Top

European Radiology

Published in:

01-03-2014 | Interventional

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

Authors: Yilun Koethe, Sheng Xu, Gnanasekar Velusamy, Bradford J. Wood, Aradhana M. Venkatesan

Published in: European Radiology | Issue 3/2014

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.

Wood BJ, Ramkaransingh JR, Fojo T et al (2002) Percutaneous tumor ablation with radiofrequency. Cancer 94:443–451PubMedCentralPubMedCrossRef

Chintapalli KN, Montgomery RS, Hatab M et al (2012) Radiation dose management: part 1, minimizing radiation dose in CT-guided procedures. AJR Am J Roentgenol 198:W347–W351PubMedCrossRef

Magnusson A, Akerfeldt D (1991) CT-guided core biopsy using a new guidance device. Acta Radiol 32:83–85PubMedCrossRef

Onik G, Cosman ER, Wells THJ et al (1988) CT-guided aspirations for the body: comparison of hand guidance with stereotaxis. Radiology 166:389–394PubMed

Bertot LC, Sato M, Tateishi R et al (2011) Mortality and complication rates of percutaneous ablative techniques for the treatment of liver tumors: a systematic review. Eur Radiol 21:2584–2596PubMedCrossRef

Tiong L, Maddern GJ (2011) Systematic review and meta-analysis of survival and disease recurrence after radiofrequency ablation for hepatocellular carcinoma. Br J Surg 98:1210–1224PubMedCrossRef

Salhab M, Canelo R (2011) An overview of evidence-based management of hepatocellular carcinoma: a meta-analysis. J Cancer Res Ther 7:463PubMedCrossRef

Cirocchi R, Trastulli S, Boselli C et al (2012) Radiofrequency ablation in the treatment of liver metastases from colorectal cancer. Cochrane Database Syst Rev 6, CD006317PubMed

Best SL, Park SK, Yaacoub RF et al (2012) Long-term outcomes of renal tumor radio frequency ablation stratified by tumor diameter: size matters. JURO 187:1183–1189

10.

Hui GC, Tuncali K, Tatli S et al (2008) Comparison of percutaneous and surgical approaches to renal tumor ablation: metaanalysis of effectiveness and complication rates. J Vasc Interv Radiol 19:1311–1320PubMedCrossRef

11.

Pleguezuelo M, Marelli L, Misseri M et al (2008) TACE versus TAE as therapy for hepatocellular carcinoma. Expert Rev Anticancer Ther 8:1623–1641PubMedCrossRef

12.

Minami Y, Kudo M (2011) Radiofrequency ablation of hepatocellular carcinoma: a literature review. Int J Hepatol 2011:1–9CrossRef

13.

Solomon SB, Patriciu A, Bohlman ME et al (2002) Robotically driven interventions: a method of using CT fluoroscopy without radiation exposure to the physician. Radiology 225:277–282PubMedCentralPubMedCrossRef

14.

Patriciu A, Awad M, Solomon SB et al (2005) Robotic assisted radio-frequency ablation of liver tumors—randomized patient study. Med Image Comput Comput Assist Interv 8:526–533PubMedCentralPubMed

15.

Stoffner R, Augschöll C, Widmann G et al (2009) Accuracy and feasibility of frameless stereotactic and robot-assisted CT-based puncture in interventional radiology: a comparative phantom study. Rofo 181:851–858PubMedCrossRef

16.

Cleary K, Melzer A, Watson V et al (2006) Interventional robotic systems: applications and technology state of the art. Minim Invasive Ther Allied Technol 15:101–113PubMedCentralPubMedCrossRef

17.

Schulz B, Eichler K, Siebenhandl P et al (2012) Accuracy and speed of robotic assisted needle interventions using a modern cone beam computed tomography intervention suite: a phantom study. Eur Radiol 23:198–204PubMedCrossRef

18.

Zangos S, Melzer A, Eichler K et al (2011) MR-compatible assistance system for biopsy in a high-field-strength system: initial results in patients with suspicious prostate lesions. Radiology 259:903–910PubMedCrossRef

19.

Schell B, Eichler K, Mack MG et al (2012) Robot-assisted biopsies in a high-field MRI system—first clinical results. Rofo 184:42–47PubMedCrossRef

20.

Stoll M, Boettger T, Schulze C, Hastenteufel M (2012) Transfer of methods from radiotherapy planning to ablation planning with focus on uncertainties and robustness. Biomed Tech (Berl). doi:10.1515/bmt-2012-4279

21.

Lehmann KS, Frericks BB, Holmer C et al (2011) In vivo validation of a therapy planning system for laser-induced thermotherapy (LITT) of liver malignancies. Int J Color Dis 26:799–808CrossRef

22.

McCreedy ES, Cheng R, Hemler PF et al (2006) Radio frequency ablation registration, segmentation, and fusion tool. IEEE Trans Inf Technol Biomed 10:490–496PubMedCentralPubMedCrossRef

23.

Covidien (2009) Cool-tip^TM RF ablation system [Pamphlet]. Covidien, Boulder

24.

Kobayashi K, Bhargava P, Raja S et al (2012) Image-guided biopsy: what the interventional radiologist needs to know about PET/CT. Radiographics 32:1483–1501PubMedCrossRef

25.

Solomon SB, Silverman SG (2010) Imaging in interventional oncology. Radiology 257:624–640PubMedCrossRef

26.

Wood BJ, Locklin JK, Viswanathan A et al (2007) Technologies for guidance of radiofrequency ablation in the multimodality interventional suite of the future. J Vasc Interv Radiol 18:9–24PubMedCentralPubMedCrossRef

27.

Wood BJ, Zhang H, Durrani A et al (2005) Navigation with electromagnetic tracking for interventional radiology procedures: a feasibility study. J Vasc Interv Radiol 16:493–505PubMedCentralPubMedCrossRef

28.

Hong CW, Xu S, Imbesi KL, Wood BJ (2013) Integrated laser-guided CT biopsy. Clin Imaging. doi:10.1016/j.clinimag.2013.08.006

29.

Wood BJ, Kruecker J, Abi-Jaoudeh N et al (2010) Navigation systems for ablation. J Vasc Interv Radiol 21:S257–S263PubMedCentralPubMedCrossRef

30.

Su L-M, Stoianovici D, Jarrett TW et al (2002) Robotic percutaneous access to the kidney: comparison with standard manual access. J Endourol 16:471–475PubMedCrossRef

Title: Accuracy and efficacy of percutaneous biopsy and ablation using robotic assistance under computed tomography guidance: a phantom study
Authors: Yilun Koethe
Sheng Xu
Gnanasekar Velusamy
Bradford J. Wood
Aradhana M. Venkatesan
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 3/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-3056-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Objective

Methods

Results

Conclusion

Key points:

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Key points:

Please log in to get access to this content

Other articles of this Issue 3/2014

Diffusion-weighted MRI for distinguishing non-neoplastic cysts from solid masses in the mediastinum: problem-solving in mediastinal masses of indeterminate internal characteristics on CT

Thoracic outlet syndrome in 3T MR neurography—fibrous bands causing discernible lesions of the lower brachial plexus

Diffusivity of intraorbital lymphoma vs. IgG4-related DISEASE: 3D turbo field echo with diffusion-sensitised driven-equilibrium preparation technique

Non-invasive evaluation of liver fibrosis: a comparison of ultrasound-based transient elastography and MR elastography in patients with viral hepatitis B and C

Dose reduction in dynamic CT stress myocardial perfusion imaging: comparison of 80-kV/370-mAs and 100-kV/300-mAs protocols

Multishot diffusion-weighted MR imaging features in acute trauma of spinal cord