Fluoroscopic guidance of a surgical robot: Pre-clinical evaluation in pelvic guidewire placement

R. C. Vijayan, R. Han, P. Wu, N. M. Sheth, P. Vagdargi, S. Vogt, G. Kleinszig, G. M. Osgood, J. H. Siewerdsen, A. Uneri

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Purpose: A method and prototype for a fluoroscopically-guided surgical robot is reported for assisting pelvic fracture fixation. The approach extends the compatibility of existing guidance methods with C-arms that are in mainstream use (without prior geometric calibration) using an online calibration of the C-arm geometry automated via registration to patient anatomy. We report the first preclinical studies of this method in cadaver for evaluation of geometric accuracy. Methods: The robot is placed over the patient within the imaging field-of-view and radiographs are acquired as the robot rotates an attached instrument. The radiographs are then used to perform an online geometric calibration via 3D-2D image registration, which solves for the intrinsic and extrinsic parameters of the C-arm imaging system with respect to the patient. The solved projective geometry is then be used to register the robot to the patient and drive the robot to planned trajectories. This method is applied to a robotic system consisting of a drill guide instrument for guidewire placement and evaluated in experiments using a cadaver specimen. Results: Robotic drill guide alignment to trajectories defined in the cadaver pelvis were accurate within 2 mm and 1° (on average) using the calibration-free approach. Conformance of trajectories within bone corridors was confirmed in cadaver by extrapolating the aligned drill guide trajectory into the cadaver pelvis. Conclusion: This study demonstrates the accuracy of image-guided robotic positioning without prior calibration of the Carm gantry, facilitating the use of surgical robots with simpler imaging devices that cannot establish or maintain an offline calibration. Future work includes testing of the system in a clinical setting with trained orthopaedic surgeons and residents.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2021
Subtitle of host publicationImage-Guided Procedures, Robotic Interventions, and Modeling
EditorsCristian A. Linte, Jeffrey H. Siewerdsen
ISBN (Electronic)9781510640252
StatePublished - 2021
EventMedical Imaging 2021: Image-Guided Procedures, Robotic Interventions, and Modeling - Virtual, Online
Duration: Feb 15 2021Feb 19 2021

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


ConferenceMedical Imaging 2021: Image-Guided Procedures, Robotic Interventions, and Modeling
CityVirtual, Online


  • 3D-2D registration
  • C-arm imaging
  • Geometric calibration
  • Image-guided surgery
  • Surgical robotics

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging
  • Biomaterials


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