Prospects in percutaneous ablative targeting: Comparison of a computer-assisted navigation system and the AcuBot robotic system

Aim: Precise targeting is essential for adequate treatment of lesions during image-guided therapy. The aim of this study was to compare the performance of two emerging image-guided targeting technologies in a phantom model. Materials and Methods: A computer-assisted navigation system and AcuBot were tested using three operators: an interventional radiologist and two endourologists. Fiducials were placed in an anatomic gelatin phantom and targeted by both systems. The images were reconstructed and analyzed using a specialized software package (Amira; Visage Imaging, Carlsbad, CA). Accuracy was assessed by measuring proximity of the tip of the needle to the fiducial on computed-tomography-guided imaging. Accuracy and time to target were quantified and compared. Results: The mean distance from the desired target for AcuBot was 1.2mm (range: 0.39-2.82). The mean distance from the desired target for the navigation system was 5.8mm (range: 1.8-11.9). The AcuBot was significantly more accurate than the navigation system (p<0.0001). The mean time from target acquisition to needle placement was 37 seconds (range: 15-75) for the AcuBot and 108 seconds (range: 45-315) for the navigation system (p=0.001). Conclusion: Emerging technologies hold promise for increased accuracy during percutaneous targeted procedures. Both the AcuBot and the computer-assisted navigation system were accurate and efficient in a phantom targeting model. AcuBot was significantly more accurate, faster, and less user dependent than the navigation system. Further studies in animal and clinical studies are warranted to further advance this promising technology.