Key result
The body-mounted robotic system achieved a translational needle placement accuracy of 2.07 ± 1.22 mm in a cadaver model and completed the clinical workflow in healthy volunteers in an average of 36 minutes.
Why the study?
The study aimed to transform the current two-step shoulder arthrography procedure into a streamlined, single-step, ionizing radiation-free procedure under MRI guidance.
An MRI-conditional, patient-mounted robotic system is feasible and accurate for guiding shoulder arthrography, potentially eliminating ionizing radiation exposure.
Answers are grounded in this paper and cite their sources.
This cadaveric feasibility data merit prospective patient trials; leaves open whether robotic guidance reduces radiation or improves outcomes in shoulder arthrography.
This paper presents an intraoperative MRI-guided, patient-mounted robotic system for shoulder arthrography procedures in pediatric patients. The robot is designed to be compact and lightweight and is constructed with nonmagnetic materials for MRI safety. Our goal is to transform the current two-step arthrography procedure (CT/x-ray-guided needle insertion followed by diagnostic MRI) into a streamlined single-step ionizing radiation-free procedure under MRI guidance. The MR-conditional robot was evaluated in a Thiel embalmed cadaver study and healthy volunteer studies. The robot was attached to the shoulder using straps and ten locations in the shoulder joint space were selected as targets. For the first target, contrast agent (saline) was injected to complete the clinical workflow. After each targeting attempt, a confirmation scan was acquired to analyze the needle placement accuracy. During the volunteer studies, a more comfortable and ergonomic shoulder brace was used, and the complete clinical workflow was followed to measure the total procedure time. In the cadaver study, the needle was successfully placed in the shoulder joint space in all the targeting attempts with translational and rotational accuracy of 2.07 ± 1.22 mm and 1.46 ± 1.06 degrees, respectively. The total time for the entire procedure was 94 min and the average time for each targeting attempt was 20 min in the cadaver study, while the average time for the entire workflow for the volunteer studies was 36 min. No image quality degradation due to the presence of the robot was detected. This Thiel-embalmed cadaver study along with the clinical workflow studies on human volunteers demonstrated the feasibility of using an MR-conditional, patient-mounted robotic system for MRI-guided shoulder arthrography procedure. Future work will be focused on moving the technology to clinical practice.
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Patel et al. (2021) studied Healthy volunteers (clinical workflow) and cadaver model for shoulder arthrography (n=5). Body-mounted robotic system for MRI-guided shoulder arthrography was evaluated on Needle placement accuracy (cadaver) and total procedure time (volunteers). The body-mounted robotic system achieved a translational needle placement accuracy of 2.07 ± 1.22 mm in a cadaver model and completed the clinical workflow in healthy volunteers in an average of 36 minutes.
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