Evaluation of a CT-Guided Robotic System for Precise Percutaneous Needle Insertion

Area of Science:

• Medical Robotics
• Image-Guided Interventions
• Surgical Navigation

Background:

• Minimally invasive procedures require precise instrument navigation.
• Computed tomography (CT) guidance is crucial for targeting deep anatomical structures.
• Robotic systems offer enhanced control and accuracy in needle insertion tasks.

Purpose of the Study:

• To evaluate the targeting accuracy of a prototype robotic system for CT-guided needle insertion.
• To assess the system's performance across common target sites including kidneys, liver, retroperitoneum, and lungs.

Main Methods:

• Metallic targets were placed in porcine organs (kidney, liver, retroperitoneum, lung).
• A patient-mounted, CT-guided robotic system with 5° motion was used for needle placement.
• Stepwise planning with predetermined checkpoints and respiratory gating were employed for accuracy.

Main Results:

• High targeting accuracy (1.2-1.4 mm ± 0.6) was achieved in kidney, retroperitoneum, and lung.
• Liver targeting accuracy was 2.9 mm ± 1.9.
• The system compensated for significant intraprocedural target movement, with 91% of cases requiring a single insertion.

Conclusions:

• Accurate needle insertion (< 3 mm error) is feasible with the CT-guided robotic system at common target sites.
• Stepwise corrective angulation can mitigate challenges posed by target movement during procedures.
• The robotic system demonstrates potential for improving precision in CT-guided interventions.