International Journal of Computer Assisted Radiology and Surgery最新文献

{"title":"Design and evaluation of an AR-based thermal imaging system for planning reconstructive surgeries.","authors":"Michael Unger, Annika Hänel, Claire Chalopin, Dirk Halama","doi":"10.1007/s11548-024-03184-1","DOIUrl":"10.1007/s11548-024-03184-1","url":null,"abstract":"<p><strong>Introduction: </strong>Thermal imaging can be used for the non-invasive detection of blood vessels of the skin. However, mapping the results to the patient currently lacks user-friendliness. Augmented reality may provide a useful tool to superimpose thermal information on the patient.</p><p><strong>Methods: </strong>A system to support planning in reconstructive surgery using a thermal camera was designed. The obtained information was superimposed on the physical object using a Microsoft HoloLens. An RGB, depth, and thermal camera were combined to capture a scene of different modalities and reconstruct a virtual scene in real time. To register the different cameras and the AR device, an active calibration target was developed and evaluated. A Vuforia marker was used to register the hologram in the virtual space. The accuracy of the projected hologram was evaluated in a laboratory setting with participants by measuring the error between the physical object and the hologram.</p><p><strong>Results: </strong>The AR-based system was evaluated by 21 participants in a laboratory setting. The mean projection error is 10.3 ± 9.4 mm. The system is able to stream a three-dimensional scene with augmented thermal information in real time at 5 frames per second. The active calibration target can be used independently of the environment.</p><p><strong>Conclusion: </strong>The calibration target provides an easy-to-use method for the registration of cameras capturing the visible to long-infrared spectral range. The inside-out tracking of the HoloLens in combination with a Vuforia marker is not accurate enough for the intended clinical use.</p>","PeriodicalId":51251,"journal":{"name":"International Journal of Computer Assisted Radiology and Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design consideration on integration of mechanical intravascular ultrasound and electromagnetic tracking sensor for intravascular reconstruction.","authors":"Wenran Cai, Kazuaki Hara, Naoki Tomii, Etsuko Kobayashi, Takashi Ohya, Ichiro Sakuma","doi":"10.1007/s11548-024-03059-5","DOIUrl":"10.1007/s11548-024-03059-5","url":null,"abstract":"<p><strong>Purpose: </strong>Considering vessel deformation, endovascular navigation requires intraoperative geometric information. Mechanical intravascular ultrasound (IVUS) with an electromagnetic (EM) sensor can be used to reconstruct blood vessels with thin diameter. However, the integration design should be evaluated based on the factors affecting the reconstruction error.</p><p><strong>Methods: </strong>The interference between the mechanical IVUS and EM sensor was measured in different relative positions. Two designs of the integrated catheter were evaluated by measuring the reconstruction errors using a rigid vascular phantom.</p><p><strong>Results: </strong>When the distance from the EM sensor to the field generator was 75 mm, the interference from mechanical IVUS to an EM sensor was negligible, with position and rotation errors less than 0.1 mm and 0.6°, respectively. The reconstructed vessel model for proximal IVUS transducer had a smooth surface but an inaccurate shape at large curvature of the vascular phantom. When the distance to the field generator was 175 mm, the error increased significantly.</p><p><strong>Conclusion: </strong>Placing the IVUS transducer on the proximal side of the EM sensor is superior in terms of interference reduction but inferior in terms of mechanical stability compared to a distal transducer. The distal side is preferred due to better mechanical stability during catheter manipulation at larger curvature. With this configuration, surface reconstruction errors less than 1.7 mm (with RMS 0.57 mm) were achieved when the distance to the field generator was less than 175 mm.</p>","PeriodicalId":51251,"journal":{"name":"International Journal of Computer Assisted Radiology and Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart and great vessels segmentation in congenital heart disease via CNN and conditioned energy function postprocessing.","authors":"Jiaxuan Liu, Bolun Zeng, Xiaojun Chen","doi":"10.1007/s11548-024-03182-3","DOIUrl":"10.1007/s11548-024-03182-3","url":null,"abstract":"<p><strong>Purpose: </strong>The segmentation of the heart and great vessels in CT images of congenital heart disease (CHD) is critical for the clinical assessment of cardiac anomalies and the diagnosis of CHD. However, the diverse types and abnormalities inherent in CHD present significant challenges to comprehensive heart segmentation.