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. 2008 Jun;4(2):180-91.
doi: 10.1002/rcs.184.

Three-dimensional ultrasound-guided robotic needle placement: an experimental evaluation

Emad M Boctor  1 , Michael A Choti, Everette C Burdette, Robert J Webster Iii
Affiliations

Three-dimensional ultrasound-guided robotic needle placement: an experimental evaluation

Emad M Boctor et al. Int J Med Robot. 2008 Jun.

Abstract

Background: Clinical use of image-guided needle placement robots has lagged behind laboratory-demonstrated robotic capability. Bridging this gap requires reliable and easy-to-use robotic systems.

Methods: Our system for image-guided needle placement requires only simple, low-cost components and minimal, entirely off-line calibration. It rapidly aligns needles to planned entry paths using 3D ultrasound (US) reconstructed from freehand 2D scans. We compare system accuracy against clinical standard manual needle placement.

Results: The US-guided robotic system is significantly more accurate than single manual insertions. When several manual withdrawals and reinsertions are allowed, accuracy becomes equivalent. In ex vivo experiments, robotic repeatability was 1.56 mm, compared to 3.19 and 4.63 mm for two sets of manual insertions. In an in vivo experiment with heartbeat and respiratory effects, robotic system accuracy was 5.5 mm.

Conclusions: A 3D US-guided robot can eliminate error bias and reduce invasiveness (the number of insertions required) compared to manual needle insertion. Remaining future challenges include target motion compensation.

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Figures

Figure 1
Figure 1
Typical radiofrequency ablation of a liver tumour guided by freehand 2D US. Image courtesy of the Johns Hopkins University Liver Cancer Center
Figure 2
Figure 2
System components of our 3D US-guided robotic needle placement system. The system uses a tracked manual US probe and a robotic arm to manipulate the needle
Figure 3
Figure 3
Shown here (bottom image) are 360 incremental rotations of α for two particular β angles (needle positions shown in green, dashed lines). This illustrates the dependency between α and β that arises when the needle tip is not placed at a mechanically constrained RCM point. Shown in blue solid lines are the closest possible alignments with the entry point-target point vector. A β of 5° offers better potential alignment (top left image) than a β of 50° (top right image), as illustrated by the lower minimum value of the cross-product heuristic with respect to α
Figure 4
Figure 4
The software user interface window, showing two views of a 3D planning and visualization environment based on 3D Slicer
Figure 5
Figure 5
The CISUS interface under the 3D Slicer. The tracked 3D US volume collected in real tissue is shown from two different angles and in the bottom pane are three 2D sections. The needle location is shown in real time as a thick cylinder registered to the US volume, with the thin line emanating from it showing a straight, forward trajectory. There are two overlaid spheres, one for selecting a planned insertion point, and the other for selecting a planned target. The targeting sphere is centred at the lesion. Note that the quality of the freehand tracked 3D US volume is sufficient for image guidance, and arbitrary slices of it have the apparent quality of normal B-mode US images
Figure 6
Figure 6
A larger view of a 3D US reconstruction similar to that found in Figure 5. This volume was collected in phantom tissue and an embedded synthetic lesion is evident. The bottom three images show 2D slices through the 3D volume
Figure 7
Figure 7
These two perpendicular X-ray projections show an example of a needle embedded in a simulated lesion (sphere inside solid red circle) and a calibration sphere (circled with a dashed line). The calibration sphere is not involved in the experiment, but was placed in the image to provide an object of known reference geometry for calibrating the C-arm. The dark square with trailing wire in the right image is the magnetic tracker attached to the needle holder. The needle holder itself was radiolucent and so does not appear in the images
Figure 8
Figure 8
A comparison of average targeting accuracy for manual freehand 2D US needle insertion and robotic 3D US needle insertion, in the lateral (or sagittal) projection and anterior–posterior (or coronal) projection. Error bars indicate SD
Figure 9
Figure 9
The 3D US-guided robotic needle placement system, as arranged for in vivo experiments with fluoroscopy to assess the targeting accuracy. Note that, in the above image, the C-arm is orientated to acquire the coronal projection, which can be difficult or impossible to acquire manually with 2D US, due to workspace constraints from patient anatomy
See this image and copyright information in PMC

References

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    1. Boctor EM, Webster RJ, III, Mathieu H, et al. Virtual remote center of motion control for needle placement robots. Sixth International Conference on Medical Image Computing and Computer-Assisted Intervention. Lect Notes Comput Sci. 2003;2878:157–165.
    1. Boctor EM, Webster RJ, III, Taylor RH, et al. Proceedings of Conference of Computer Assisted Radiology and Surgery (CARS), Chicago. Elsevier; New York: 2004. 2004. Robotically assisted ablative treatment guided by freehand 3D ultrasound; pp. 503–508.

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