A multimodality imaging-compatible insertion robot with a respiratory motion calibration module designed for ablation of liver tumors: a preclinical study

Figures & data

Figure 1. (a) and (b) show the robot designed by our team including the ultrasound unit (△), the electromagnetic sensor (○), the robotic arm (↓), microwave ablation unit (□), the controller (◇) and screens. c, d show the rigid body and phantom body model with a respiratory simulation device.

Figure 2. (a) and (b) showed the real-time multimodality imaging of the rabbit liver cancer model and the respiratory calibration curve (△). (c) and (d) showed the real-time multimodality imaging of the porcine liver tumor model.

Figure 3. The microwave ablation tests on porcine liver tumor models and rabbit liver cancer models (a,b). (c), (d) and (e) showed the tumors created in the liver and the one in the rabbit.

Table 1. Data and statistical results of the accuracy tests of rigid body model and phantom model.

SubjectsMethodsPhysicians	Rigid body model			Phantom model
	Robot			Tradition
	Five-year experience	No experience	p	Five-year experience	No experience	p
Insertion time (s)	6.5 ± 1.3	6.3 ± 0.9	.137	6.7 ± 1.9	15.7 ± 1.1	.001
Distance (mm)	1.3 ± 0.1	1.2 ± 0.3	.096	1.8 ± 0.3	5.1 ± 0.9	.003
Angle (°)
Horizontal (x–y)	0.9 ± 0.01	1.5 ± 0.01	.254	1.5 ± 0.03	8.4 ± 1.2	.015
Vertical (y–z)	1.1 ± 0.04	1.0 ± 0.02	.371	1.1 ± 0.06	7.1 ± 1.4	.024
Sagittal (x–z)	1.2 ± 0.01	1.3 ± 0.01	.532	1.4 ± 0.01	9.4 ± 1.9	.013
NASA-TLX (1–10) (median)
Mental demand	3	4	.083	4	8	.046
Physical demand	2	2	.092	3	6	.025
Temporal demand	2	3	.198	3	8	.013
Performance	2	3	.072	2	7	.003
Effort	3	4	.359	3	8	.002
Frustration	3	3	.522	3	9	.001
Methods	Tradition			Robot
Insertion time (s)	6.7 .71.2	19.4 9.3.4	.002	6.3 .30.4	5.9 .90.1	.521
Distance (mm)	1.6 .60.4	9.3 .30.8	.001	1.1 .10.1	1.3 .30.1	.622
Angle (°)
Horizontal (x–y)	1.1 .10.25	5.3 .31.2	.015	0.9 .90.03	1.1 .10.01	.312
Vertical (y–z)	1.6 .60.31	6.6 .60.9	.024	1.2 .20.01	0.9 .90.02	.351
Sagittal (x–z)	1.3 .30.22	8.3 .31.1	.021	0.8 .80.01	1.0 .00.01	.261
NASA-TLX (1–10) (median)
Mental demand	3	8	.001	2	3	.098
Physical demand	3	6	.034	3	2	.167
Temporal demand	2	7	.021	3	2	.257
Performance	2	8	.041	2	3	.341
Effort	2	8	.037	2	3	.522
Frustration	2	8	.007	2	3	.348
p^a (T, D, Ah, Av, As, M, Ph, T, Pe, E, F)^b	.055, .061, .083, .124, .253, .184, .218, .533, .341, .252, .233	.001, .001, .001, .004, .003, .001, .002, .005, .001, .003, .007	–	.262, .098, .079, .133, 0078, .126, .097, .132, .096, .134, .146	.002, .001, .021, .001, .001, .001, .003, .001, .004, .001, .001	–

^ap: p values of the difference of the data between robot group and traditional group.

^bT: insertion time; D: distance; Ah: horizontal angle; Av: vertical angle; As: sagittal angle; M: mental demand; Ph: physical demand; T: temporal demand; Pe: performance; E: effort; F: frustration.

Table 2. Data and statistical results of the microwave ablation tests of porcine liver and rabbit.

SubjectsMethodsPhysicians	Porcine liver tumor model			Rabbit liver cancer model
	Robot			Tradition
	Five-year experience	No experience	p	Five-year experience	No experience	p
Insertion number (median)	1	1	.937	1	3	.012
Total ablation time (min)	5	5	.996	5	3	.047
Complete ablation rate (%)	100	100	–	100	80	–
Technical success rate (%)	100	100	–	100	100	–
NASA-TLX (1–10) (median)
Mental demand	2	3	.863	2	9	.001
Physical demand	3	2	.991	3	9	.001
Temporal demand	3	2	.952	2	8	.001
Performance	2	2	.771	2	9	.001
Effort	2	2	.792	3	9	.001
Frustration	2	3	.993	3	9	.001
Methods	Tradition			Robot
Insertion number (median)	1	3	.031	1	1	.962
Total ablation time (min)	5	3	.047	5	5	.981
Complete ablation rate (%)	100	73	–	100	100	–
Technical success rate (%)	100	100	–	100	100	–
NASA-TLX (1–10) (median)
Mental demand	3	8	.005	3	3	.061
Physical demand	3	8	.009	2	3	.067
Temporal demand	2	7	.003	2	2	.067
Performance	3	8	.002	3	2	.077
Effort	2	8	.001	2	3	.082
Frustration	2	8	.001	3	2	.093
p^a (N, T, M, Ph, T, Pe, E, F)^b	.168, .152, .174, .153, .266, .581, .264, .537	.023, .016, .001, .003, .005, .001, .004, .008	–	.233, .154, .252, .264, .194, .184, .256, .175	.001, .002, .001, .004, .001, .001, .003, .002	–

^ap: p values of the difference of the data between robot group and traditional group.

^bN: insertion number; T: total ablation time; M: mental demand; Ph: physical demand; T: temporal demand; Pe: performance; E: effort; F: frustration.