</p><p><strong>Methods: </strong>We proposed a novel two-stage segmentation approach, integrating a Convolutional Neural Network (CNN) with a postprocessing method with conditioned energy function for pulmonary and aorta. The initial stage employs a CNN enhanced by a gated self-attention mechanism for the segmentation of five primary heart structures and two major vessels. Subsequently, the second stage utilizes a conditioned energy function specifically tailored to refine the segmentation of the pulmonary artery and aorta, ensuring vascular continuity.</p><p><strong>Results: </strong>Our method was evaluated on a public dataset including 110 3D CT volumes, encompassing 16 CHD variants. Compared to prevailing segmentation techniques (U-Net, V-Net, Unetr, dynUnet), our approach demonstrated improvements of 1.02, 1.04, and 1.41% in Dice Coefficient (DSC), Intersection over Union (IOU), and the 95th percentile Hausdorff Distance (HD95), respectively, for heart structure segmentation. For the two great vessels, the enhancements were 1.05, 1.07, and 1.42% in these metrics.</p><p><strong>Conclusion: </strong>The outcomes on the public dataset affirm the efficacy of our proposed segmentation method. Precise segmentation of the entire heart and great vessels can significantly aid in the diagnosis and treatment of CHD, underscoring the clinical relevance of our findings.</p>","PeriodicalId":51251,"journal":{"name":"International Journal of Computer Assisted Radiology and Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulated augmented reality-based calibration of optical see-through head mound display for surgical navigation.","authors":"Ho-Gun Ha, Kyeongmo Gu, Deokgi Jeung, Jaesung Hong, Hyunki Lee","doi":"10.1007/s11548-024-03164-5","DOIUrl":"10.1007/s11548-024-03164-5","url":null,"abstract":"<p><strong>Purpose: </strong>Calibration of an optical see-through head-mounted display is critical for augmented reality-based surgical navigation. While conventional methods have advanced, calibration errors remain significant. Moreover, prior research has focused primarily on calibration accuracy and procedure, neglecting the impact on the overall surgical navigation system. Consequently, these enhancements do not necessarily translate to accurate augmented reality in the optical see-through head mount due to systemic errors, including those in calibration.</p><p><strong>Method: </strong>This study introduces a simulated augmented reality-based calibration to address these issues. By replicating the augmented reality that appeared in the optical see-through head mount, the method achieves calibration that compensates for augmented reality errors, thereby reducing them. The process involves two distinct calibration approaches, followed by adjusting the transformation matrix to minimize displacement in the simulated augmented reality.</p><p><strong>Results: </strong>The efficacy of this method was assessed through two accuracy evaluations: registration accuracy and augmented reality accuracy. Experimental results showed an average translational error of 2.14 mm and rotational error of 1.06° across axes in both approaches. Additionally, augmented reality accuracy, measured by the overlay regions' ratio, increased to approximately 95%. These findings confirm the enhancement in both calibration and augmented reality accuracy with the proposed method.</p><p><strong>Conclusion: </strong>The study presents a calibration method using simulated augmented reality, which minimizes augmented reality errors. This approach, requiring minimal manual intervention, offers a more robust and precise calibration technique for augmented reality applications in surgical navigation.</p>","PeriodicalId":51251,"journal":{"name":"International Journal of Computer Assisted Radiology and Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver respiratory-induced motion estimation using abdominal surface displacement as a surrogate: robotic phantom and clinical validation with varied correspondence models.","authors":"Ana Cordón Avila, Momen Abayazid","doi":"10.1007/s11548-024-03176-1","DOIUrl":"10.1007/s11548-024-03176-1","url":null,"abstract":"<p><strong>Purpose: </strong>This work presents the implementation of an RGB-D camera as a surrogate signal for liver respiratory-induced motion estimation. This study aims to validate the feasibility of RGB-D cameras as a surrogate in a human subject experiment and to compare the performance of different correspondence models.