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Advantage of robotic needle placement on a prostate model in HDR brachytherapy

Vorteil der robotergestüzten Nadelapplikation in der HDR - Brachytherapie am Prostatamodell

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Purpose:

To compare the accuracy of the robot-assisted needle positioning with that of the conventional template-guided method with the help of a prostate model in high dose rate (HDR) brachytherapy.

Materials and Methods:

A prostate model of fresh porcine abdomen and special polyvinylchloride (PVC) sheets was developed. To verify the model, deviations from 311 needle placements of real prostate implants were analyzed. Second, the accuracy of the template-guided positioning versus robot-assisted positioning was measured with 20 needle insertions in the model. For robot-assisted positioning, different velocities (2.7, 5.4, 9.8 mm/s) of needle insertion were investigated.

Results:

The average needle positioning accuracies of manual template guidance on the model closely resembled those of real patients (approximately 3 mm). The average needle positioning accuracy for the robot-assisted method on the prostate model was 1.8 ± 0.6 mm, at a velocity of 2.7 mm/s and, in comparison to the template-guided method (2.7 ± 0.7 mm), was statistically more precise (p < 0.001). At higher robotic velocities, the measured needle positioning accuracy showed no significant difference from that of the manual insertion procedure.

Conclusion:

By employing a prostate model, we showed for the first time that robot-assisted needle placement for HDR brachy-therapy is significantly more precise than the conventional method at a velocity of 2.7 mm/s. The robot-assisted needle positioning technique improves the degree of freedom by providing additional oblique insertion channels and could be potentially exploited not only for LDR but also for HDR brachytherapy.

Fragestellung:

Ziel der Arbeit ist der Vergleich der Genauigkeit der Roboter-assistierten mit der Template-gestützten Nadelpositionierung am Prostatamodell.

Material und Methode:

Für die Messung wurde ein Prostatamodell aus frischem Schweinebauch und speziellen PVC-Folien entwickelt. Zur Verifikation des Modells wurde die Genauigkeit der interstitiellen Template-gestützten Nadelpositionierung von 311 Nadeln, die im Rahmen einer HDR-Brachytherapie positioniert wurden, anhand von Ultraschallbildern ermittelt. Danach erfolgte die Messung der Genauigkeit von jeweils 20 Roboter-assistierten Nadelpositionierung mit den Geschwindigkeiten 2,7/5,4/9,8 mm/s und 20 Template-gestützten Nadelpositionierung am Prostatamodell.

Ergebnisse:

Die mittlere Nadelpositionierungsgenauigkeit der manuellen Template-gestützten Nadelapplikation am Modell war mit der Genauigkeit am realen Patienten vergleichbar (≈3mm). Die mittlere Nadelpositionierungsgenauigkeit der Roboter-gestützten Methode am Prostatamodell war mit 1,8 ± 0,6 mm (Geschwindigkeit 2,7 mm/s) signifikant besser als die Template-gestützte manuelle Applikation mit 2.7 ± 0.7 mm. Bei höheren Geschwindigkeiten für die Roboter-gestützte Applikation konnte kein Unterschied in der Positionierungsgenauigkeit im Vergleich zu der manuellen Methode nachgewiesen werden.

Schlussfolgerung:

Die von uns durchgeführte Studie zeigt erstmals einen signifikanten Vorteil der Roboter-gestützten Nadelapplikation bei einer Geschwindigkeit von 2,7 mm/s gegenüber der konventionellen Methode am Prostatamodell. Die Roboter-gestützte Nadelapplikation ermöglicht auch schräge Einstichkanäle und erhöht dadurch die Freiheitsgrade der Nadelpositionierung, daher ist sie für die LDR- und auch für die HDR-Brachytherapie sinnvoll.

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Authors and Affiliations

  1. Department of Radiotherapy and Radiation Oncology, University of Marburg, Marburg, Germany

    Gerd Strassmann, Emmanouil Fokas & Rita Engenhart-Cabillic

  2. Department of Informatics, Hochschule RheinMain, University of Applied Science, Wiesbaden, Germany

    Detlev Richter

  3. Department of Urology, University of Marburg, Marburg, Germany

    Peter Olbert, Axel Hegele & Rainer Hofmann

  4. Department of Medical Biometry and Epidemiology, University of Marburg, Marburg, Germany

    Nina Timmesfeld

  5. Department of Radiotherapy and Radiation Oncology, University of Marburg, Baldingerstr. 1, 35033, Marburg, Germany

    Gerd Strassmann

Authors
  1. Gerd Strassmann
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  2. Peter Olbert
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  3. Axel Hegele
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  4. Detlev Richter
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  5. Emmanouil Fokas
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  6. Nina Timmesfeld
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  8. Rita Engenhart-Cabillic
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Correspondence to Gerd Strassmann.

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Strassmann, G., Olbert, P., Hegele, A. et al. Advantage of robotic needle placement on a prostate model in HDR brachytherapy. Strahlenther Onkol 187, 367–372 (2011). https://doi.org/10.1007/s00066-011-2185-y

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  • DOI: https://doi.org/10.1007/s00066-011-2185-y

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