From the Department of Radiology (T.H., T. Komaki, Y. Masaoka, Y. Matsui, H.F., T.I., S.K.) and Graduate School of Health Sciences (R.M.), Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan; Graduate School of Natural Science and Technology (T. Kamegawa, T. Matsuno) and Organization for Research Promotion & Collaboration (Y.K.), Okayama University, Okayama, Japan; Collaborative Research Center for OMIC, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan (T.S.); Center for Innovative Clinical Medicine (J.S., T. Mitsuhashi), Division of Radiology, Medical Technology Department (T.Y.), and Division of Medical Informatics (H.G.), Okayama University Hospital, Okayama, Japan.
Radiology. 2017 Nov;285(2):454-461. doi: 10.1148/radiol.2017162856. Epub 2017 Jun 12.
Purpose To evaluate the accuracy of the remote-controlled robotic computed tomography (CT)-guided needle insertion in phantom and animal experiments. Materials and Methods In a phantom experiment, 18 robotic and manual insertions each were performed with 19-gauge needles by using CT fluoroscopic guidance for the evaluation of the equivalence of accuracy of insertion between the two groups with a 1.0-mm margin. Needle insertion time, CT fluoroscopy time, and radiation exposure were compared by using the Student t test. The animal experiments were approved by the institutional animal care and use committee. In the animal experiment, five robotic insertions each were attempted toward targets in the liver, kidneys, lungs, and hip muscle of three swine by using 19-gauge or 17-gauge needles and by using conventional CT guidance. The feasibility, safety, and accuracy of robotic insertion were evaluated. Results The mean accuracies of robotic and manual insertion in phantoms were 1.6 and 1.4 mm, respectively. The 95% confidence interval of the mean difference was -0.3 to 0.6 mm. There were no significant differences in needle insertion time, CT fluoroscopy time, or radiation exposure to the phantom between the two methods. Effective dose to the physician during robotic insertion was always 0 μSv, while that during manual insertion was 5.7 μSv on average (P < .001). Robotic insertion was feasible in the animals, with an overall mean accuracy of 3.2 mm and three minor procedure-related complications. Conclusion Robotic insertion exhibited equivalent accuracy as manual insertion in phantoms, without radiation exposure to the physician. It was also found to be accurate in an in vivo procedure in animals. RSNA, 2017 Online supplemental material is available for this article.
目的 在体模和动物实验中评估遥控机器人计算机断层扫描（CT）引导下针插入的准确性。
材料与方法 在体模实验中，使用 CT 透视引导对 19 号针进行了 18 次机器人和手动插入，以评估两组之间插入精度的等效性，每组的边界为 1.0mm。使用学生 t 检验比较了针插入时间、CT 透视时间和辐射暴露。动物实验得到了机构动物护理和使用委员会的批准。在动物实验中，使用 19 号或 17 号针，通过常规 CT 引导，对三头猪的肝脏、肾脏、肺部和臀部肌肉中的五个目标分别进行了五次机器人插入尝试。评估了机器人插入的可行性、安全性和准确性。
结果 在体模中，机器人和手动插入的平均精度分别为 1.6mm 和 1.4mm。平均差异的 95%置信区间为-0.3 至 0.6mm。两种方法在针插入时间、CT 透视时间或对体模的辐射暴露方面无显著差异。机器人插入过程中，医生的有效剂量始终为 0μSv，而手动插入时平均为 5.7μSv（P<0.001）。机器人插入在动物中是可行的，总平均精度为 3.2mm，有 3 次轻微的与程序相关的并发症。
结论 在体模中，机器人插入与手动插入的准确性相当，且不会对医生造成辐射暴露。在动物体内实验中也发现其具有准确性。RSNA，2017 在线补充材料可用于本文。
