Robotic assistance for ultrasound-guided prostate brachytherapy
Robotic assistance for ultrasound-guided prostate brachytherapy
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DOI：
10.1016/j.media.2008.06.002
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发表时间：
2008-10-01
影响因子：
10.9
通讯作者：
Kazanzides, Peter
中科院分区：
文献类型：
--
作者：
Fichtinger, Gabor;Fiene, Jonathan P.;Kazanzides, Peter
我们提出了一个机器人辅助前列腺近距离放射治疗系统和测试结果的培训phantomy和I期临床试验。该系统由经直肠超声（TRUS）和空间共配准机器人组成，与FDA批准的商业治疗计划系统完全集成。该系统的显着特点是一个小型的并联机器人固定在模板的安装柱。机器人使用相同的坐标系可互换地替换模板。已建立的临床硬件、工作流程和校准保持不变。在所有的体模实验中，我们记录了第一次插入尝试，没有调整。到达前列腺中的所有临床相关位置。实现了非平行的针轨迹。插入前横向和旋转误差（使用Polaris光学跟踪仪相对于模板坐标系测量）为0.25 mm（STD = 0.17 mm）和0.75度（STD = 0.37度）。在体模中，在TRUS中测量的针尖放置误差为1.04 mm（STD = 0.50 mm）。该系统已成功完成I期临床可行性和安全性试验。我们在179个机器人引导的针中仅在2个中遇到了大于4 mm的针尖定位误差，与手动模板引导相反，手动模板引导中这种量级的误差更为常见。需要进一步的临床试验来确定机器人助手的明显益处是否会导致临床疗效和结果的改善。(C)2008 Elsevier B.V.保留所有权利。
We present a robotically assisted prostate brachytherapy system and test results in training phantoms and Phase-I clinical trials. The system consists of a transrectal ultrasound (TRUS) and a spatially co-registered robot, fully integrated with an FDA-approved commercial treatment planning system. The salient feature of the system is a small parallel robot affixed to the mounting posts of the template. The robot replaces the template interchangeably, using the same coordinate system. Established clinical hardware, workflow and calibration remain intact. In all phantom experiments, we recorded the first insertion attempt without adjustment. All clinically relevant locations in the prostate were reached. Non-parallel needle trajectories were achieved. The pre-insertion transverse and rotational errors (measured with a Polaris optical tracker relative to the template's coordinate frame) were 0.25 mm (STD = 0.17 mm) and 0.75 degrees (STD = 0.37 degrees). In phantoms, needle tip placement errors measured in TRUS were 1.04 mm (STD = 0.50 mm). A Phase-I clinical feasibility and safety trial has been successfully completed with the system. We encountered needle tip positioning errors of a magnitude greater than 4 mm in only 2 of 179 robotically guided needles, in contrast to manual template guidance where errors of this magnitude are much more common. Further clinical trials are necessary to determine whether the apparent benefits of the robotic assistant will lead to improvements in clinical efficacy and outcomes. (C) 2008 Elsevier B.V. All rights reserved.