Robots for CT-guided needle insertion: clinical implementation and future perspectives

Robotic systems for computed tomography (CT)-guided needle insertion have been developed to address the limitations of conventional manual needle insertion. Thus far, various robotic systems have been clinically implemented, and accumulating evidence has suggested their clinical utility. The evidence has evolved beyond initial feasibility and early clinical experience to include larger observational and comparative studies. These studies have demonstrated high success rates of robot-assisted needle insertion in various CT-guided interventions, including thermal ablation, biopsy, and preoperative localization. Furthermore, an increasing number of comparative studies have demonstrated the advantages of robot-assisted procedures over conventional manual procedures. These advantages include improved needle insertion accuracy and reduced radiation doses to patients and/or physicians. Although most currently available robotic systems are needle-guiding robots designed to align a needle guide with a predetermined insertion trajectory, we have developed a CT-guided needle insertion robot capable of robotic needle advancement via remote control. Clinical studies have demonstrated the feasibility of robotic needle insertion using this system, as well as needle placement accuracy comparable to that of manual procedures, while eliminating radiation exposure to physicians. The integration of artificial intelligence and the implementation of telerobotic interventions are expected to contribute significantly to the further advancement of robotic systems for CT-guided needle insertion. This narrative review summarizes the current clinical implementations and available evidence for robotic systems for CT-guided needle insertion, including our system, and discusses future perspectives in this field.