Toward autonomous robotic prostate biopsy: a pilot study

Abstract

Purpose We present the validation of PROST, a robotic device for prostate biopsy. PROST is designed to minimize human error by introducing some autonomy in the execution of the key steps of the procedure, i.e., target selection, image fusion and needle positioning. The robot allows executing a targeted biopsy through ultrasound (US) guidance and fusion with magnetic resonance (MR) images, where the target was defined. Methods PROST is a parallel robot with 4 degrees of freedom (DOF) to orient the needle and 1 DOF to rotate the US probe. We reached a calibration error of less than 2 mm, computed as the difference between the needle positioning in robot coordinates and in the US image. The autonomy of the robot is given by the image analysis software, which employs deep learning techniques, the integrated image fusion algorithms and automatic computation of the needle trajectory. For safety reasons, the insertion of the needle is assigned to the doctor. Results System performance was evaluated in terms of positioning accuracy. Tests were performed on a 3D printed object with nine 2-mm spherical targets and on an anatomical commercial phantom that simulates human prostate with three lesions and the surrounding structures. The average accuracy reached in the laboratory experiments was 1.30 ± 0.44 mm in the first test and 1.54 ± 0.34 mm in the second test. Conclusions We introduced a first prototype of a prostate biopsy robot that has the potential to increase the detection of clinically significant prostate cancer and, by including some level of autonomy, to simplify the procedure, to reduce human errors and shorten training time. The use of a robot for the biopsy of the prostate will create the possibility to include also a treatment, such as focal ablation, to be delivered through the same system.

Robot-Aided Prostate Cancer Diagnosis with Fiber Optic Sensing: A Validation Study on Phantoms and Ex-Vivo Tissues

“…In this work, the authors presented a novel robotic system for prostate cance diagnosis with the aim to improve the current diagnostic procedures using a fiber optics based sensor that can inspect different organ points through indentation. Othe prototypes of prostate biopsy robots have been developed and validated in the past however, none of them have used such technology to improve prostate cancer detection Maris et al developed a robot able to perform a targeted biopsy through ultrasound guidance and magnetic resonance images fusion, and needle positioning [18].…”

“…Other prototypes of prostate biopsy robots have been developed and validated in the past; however, none of them have used such technology to improve prostate cancer detection. Maris et al developed a robot able to perform a targeted biopsy through ultrasound guidance and magnetic resonance images fusion, and needle positioning [18].…”

Prostate Cancer Diagnosis: Biopsy Approaches

“…Robotic biopsy methods have been developed using TRUS-MR fusion. Various designs exist, though the general principle is that lesions identified on mpMRI and fused with TRUS images are targeted with the robotic arm which defines penetration angle and depth by positioning a needle guide with stop bar (141)(142)(143). The insertion and firing of the needle gun are then performed by the surgeon at the predefined position and depth (142,143).…”

Autonomous Robotic System for Breast Biopsy With Deformation Compensation

“…Moreover, such systems deform the anatomy during acquisition, making the registration with pre-operative MRI cumbersome. An area of application where the integration of 3D US imaging and robotic guidance may lead to autonomous systems is the robotic prostate biopsy [15]. A complete review of the existing autonomous capabilities of surgical robots with the introduction of a practical scale to assess the level of autonomy of current and future surgical robots may be found in [16], [17].…”