Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
Department of Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
J Robot Surg. 2024 May 21;18(1):219. doi: 10.1007/s11701-024-01957-z.
An experimental validation of a robotic system for radioactive iodine-125 seed implantation (RISI) in tumor treatment was conducted using customized phantom models and animal models simulating liver and lung lesions. The robotic system, consisting of planning, navigation, and implantation modules, was employed to implant dummy radioactive seeds into the models. Fiducial markers were used for target localization. In phantom experiments across 40 cases, the mean errors between planned and actual seed positions were 0.98 ± 1.05 mm, 1.14 ± 0.62 mm, and 0.90 ± 1.05 mm in the x, y, and z directions, respectively. The x, y, and z directions correspond to the left-right, anterior-posterior, and superior-inferior anatomical planes. Silicone phantoms exhibiting significantly smaller x-axis errors compared to liver and lung phantoms (p < 0.05). Template assistance significantly reduced errors in all axes (p < 0.05). No significant dosimetric deviations were observed in parameters such as D90, V100, and V150 between plans and post-implant doses (p > 0.05). In animal experiments across 23 liver and lung cases, the mean implantation errors were 1.28 ± 0.77 mm, 1.66 ± 0.69 mm, and 1.86 ± 0.93 mm in the x, y, and z directions, slightly higher than in phantoms (p < 0.05), with no significant differences between liver and lung models. The dosimetric results closely matched planned values, confirming the accuracy of the robotic system for RISI, offering new possibilities in clinical tumor treatment.
采用定制的体模和模拟肝脏及肺部病变的动物模型,对用于肿瘤治疗的放射性碘-125 种子植入术(RISI)的机器人系统进行了实验验证。该机器人系统由规划、导航和植入模块组成,用于将虚拟放射性种子植入模型中。采用基准标记进行靶定位。在 40 例体模实验中,计划和实际种子位置之间的平均误差分别为 x、y 和 z 方向上的 0.98±1.05mm、1.14±0.62mm 和 0.90±1.05mm。x、y 和 z 方向分别对应于左右、前后和上下解剖平面。硅胶体模在 x 轴上的误差明显小于肝脏和肺部体模(p<0.05)。模板辅助显著降低了所有轴上的误差(p<0.05)。在 D90、V100 和 V150 等参数方面,计划剂量和植入后剂量之间没有观察到显著的剂量偏差(p>0.05)。在 23 例肝脏和肺部动物实验中,x、y 和 z 方向的平均植入误差分别为 1.28±0.77mm、1.66±0.69mm 和 1.86±0.93mm,略高于体模(p<0.05),肝脏和肺部模型之间无显著差异。剂量学结果与计划值非常吻合,证实了机器人系统用于 RISI 的准确性,为临床肿瘤治疗提供了新的可能性。