Research On Robotic Navigation System For CT-Guided Percutaneous Intervention

Background: With the development of image fusion technology and the enrichment of minimally invasive treatment options,CT-guided non-vascular intervention have gradually shown many advantages in clinical diagnosis and treatment,such as tumor ablation,implantation of radioactive particles and biopsy.The premise of minimally invasive diagnosis and treatment is accurate and safe puncture.For example,inaccurate puncture in the process of puncture biopsy will result in disqualification of samples,which will affect the follow-up pathological diagnosis.Traditional puncture is based on the CT images scanned multiple times intermittently.The step-and-shoot approach is based on the operator ’ s subjective assessment of needle path and may result in increased procedure duration,puncture deviation and complication rate.At present,various assisting technologies have been developed in the clinic,including robotic navigation systems,electromagnetic navigation systems,optical navigation systems,laser positioning systems and so on.Among them,the robotic navigation systems has accurate positioning and is not affected by the surrounding environment.The accuracy and safety of ROBIO and MAXIO systems abroad have been confirmed in the clinic.Objective: To design a new domestic robotic navigation system and evaluate its accuracy,safety and availability.Contents:(1)The clinical cases of CT and ultrasound guided interventional treatment were counted.The ultrasound group collected 49 patients with malignant biliary obstruction who needed PTCD.The puncture duration was 2.39 ± 2.04 min.Forty patients underwent one-needle puncture successfully,8 cases were completed twice,and 1 case was completed three times.The success rate of one-needle puncture was 81.6%.Three cases had bleeding during operation.In the CT group,79 CT-guided conventional punctures were collected.The operation time was 21.46 ± 4.64 min,the number of puncture needle adjustments was 4.28 ± 0.98 times,and the puncture error was 5.73 ± 1.32 mm.Four patients developed pneumothorax.(2)According to the process requirements of CT-guided puncture assisted by robotic navigation system,a new domestic navigation device was designed.The requirements and functions of the overall system architecture,various hardware and software were introduced.(3)Animal experiment were designed to compare the new navigation system-assisted puncture with the traditional puncture.The results showed that the navigation system-assisted group completed 40 punctures.The success rate of one-needle puncture was 100%.The puncture deviation was 3.73 ± 1.32 mm,and the puncture duration was 11.47 ± 0.74 min.Forty punctures in the traditional puncture group were successfully completed.The number of puncture needle adjustments was 3.6 ± 0.67,the puncture deviation was 4.68 ± 1.16 mm,and the puncture duration was 19.45 ± 3.18 min.There was a statistically significant difference in puncture deviation and puncture duration between the two groups(P <0.05).Puncture assisted by robotic navigation system is more accurate and convenient than the traditional step-and-shoot technique.