Observations And Experiments For The Definition Of A New Robotic Device Dedicated To CT, CBCT And MRI-Guided Percutaneous Procedures.

In this paper, we present the work achieved to define the robotic functionalities of interest for percutaneous procedures as performed in interventional radiology. Our contributions are twofold. First, a detailed task analysis is performed with workflow analysis of biopsies, one of the most frequent tasks, under three imaging modalities, namely CT, CBCT and MRI. Second, the functionalities of a robotic assistant are identified, and we analyze whether a single device can bring an added value during procedures in the three modalities while keeping the robotized workflow close to manual tasks, to minimize learning time and difficulty of use. Experimental analysis on CBCT is notably used to confirm the interest of the determined robotic functionalities.journal articleresearch support, non-u.s. gov't2018 07importedIEEE Engineering in Medicine and Biology Society, Honolulu, United States, juillet 2018 Research team : AV

Robotically Assisted CBCT-Guided Needle Insertions: Preliminary Results in a Phantom Model

Aim To compare robotic-assisted needle insertions performed under CBCT guidance to standard manual needle insertions. Materials and Methods A homemade robotic prototype was used by two operators to perform robotic and manual needle insertions on a custom-made phantom. Both the operators had no experience with the prototype before starting the trial. The primary endpoint was accuracy (i.e., the minimal distance between the needle tip and the center of the target) between robotic and manual insertions. Secondary endpoints included total procedure time and operators’ radiation exposure. The Wilcoxon test was used. A p value less than 0.05 was considered statistically significant. Results Thirty-three (17 manual, 16 robotic) needle insertions were performed. Mean accuracy for robotic insertion was 2.3 ± 0.9 mm (median 2.1; range 0.8–4.2) versus 2.3 ± 1 mm (median 2.1; range 0.7–4.4) for manual insertion (p = 0.84). Mean procedure time was 683 ± 57 s (median 670; range 611–849) for the robotic group versus 552 ± 40 s (median 548; range 486–621) for the manual group (p = 0.0002). Mean radiation exposure was 3.25 times less for the robotic insertion on comparison to manual insertion for the operator 1 (0.4 vs 1.3 µGy); and 4.15 times less for the operator 2 (1.9 vs 7.9 µGy). Conclusion The tested robotic prototype showed accuracy comparable to that achieved with manual punctures coupled to a significant reduction of operators’ radiation exposure. Further, in vivo studies are necessary to confirm the efficiency of the system

Dietemann J : Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. Am J Neuroradiol 15

Summary: We describe the technique of percutaneous vertebroplasty using methyl methacrylate. We injected under the guid· ance of CT and fluoroscopy a group of 10 patients with back pain caused by a variety of vertebral lesions including severe osteoporosis (n = 4), hemangiomas (n = 5) and metastasis (n = 1). Over varying periods of follow-up (ranging from 4 to 17 months) none of the injected vertebral bodies demonstrated compression. All patients had relief of back pain; none had complications related to the technique. We emphasize that the efficacy of this technique in preventing vertebral collapse could not be evaluated in this small sample; a well-controlled study would be required to determine the proper indications and efficacy of this treatment

CIRSE Position Statement: Interventional Radiologists and Intra-arterial Stroke Therapy

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Complications of percutaneous image-guided screw fixation:An analysis of 94 consecutive patients

Purpose The purpose of this study was to retrospectively assess the safety profile of percutaneous image-guided screw fixation (PIGSF) for insufficiency, impending or pathological fractures. Materials and methods From July 2012 to April 2020, all consecutive patients who underwent PIGSF were retrospectively included in the study. Patient characteristics, fracture type, procedural data and complications were analyzed. Complications were divided into per-procedural, early ( 24 hours) and classified into minor (grade 1-2) and major complications (grade 3-5) according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Results A total of 110 fractures (40 insufficiency [36%], 53 pathological [48.5%] and 17 impending [15.5%] fractures) in 94 patients (48 women, 46 men; mean age, 62.7 ± 12.7 [SD] years; age range: 32–88 years) were treated with PIGSF during 95 procedures. Twenty-four-hours follow-up was available for all patients, and > 24-hours follow-up was available for 79 (79/110; 71.8%) fractures in 69 (69/94; 73.4%) patients. Per-procedural complications occurred in 3/110 fractures (2.7%, all minor). Early complications were reported in 4/110 fractures (3.6%, 1 major and 3 minor) and delayed ones in 14/79 fractures (17.7%, 5 major and 9 minor). The most frequent major delayed complication was infection (3/79; 3.8%). Conclusion The rate of per-procedural and early (within 24 hours) complications following PIGSF is extremely low with most complications being minor, with major complications being delayed ones (> 24 hours)

Percutaneous thermal ablation of sacral metastases:Assessment of pain relief and local tumor control

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