Artikel
Experimental comparison of robotic and stereotactic accuracy – a phantom study
Experimentelle Genauigkeitsanalyse – Robotik vs Stereotaxie – eine Phantomstudie
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Autoren
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Andrea Spyrantis
- Goethe Universität Frankfurt am Main, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
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Tirza Woebbecke
- Goethe Universität Frankfurt am Main, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
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Daniel Rueß
- Universitätsklinikum Köln, Stereotaktische Neurochirurgie, Köln, Deutschland
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Anne Constantinescu
- Goethe Universität Frankfurt am Main, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
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Andreas Gierich
- Universitätsklinikum Köln, Stereotaktische Neurochirurgie, Köln, Deutschland
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Klaus Luyken
- Universitätsklinikum Köln, Stereotaktische Neurochirurgie, Köln, Deutschland
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Veerle Visser-Vandewalle
- Universitätsklinikum Köln, Stereotaktische Neurochirurgie, Köln, Deutschland
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Eva Herrmann
- Goethe Universität Frankfurt am Main, Biostatistik, Frankfurt am Main, Deutschland
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Volker Seifert
- Goethe Universität Frankfurt am Main, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
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Harald Treuer
- Universitätsklinikum Köln, Stereotaktische Neurochirurgie, Köln, Deutschland
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Maximilian I. Ruge
- Universitätsklinikum Köln, Stereotaktische Neurochirurgie, Köln, Deutschland
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Thomas Freiman
- Goethe Universität Frankfurt am Main, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
| Veröffentlicht: | 4. Juni 2021 |
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Gliederung
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Objective: The development of robotic systems has brought an alternative to frame-based stereotactic procedures. In this experimental setting we aim to reduce procedural errors to a minimum when comparing the ROSA robot and the Leksell stereotactic system regarding mechanical accuracy.
Methods: In order to precisely compare mechanical accuracy, the stereotactic system was chosen as means of referencing for both methods. We performed a 0,67 mm slice thin layer CT Scan with an acrylic phantom fixed to the frame and a Localizer enabling the software to recognize the coordinate system. For each of the 5 phantom targets, 2 different trajectories were planned, resulting in 10 trajectories. We performed a series of 5 cycles, each time based on a new CT scan. We therefore analysed 50 trajectories for each method. X-rays of the final canula position were fused with the planning data. The coordinates of the target point and the endpoint of the robotic or stereotactic probe were visually determined using the robotic software. The target point error (TPE) was calculated applying the Euclidian distance. We separately calculated the depth deviation along the trajectory and the lateral deviation.
Results: In this experimental setting, robotics was significantly more accurate, with an arithmetic TPE mean of 0.53 mm (95% CI 0.41 – 0.55 mm) compared to 0.72 mm (95% CI 0.63 – 0.8 mm) in stereotaxy (p < 0.05). Direct comparison showed a mean difference in TPE of 0.19 mm. In robotics, the mean depth deviation along the trajectory was -0.22 mm (95% CI -0.25 – -0.14 mm). The mean lateral deviation with 0.43 mm (95% CI 0.32 – 0.49 mm). In stereotaxy, the mean depth deviation amounted to -0.20 mm (95% CI -0.26 – -0.14 mm), the mean lateral deviation to 0.65 mm (95% CI 0.55 – 0.74 mm).
Conclusion: Both robotic and stereotactic approaches proved accurate. In this experimental phantom study, the robotic procedure showed significantly higher accuracy. For both methods, procedural factors occurring during surgery might have a more relevant impact on overall accuracy.
