Comparison of a Patient-Mounted Needle-Driving Robotic System vs. Manual CT Fluoroscopy to Perform Percutaneous CT-Guided Lung Biopsies

Abstract:

Purpose

This preliminary retrospective cohort study aims to compare the efficacy of percutaneous lung biopsy using a patient-mounted needle-driving robotic system or a manual insertion of needles under computed tomography fluoroscopy (CTF) guidance

Materials and methods

In this IRB approved study, the cohort consisted of a series of patients who underwent lung biopsies following the intention-to-treat protocol from September 2022 to September 2023, using robot (n=15) or manual insertion under CTF (n=66). Patients and procedures' characteristics were recorded, as well as outcomes

Results

While age, body mass index, and skin-to-target distance were not statistically different, target size varied (median: 8 mm [interquartile range: 6.5–9.5] for robot vs. 12mm [8–18]) for CTF (P=.001). No statistical differences were observed in technical success (86.7% [13/15] vs. 89.4% [59/66], P=.673); grade 3 adverse event (6.7% [1/15] vs. 12.1% [8/66], P=.298); procedure time (28 minutes [22–32] vs. 19 minutes [14.3–30.5], P=.086), and patient radiation dose (3.9 mSV [3.2–5.6] vs. 4.6 mSv [3.3–7.5], P=.398). In robot-assisted cases, the median angle out of gantry plane was ten degrees (6.5–16) although it was null (0–5) for CTF (P=.001)

Conclusion

Robot-assisted and CTF-guided percutaneous lung biopsy were similar in terms of technical success, diagnostic yield, procedure time, adverse events, and radiation dose, though robot allowed for out-of-gantry plane navigation along the needle axis