Starup-Hansen Joachim, Williams Simon C, Funnell Jonathan P, Hanrahan John G, Islam Shah, Al-Mohammad Alaa, Hill Ciaran S
Charing Cross Hospital, Imperial College NHS Healthcare Trust, London, United Kingdom.
Department of Neurosurgery, St George's Hospital, London, United Kingdom.
Br J Neurosurg. 2025 Apr;39(2):163-172. doi: 10.1080/02688697.2023.2210225. Epub 2023 May 13.
Despite advances in technology, stereotactic brain tumour biopsy remains challenging due to the risk of injury to critical structures. Indeed, choosing the correct trajectory remains essential to patient safety. Artificial intelligence can be used to perform automated trajectory planning. We present a systematic review of automated trajectory planning algorithms for stereotactic brain tumour biopsies.
A PRISMA adherent systematic review was conducted. Databases were searched using keyword combinations of 'artificial intelligence', 'trajectory planning' and 'brain tumours'. Studies reporting applications of artificial intelligence (AI) to trajectory planning for brain tumour biopsy were included.
All eight studies were in the earliest stage of the IDEAL-D development framework. Trajectory plans were compared through a variety of surrogate markers of safety, of which the minimum distance to blood vessels was the most common. Five studies compared manual to automated planning strategies and favoured automation in all cases. However, this comes with a significant risk of bias.
This systematic review reveals the need for IDEAL-D Stage 1 research into automated trajectory planning for brain tumour biopsy. Future studies should establish the congruence between expected risk of algorithms and the ground truth through comparisons to real world outcomes.
尽管技术不断进步，但由于存在损伤关键结构的风险，立体定向脑肿瘤活检仍然具有挑战性。事实上，选择正确的穿刺路径对于患者安全至关重要。人工智能可用于执行自动穿刺路径规划。我们对立体定向脑肿瘤活检的自动穿刺路径规划算法进行了系统综述。
进行了一项遵循PRISMA的系统综述。使用“人工智能”、“穿刺路径规划”和“脑肿瘤”的关键词组合搜索数据库。纳入了报告人工智能（AI）在脑肿瘤活检穿刺路径规划中的应用的研究。
所有八项研究均处于IDEAL-D开发框架的最早阶段。通过各种安全替代指标比较穿刺路径计划，其中与血管的最小距离是最常见的。五项研究将手动与自动规划策略进行了比较，在所有情况下都倾向于自动化。然而，这存在显著的偏倚风险。
本系统综述揭示了对脑肿瘤活检自动穿刺路径规划进行IDEAL-D第1阶段研究的必要性。未来的研究应通过与实际结果的比较，确定算法的预期风险与实际情况之间的一致性。
