Robotic needle insertion during computed tomography fluoroscopy-guided biopsy: prospective first-in-human feasibility trial

Eur Radiol. 2020 Feb;30(2):927-933. doi: 10.1007/s00330-019-06409-z. Epub 2019 Aug 23.

Abstract

Introduction: This was a prospective, first-in-human trial to evaluate the feasibility and safety of insertion of biopsy introducer needles with our robot during CT fluoroscopy-guided biopsy in humans.

Materials and methods: Eligible patients were adults with a lesion ≥ 10 mm in an extremity or the trunk requiring pathological diagnosis with CT fluoroscopy-guided biopsy. Patients in whom at-risk structures were located within 10 mm of the scheduled needle tract were excluded. Ten patients (4 females and 6 males; mean [range] age, 72 [52-87] years) with lesions (mean [range] maximum diameter, 28 [14-52] mm) in the kidney (n = 4), lung (n = 3), mediastinum (n = 1), adrenal gland (n = 1), and muscle (n = 1) were enrolled. The biopsy procedure involved robotic insertion of a biopsy introducer needle followed by manual acquisition of specimens using a biopsy needle. The patients were followed up for 14 days. Feasibility was defined as the distance of ≤ 10 mm between needle tip after insertion and the nearest lesion edge on the CT fluoroscopic images. The safety of robotic insertion was evaluated on the basis of machine-related troubles and adverse events according to the Clavien-Dindo classification.

Results: Robotic insertion of the introducer needle was feasible in all patients, enabling pathological diagnosis. There was no machine-related trouble. A total of 11 adverse events occurred in 8 patients, including 10 grade I events and 1 grade IIIa event.

Conclusion: Insertion of biopsy introducer needles with our robot was feasible at several locations in the human body.

Key points: • Insertion of biopsy introducer needles with our robot during CT fluoroscopy-guided biopsy was feasible at several locations in the human body.

Keywords: Biopsy; Image-guided biopsy; Needle; Robotics.

Publication types

  • Observational Study
  • Video-Audio Media

MeSH terms

  • Adult
  • Biopsy, Needle / methods
  • Equipment Design
  • Feasibility Studies
  • Female
  • Fluoroscopy / methods
  • Humans
  • Image-Guided Biopsy / instrumentation
  • Image-Guided Biopsy / methods*
  • Male
  • Middle Aged
  • Needles
  • Prospective Studies
  • Radiography, Interventional / methods*
  • Robotic Surgical Procedures / methods*
  • Robotics / methods
  • Tomography, X-Ray Computed / methods