Optical navigation robot-assisted puncture system for accurate lung nodule biopsy: an animal study

Jing Li; Liyilei Su; Jun Liu; Qian Peng; Rongde Xu; Wei Cui; Yi Deng; Weiguo Xie; Bingding Huang; Jingjing Chen

doi:10.21037/qims-23-576

Optical navigation robot-assisted puncture system for accurate lung nodule biopsy: an animal study

Quant Imaging Med Surg. 2023 Dec 1;13(12):7789-7801. doi: 10.21037/qims-23-576. Epub 2023 Oct 10.

Authors

Jing Li^#^{1

2}, Liyilei Su^#³, Jun Liu⁴, Qian Peng², Rongde Xu⁵, Wei Cui⁵, Yi Deng¹, Weiguo Xie⁴, Bingding Huang³, Jingjing Chen²

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
² Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
³ College of Big Data and Internet, Shenzhen Technology University, Shenzhen, China.
⁴ Wuerzburg Dynamics Inc., Shenzhen, China.
⁵ Department of Interventional Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

^# Contributed equally.

Abstract

Background: As lung cancer is one of the most significant factors seriously endangering human health, a robot-assisted puncture system with high accuracy and safety is urgently needed. The purpose of this investigation was to compare the safety and effectiveness of such a robot-assisted system to the conventional computed tomography (CT)-guided manual method for percutaneous lung biopsies (PLBs) in pigs.

Methods: An optical navigation robot-assisted puncture system was developed and compared to the traditional CT-guided PLB using simulated lesions in experimental animals. A total of 30 pulmonary nodules were successfully created in 5 pigs (Wuzhishan pig, 1 male and 4 females). Of these, 15 were punctured by the optical navigation robot-assisted puncture system (robotic group), and 15 were manually punctured under CT guidance (manual group). The biopsy success rate, operation time, first needle tip-target point deviation, and needle adjustment times were compared between groups. Postoperative CT scans were performed to identify complications.

Results: The single puncture success rate was higher in the robotic group (13/15; 86.7%) than in the manual group (8/15; 53.3%). The first puncture was closer to the target lesion (1.8±1.7 mm), and the operation time was shorter (7.1±3.7 minutes) in the robotic group than in the manual group (4.4±2.8 mm and 12.9±7.6 minutes, respectively). The angle deviation was smaller in the robotic group (3.26°±2.48°) than in the manual group (7.71°±3.86°). The robotic group displayed significant advantages (P<0.05). The primary complication in both groups was slight bleeding, with an incidence of 26.7% in the robotic group and 40.0% in the manual group. There was 1 case of pneumothorax in the manual group, and there were no deaths due to complications in either group.

Conclusions: An optical navigation robot-assisted system for PLBs guided by CT images was developed and demonstrated. The experimental results indicate that the proposed system is accurate, efficient, and safe in pigs.

Keywords: Percutaneous lung biopsy (PLB); computed tomography (CT); computed tomography-guided biopsy (CT-guided biopsy); optical navigation robot-assisted puncture system.