Scharll Yannick, Mitteregger Alexander, Laimer Gregor, Schwabl Christoph, Schullian Peter, Bale Reto
Department of Radiology, Section of Interventional Oncology-Microinvasive Therapy (SIP), Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
J Clin Med. 2022 Jun 28;11(13):3746. doi: 10.3390/jcm11133746.
Background: Robotic-based guidance systems are becoming increasingly capable of assisting in needle placement during interventional procedures. Despite these technical advances, less sophisticated low-cost guidance devices promise to enhance puncture accuracy compared with the traditional freehand technique. Purpose: To compare the in vitro accuracy and feasibility of two different aiming devices for computed-tomography (CT)-guided punctures. Methods: A total of 560 CT-guided punctures were performed by using either a robotic (Perfint Healthcare: Maxio) or a novel low-cost patient-mounted system (Medical Templates AG: Puncture Cube System [PCS]) for the placement of Kirschner wires in a plexiglass phantom with different slice thicknesses. Needle placement accuracy as well as procedural time were assessed. The Euclidean (ED) and normal distances (ND) were calculated at the entry and target point. Results: Using the robotic device, the ND at the target for 1.25 mm, 2.5 mm, 3.75 mm and 5 mm slice thickness were 1.28 mm (SD ± 0.79), 1.25 mm (SD ± 0.81), 1.35 mm (SD ± 1.00) and 1.35 mm (SD ± 1.03). Using the PCS, the ND at the target for 1 mm, 3 mm and 5 mm slices were 3.84 mm (SD ± 1.75), 4.41 mm (SD ± 2.31) and 4.41 mm (SD ± 2.11), respectively. With all comparable slice thicknesses, the robotic device was significantly more accurate compared to the low-cost device (p < 0.001). Needle placement with the PCS resulted in lower intervention time (mean, 158.83 s [SD ± 23.38] vs. 225.67 s [SD ± 17.2]). Conclusion: Although the robotic device provided more accurate results, both guidance systems showed acceptable results and may be helpful for interventions in difficult anatomical regions and for those requiring complex multi-angle trajectories.
基于机器人的引导系统在介入手术中辅助针穿刺的能力日益增强。尽管有这些技术进步，但与传统徒手技术相比，不太复杂的低成本引导设备有望提高穿刺准确性。目的：比较两种不同的用于计算机断层扫描（CT）引导穿刺的瞄准设备的体外准确性和可行性。方法：使用机器人（Perfint Healthcare：Maxio）或新型低成本患者安装系统（Medical Templates AG：穿刺立方体系统[PCS]）在具有不同切片厚度的有机玻璃模型中进行克氏针置入，共进行了560次CT引导穿刺。评估针放置的准确性以及操作时间。在进针点和靶点计算欧几里得距离（ED）和法线距离（ND）。结果：使用机器人设备，对于1.25毫米、2.5毫米、3.75毫米和5毫米切片厚度，靶点处的ND分别为1.28毫米（标准差±0.79）、1.25毫米（标准差±0.81）、1.35毫米（标准差±1.00）和1.35毫米（标准差±1.03）。使用PCS，对于1毫米、3毫米和5毫米切片，靶点处的ND分别为3.84毫米（标准差±1.75）、4.41毫米（标准差±2.31）和4.41毫米（标准差±2.11）。在所有可比切片厚度下，与低成本设备相比，机器人设备的准确性显著更高（p < 0.001）。使用PCS进行针放置导致干预时间更短（平均，158.83秒[标准差±23.38]对225.67秒[标准差±17.2]）。结论：尽管机器人设备提供了更准确的结果，但两种引导系统均显示出可接受的结果，可能有助于在困难解剖区域以及需要复杂多角度轨迹的干预中发挥作用。