</p><p><strong>Methods: </strong>The proposed approach uses an RGB-D camera to compute an abdominal surface reconstruction and estimate the liver respiratory-induced motion. Two sets of validation experiments were conducted, first, using a robotic liver phantom and, secondly, performing a clinical study with human subjects. In the clinical study, three correspondence models were created changing the conditions of the learning-based model.</p><p><strong>Results: </strong>The motion model for the robotic liver phantom displayed an error below 3 mm with a coefficient of determination above 90% for the different directions of motion. The clinical study presented errors of 4.5, 2.5, and 2.9 mm for the three different motion models with a coefficient of determination above 80% for all three cases.</p><p><strong>Conclusion: </strong>RGB-D cameras are a promising method to accurately estimate the liver respiratory-induced motion. The internal motion can be estimated in a non-contact, noninvasive and flexible approach. Additionally, three training conditions for the correspondence model are studied to potentially mitigate intra- and inter-fraction motion.</p>","PeriodicalId":51251,"journal":{"name":"International Journal of Computer Assisted Radiology and Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IRE made easy: introducing the robotic grid system for multiple parallel needle insertion in irreversible electroporation treatment.","authors":"Girindra Wardhana, Jurgen J Fütterer, Momen Abayazid","doi":"10.1007/s11548-024-03216-w","DOIUrl":"10.1007/s11548-024-03216-w","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate needle placement is crucial for successful tumor treatment using the irreversible electroporation (IRE) method. Multiple needles are inserted around the tumor, ideally in parallel, to achieve uniform electric field distribution. This paper presents a robot utilizing a grid system to enable multiple needles insertion while maintaining parallelism between them.</p><p><strong>Methods: </strong>The robotic system has two degrees of freedom, which allow for the adjustment of the grid system to accommodate targeting lesions in various positions. The robot's performance was evaluated by testing its accuracy across various configurations and target depth locations, as well as its ability to maintain the needle parallelism.</p><p><strong>Results: </strong>The robot has dimensions of <math><mi>ϕ</mi></math> 134 mm and a height of 46 mm, with a total weight of 295 g. The system accuracy test showed that the robot can precisely target points across different target depths and needle orientations, with an average error of <math><mrow><mn>2.71</mn> <mo>±</mo> <mn>0.68</mn></mrow> </math> mm. Moreover, multiple insertions at different grid locations reveal needle orientation deviations typically below <math><msup><mn>1</mn> <mo>∘</mo></msup> </math> .</p><p><strong>Conclusion: </strong>This study presented the design and validation of a robotic grid system. The robot is capable of maintaining insertion accuracy and needle parallelism during multiple needle insertions at various robot configurations. The robot showed promising results with limited needle deviation, making it suitable for IRE procedures.</p>","PeriodicalId":51251,"journal":{"name":"International Journal of Computer Assisted Radiology and Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced muscle and fat segmentation for CT-based body composition analysis: a comparative study.","authors":"Benjamin Hou, Tejas Sudharshan Mathai, Jianfei Liu, Christopher Parnell, Ronald M Summers","doi":"10.1007/s11548-024-03167-2","DOIUrl":"10.1007/s11548-024-03167-2","url":null,"abstract":"<p><strong>Purpose: </strong>Body composition measurements from routine abdominal CT can yield personalized risk assessments for asymptomatic and diseased patients. In particular, attenuation and volume measures of muscle and fat are associated with important clinical outcomes, such as cardiovascular events, fractures, and death. This study evaluates the reliability of an Internal tool for the segmentation of muscle and fat (subcutaneous and visceral) as compared to the well-established public TotalSegmentator tool.