The James Buchanan Urologic Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
J Endourol. 2010 Aug;24(8):1269-72. doi: 10.1089/end.2009.0482.
Precise targeting is essential for adequate treatment of lesions during image-guided therapy. The aim of this study was to compare the performance of two emerging image-guided targeting technologies in a phantom model.
A computer-assisted navigation system and AcuBot were tested using three operators: an interventional radiologist and two endourologists. Fiducials were placed in an anatomic gelatin phantom and targeted by both systems. The images were reconstructed and analyzed using a specialized software package (Amira; Visage Imaging, Carlsbad, CA). Accuracy was assessed by measuring proximity of the tip of the needle to the fiducial on computed-tomography-guided imaging. Accuracy and time to target were quantified and compared.
The mean distance from the desired target for AcuBot was 1.2 mm (range: 0.39-2.82). The mean distance from the desired target for the navigation system was 5.8 mm (range: 1.8-11.9). The AcuBot was significantly more accurate than the navigation system (p < 0.0001). The mean time from target acquisition to needle placement was 37 seconds (range: 15-75) for the AcuBot and 108 seconds (range: 45-315) for the navigation system (p = 0.001).
Emerging technologies hold promise for increased accuracy during percutaneous targeted procedures. Both the AcuBot and the computer-assisted navigation system were accurate and efficient in a phantom targeting model. AcuBot was significantly more accurate, faster, and less user dependent than the navigation system. Further studies in animal and clinical studies are warranted to further advance this promising technology.
在影像引导治疗中，精确靶向对于充分治疗病变至关重要。本研究旨在比较两种新兴的影像引导靶向技术在体模模型中的性能。
使用三位操作人员（一位介入放射科医生和两位泌尿科医生）测试了计算机辅助导航系统和 AcuBot。在解剖学明胶体模中放置基准标记，并由这两种系统进行靶向定位。使用专门的软件包（Amira；Visage Imaging，Carlsbad，CA）重建和分析图像。通过测量 CT 引导成像时针的尖端与基准标记的接近程度来评估准确性。定量比较并评估准确性和靶向时间。
AcuBot 的目标距离平均值为 1.2 毫米（范围：0.39-2.82）。导航系统的目标距离平均值为 5.8 毫米（范围：1.8-11.9）。AcuBot 比导航系统更准确（p<0.0001）。从目标获取到针放置的平均时间为 AcuBot 37 秒（范围：15-75），导航系统 108 秒（范围：45-315）（p=0.001）。
新兴技术有望提高经皮靶向手术的准确性。在体模靶向模型中，AcuBot 和计算机辅助导航系统均准确且高效。AcuBot 比导航系统更准确、更快且对用户的依赖性更小。需要在动物和临床研究中进一步研究以进一步推进这项有前途的技术。
