System for CT-guided needle placement in the thorax and abdomen: A design for clinical acceptability, applicability and usability

Int J Med Robot. 2018 Feb;14(1). doi: 10.1002/rcs.1877. Epub 2017 Dec 5.

Abstract

Background: Various systems exist for CT-guided needle placement in the thorax and abdomen, but widespread adoption is lacking. The goal of this work is to develop a system for precise needle placement with a design focus on clinical acceptability, applicability and usability.

Methods: A system was outlined incorporating a needle guide on a mechanism with a remote centre of motion, manually placeable around the patient at the desired entry point and lockable by push-button to the CT table. System and patient are scanned for system-to-CT registration and target specification. The needle guide is automatically aimed at the target, for manual needle insertion to specified depth.

Results: A fully functional prototype was realized, achieving 1.2±0.6 mm placement error at 79.0±8.4 mm depth and 2.1±0.7 mm at 156.0±6.9 mm for 2×12 in- and out-of-plane punctures in a gelatin phantom.

Conclusions: The system enables precise needle placement in a single insertion and is ready for its first clinical deployment.

MeSH terms

  • Abdomen / diagnostic imaging*
  • Computer Simulation
  • Computer-Aided Design
  • Equipment Design
  • Humans
  • Image-Guided Biopsy / methods*
  • Liver Neoplasms / surgery*
  • Motion
  • Needles
  • Phantoms, Imaging
  • Punctures
  • Robotics
  • Surgery, Computer-Assisted
  • Thorax / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*
  • User-Computer Interface
  • X-Rays