</p><p><strong>Methods: </strong>We assessed the tools across 900 CT series from the publicly available SAROS dataset, focusing on muscle, subcutaneous fat, and visceral fat. The Dice score was employed to assess accuracy in subcutaneous fat and muscle segmentation. Due to the lack of ground truth segmentations for visceral fat, Cohen's Kappa was utilized to assess segmentation agreement between the tools.</p><p><strong>Results: </strong>Our Internal tool achieved a 3% higher Dice (83.8 vs. 80.8) for subcutaneous fat and a 5% improvement (87.6 vs. 83.2) for muscle segmentation, respectively. A Wilcoxon signed-rank test revealed that our results were statistically different with p < 0.01. For visceral fat, the Cohen's Kappa score of 0.856 indicated near-perfect agreement between the two tools. Our internal tool also showed very strong correlations for muscle volume (R <math><msup><mrow></mrow> <mn>2</mn></msup> </math> =0.99), muscle attenuation (R <math><msup><mrow></mrow> <mn>2</mn></msup> </math> =0.93), and subcutaneous fat volume (R <math><msup><mrow></mrow> <mn>2</mn></msup> </math> =0.99) with a moderate correlation for subcutaneous fat attenuation (R <math><msup><mrow></mrow> <mn>2</mn></msup> </math> =0.45).</p><p><strong>Conclusion: </strong>Our findings indicated that our Internal tool outperformed TotalSegmentator in measuring subcutaneous fat and muscle. The high Cohen's Kappa score for visceral fat suggests a reliable level of agreement between the two tools. These results demonstrate the potential of our tool in advancing the accuracy of body composition analysis.</p>","PeriodicalId":51251,"journal":{"name":"International Journal of Computer Assisted Radiology and Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A robot-assisted tracheal intubation system based on a soft actuator?","authors":"Jiayuan Liu, Longfei Ma, Chengquan Hu, Jingyi Kang, Boyu Zhang, Ruiyang Li, Hongen Liao","doi":"10.1007/s11548-024-03209-9","DOIUrl":"10.1007/s11548-024-03209-9","url":null,"abstract":"<p><strong>Purpose: </strong>Tracheal intubation is the gold standard of airway protection and constitutes a pivotal life-saving technique frequently employed in emergency medical interventions. Hence, in this paper, a system is designed to execute tracheal intubation tasks automatically, offering a safer and more efficient solution, thereby alleviating the burden on physicians.</p><p><strong>Methods: </strong>The system comprises a tracheal tube with a bendable front end, a drive system, and a tip endoscope. The soft actuator provides two degrees of freedom for precise orientation. It is fabricated with varying-hardness silicone and reinforced with fibers and spiral steel wire for flexibility and safety. The hydraulic actuation system and tube feeding mechanism enable controlled bending and delivery. Object detection of key anatomical features guides the robotic arm and soft actuator. The control strategy involves visual servo control for coordinated robotic arm and soft actuator movements, ensuring accurate and safe tracheal intubation.</p><p><strong>Results: </strong>The kinematics of the soft actuator were established using a constant curvature model, allowing simulation of its workspace. Through experiments, the actuator is capable of 90° bending as well as 20° deflection on the left and right sides. The maximum insertion force of the tube is 2 N. Autonomous tracheal intubation experiments on a training manikin were successful in all 10 trials, with an average insertion time of 45.6 s.</p><p><strong>Conclusion: </strong>Experimental validation on the manikin demonstrated that the robot tracheal intubation system based on a soft actuator was able to perform safe, stable, and automated tracheal intubation. In summary, this paper proposed a safe and automated robot-assisted tracheal intubation system based on a soft actuator, showing considerable potential for clinical applications.</p>","PeriodicalId":51251,"journal":{"name":"International Journal of Computer Assisted Radiology and Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomous navigation of catheters and guidewires in mechanical thrombectomy using inverse reinforcement learning.","authors":"Harry Robertshaw, Lennart Karstensen, Benjamin Jackson, Alejandro Granados, Thomas C Booth","doi":"10.1007/s11548-024-03208-w","DOIUrl":"10.1007/s11548-024-03208-w","url":null,"abstract":"<p><strong>Purpose: </strong>Autonomous navigation of catheters and guidewires can enhance endovascular surgery safety and efficacy, reducing procedure times and operator radiation exposure. Integrating tele-operated robotics could widen access to time-sensitive emergency procedures like mechanical thrombectomy (MT). Reinforcement learning (RL) shows potential in endovascular navigation, yet its application encounters challenges without a reward signal. This study explores the viability of autonomous guidewire navigation in MT vasculature using inverse reinforcement learning (IRL) to leverage expert demonstrations.