CardioVascular and Interventional Radiology

, Volume 42, Issue 2, pp 283–288 | Cite as

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

  • Antoine PfeilEmail author
  • Roberto Luigi Cazzato
  • Laurent Barbé
  • Pierre De Marini
  • Jeanie Betsy Chiang
  • Julien Garnon
  • Pierre Renaud
  • Afshin Gangi
Laboratory Investigation



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.


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).


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.


Percutaneous biopsy Cone-beam CT Robot Radiation dose 



Authors would like to sincerely thank Marie Charlotte Hesler (MD) and Emile Reeb for their participation in the experiments; Luc Mertz (Ph.D.), Nicolas Clauss and Elise Bottlaender from the Radiophysics and Radioprotection Department of the University of Strasbourg for their kind assistance in lending and reading the TLD dosimeters.


This work was supported by the INTERREG Upper Rhine program from the ERDF (European Regional Development Fund), SPIRITS project.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and Animal Rights

This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Antoine Pfeil
    • 1
    Email author
  • Roberto Luigi Cazzato
    • 2
  • Laurent Barbé
    • 1
  • Pierre De Marini
    • 2
  • Jeanie Betsy Chiang
    • 3
  • Julien Garnon
    • 2
  • Pierre Renaud
    • 1
  • Afshin Gangi
    • 2
  1. 1.ICube LaboratoryUniversity of Strasbourg, CNRS, INSA StrasbourgStrasbourg CedexFrance
  2. 2.Department of Interventional RadiologyUniversity Hospital of StrasbourgStrasbourg CedexFrance
  3. 3.Interventional RadiologyQueen Marie Hospital, Hong KongPok Fu LamHong Kong

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