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Τετάρτη 26 Μαΐου 2021

Patient‐to‐robot registration: the fate of robot‐assisted stereotaxy

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ABSTRACT

Background

Robot-assisted stereotaxy (RAS) promises higher stereotactic accuracy (SA) and time efficiency (TE) than frame-based stereotaxy. However, both aspects are attributed to the problem of patient-to-robot registration.

Objective

To examine different registration techniques regarding their SA and TE.

Methods

This study enrolled 57 patients undergoing RAS with bone fiducial (BFR) or laser surface registration (LSR). SA was measured by the entry point error (EPE). Additionally, predictors of SA (registration error [RegE], distance-to-registration plane [DTC]) and TE (imaging, skin-to-skin) were assessed.

Results

The mean SA was 1.0±0.8mm. BFR increased SA by reducing RegE and DTC. In LSR, EPE depended on DTC (face and forehead) with highest accuracy for DTC≤100mm. CT-based LSR exerted a higher SA than MR-based LSR. In BFR, TE was confined by the additional imaging.

Conclusion

Every registration technique counteracts one of the promises of RAS. New solutions are needed to increase the acceptance of RAS in neurosurgery.

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