</p><p><strong>Methods: </strong>Employing the Simulation Open Framework Architecture (SOFA), this study established a simulation-based training and evaluation environment for MT navigation. We used IRL to infer reward functions from expert behaviour when navigating a guidewire and catheter. We utilized the soft actor-critic algorithm to train models with various reward functions and compared their performance in silico.</p><p><strong>Results: </strong>We demonstrated feasibility of navigation using IRL. When evaluating single- versus dual-device (i.e. guidewire versus catheter and guidewire) tracking, both methods achieved high success rates of 95% and 96%, respectively. Dual tracking, however, utilized both devices mimicking an expert. A success rate of 100% and procedure time of 22.6 s were obtained when training with a reward function obtained through 'reward shaping'. This outperformed a dense reward function (96%, 24.9 s) and an IRL-derived reward function (48%, 59.2 s).</p><p><strong>Conclusions: </strong>We have contributed to the advancement of autonomous endovascular intervention navigation, particularly MT, by effectively employing IRL based on demonstrator expertise. The results underscore the potential of using reward shaping to efficiently train models, offering a promising avenue for enhancing the accessibility and precision of MT procedures. We envisage that future research can extend our methodology to diverse anatomical structures to enhance generalizability.</p>","PeriodicalId":51251,"journal":{"name":"International Journal of Computer Assisted Radiology and Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7616368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micro-robotic percutaneous targeting of type II endoleaks in the angio-suite.","authors":"Gerlig Widmann, Johannes Deeg, Andreas Frech, Josef Klocker, Gudrun Feuchtner, Martin Freund","doi":"10.1007/s11548-024-03195-y","DOIUrl":"10.1007/s11548-024-03195-y","url":null,"abstract":"<p><strong>Purpose: </strong>Endovascular aneurysm repair has emerged as the standard therapy for abdominal aortic aneurysms. In 9-30% of cases, retrograde filling of the aneurysm sac through patent branch arteries may result in persistence of blood flow outside the graft and within the aneurysm sac. This condition is called an endoleak type II, which may be treated by catheter-based embolization in case of continued sac enlargement. If an endovascular access is not possible, percutaneous targeting of the perfused nidus remains the only option. However, this can be very challenging due to the difficult access and deep puncture with risk of organ perforation and bleeding. Innovative targeting techniques such as robotics may provide a promising option for safe and successful targeting.</p><p><strong>Methods: </strong>In nine consecutive patients, percutaneous embolization of type II endoleaks was performed using a table-mounted micro-robotic targeting platform. The needle path from the skin entry to the perfused nidus was planned based on the C-arm CT image data in the angio-suite. Entry point and path angle were aligned using the joystick-operated micro-robotic system under fluoroscopic control, and the coaxial needle was introduced until the target point within the perfused nidus was reached.</p><p><strong>Results: </strong>All punctures were successful, and there were no puncture-related complications. The pre-operative C-arm CT was executed in 11-15 s, and pathway planning required 2-3 min. The robotic setup and sterile draping were performed in 1-2 min, and the alignment to the surgical plan took no longer than 30 s.</p><p><strong>Conclusion: </strong>Due to the small size, the micro-robotic platform seamlessly integrated into the routine clinical workflow in the angio-suite. It offered significant benefits to the planning and safe execution of double-angulated deeply localized targets, such as type II endoleaks.</p>","PeriodicalId":51251,"journal":{"name":"International Journal of Computer Assisted Radiology and Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}