tip-to-target distance in phantom experiments was measured at 1.04 mm.

Conclusions:

• The developed image-guided robotic system demonstrates high accuracy and consistency for percutaneous needle placement.
• The system's design, utilizing pure image-based registration and minimal calibration, makes it adaptable for diverse clinical scenarios.
• This technology shows significant promise for improving the safety and efficacy of CT-guided percutaneous interventions.