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Feasibility of Robot-Assisted CT-Guided Interventions Compared with Conventional Technique: A Prospective,
Takafumi Sato1, Tatsuya Kawai2, Junichi Takikawa3
1Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
Purpose:
To investigate the feasibility of robot-assisted computed tomography (CT)-guided percutaneous needle placement compared with the conventional technique.
Materials And Methods:
This single-center, open-label, randomized clinical trial included 70 patients with indications for CT-guided intervention, randomly assigned to conventional or robot-assisted groups. A table-mounted robotic system, automated needle-targeting device for CT, was utilized. Needle insertion time, technical success, diagnostic accuracy, procedure duration, needle angle adjustments, number of CT fluoroscopic acquisitions, radiation dose, and adverse event rates were compared.
Results:
Seventy patients were enrolled, and 65 patients (33 robot-assisted) were analyzed. Lesion sizes were 44.3 mm (SD ± 26.7) and 43.0 mm (SD ± 28.4) in the conventional and robot-assisted groups, respectively (P = .845). There was no significant difference in the needle insertion time between the 2 groups (175.6 seconds [SD ± 211.8] vs 218.2 seconds [SD ± 242.1], P = .452). Technical success was 100% in both groups. Diagnostic accuracy was 87.0% in the conventional group and 93.3% in the and robot-assisted group (P = .671). Procedure duration was longer in the robot-assisted group (21.4 minutes [SD ± 5.6] vs 33.4 minutes [SD ± 10.3], P < .001). Needle adjustments (2.1 times [SD ± 1.8] vs 0.3 times [SD ± 0.7], P < .001), CT fluoroscopic acquisitions (10.0 times [SD ± 4.9] vs 7.7 times [SD ± 3.4], P = .027), and volume CT dose index (11.2 mGy [SD ± 5.9] vs 8.5 mGy [SD ± 4.7], P = .049) were lower in the robot-assisted group. Dose length product (667.4 mGy·cm [SD ± 247.2] vs 578.5 mGy·cm [SD ± 232.5], P = .143) and adverse event rates (28.1% vs 24.2%, P = .885) were not significant difference between groups.
Conclusions:
The robotic system may allow accurate needle insertion across multiple sites, although with prolonged procedure time.
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