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Accuracy and efficacy of percutaneous biopsy and ablation using robotic assistance under computed tomography guidance: a phantom study

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Abstract

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).

Conclusion

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.

Key points:

• 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.

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Abbreviations

IR:

Interventional radiologist

RFA:

Radiofrequency ablation

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Acknowledgements

A year-long research fellowship for Y.K. was made possible through the National Institutes of Health (NIH) Medical Research Scholars Program, a public-private partnership supported jointly by the NIH and generous contributions to the Foundation for the NIH from Pfizer Inc., The Leona M. and Harry B. Helmsley Charitable Trust, and the Howard Hughes Medical Institute, as well as other private donors. For a complete list, please visit the Foundation website at http://www.fnih.org/work/programs-development/medical-research-scholars-program). The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

X.S.: No potential conflicts of interest to disclose.

G.V. is a full-time salaried employee (Principle Systems Architect, ATO) of Perfint Healthcare Pvt. Ltd. Perfint Healthcare owns intellectual property related to technologies used in this published work, including USPTO # US20130072784, US20120190970, US20130085380, etc. For detailed information, please visit the company website, www.perfinthealthcare.com.

B.J.W. and A.M.V: This research was supported by the NIH Intramural Research Program and the NIH Center for Interventional Oncology. The interventional radiologist assistance platform was supplied by Perfint Healthcare Pvt. Ltd. (Chennai, India) under a Materials Transfer Agreement between the NIH Center for Interventional Oncology and Perfint Healthcare. NIH and Perfint Healthcare have discussed details of a draft Cooperative Research and Development Agreement (CRADA). The content does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organisations imply endorsement by the U.S. Government.

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Authors and Affiliations

  1. Center for Interventional Oncology, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA

    Yilun Koethe, Sheng Xu, Bradford J. Wood & Aradhana M. Venkatesan

  2. Radiology and Imaging Sciences, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA

    Yilun Koethe, Bradford J. Wood & Aradhana M. Venkatesan

  3. Duke University School of Medicine, Durham, NC, USA

    Yilun Koethe

  4. Perfint Healthcare Pvt. Ltd., Chennai, India

    Gnanasekar Velusamy

  5. Center for Interventional Oncology, Radiology and Imaging Sciences, NIH Clinical Center, National Institutes of Health, 10 Center Drive, Building 10 CRC, Room 1C369, MSC 1182, Bethesda, MD, 20892, USA

    Aradhana M. Venkatesan

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  1. Yilun Koethe
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  2. Sheng Xu
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  3. Gnanasekar Velusamy
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  4. Bradford J. Wood
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  5. Aradhana M. Venkatesan
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Correspondence to Aradhana M. Venkatesan.

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Koethe, Y., Xu, S., Velusamy, G. et al. Accuracy and efficacy of percutaneous biopsy and ablation using robotic assistance under computed tomography guidance: a phantom study. Eur Radiol 24, 723–730 (2014). https://doi.org/10.1007/s00330-013-3056-y

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  • DOI: https://doi.org/10.1007/s00330-013-3056-y

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