Treffer: Multimodal CT-ultrasound image-guided robotic system for automated abdominal puncture.
Title:
Multimodal CT-ultrasound image-guided robotic system for automated abdominal puncture.
Authors:
Li J; The key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, Tianjin, 300350, China.; The Institute of Medical Robotics and Intelligent Systems, Tianjin University, Tianjin, 300392, China., Yu H; The key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, Tianjin, 300350, China.; The Institute of Medical Robotics and Intelligent Systems, Tianjin University, Tianjin, 300392, China., Jiao W; The key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, Tianjin, 300350, China.; Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China., Zhang S; The key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, Tianjin, 300350, China.; The Institute of Medical Robotics and Intelligent Systems, Tianjin University, Tianjin, 300392, China., Tian S; The key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, Tianjin, 300350, China.; The Institute of Medical Robotics and Intelligent Systems, Tianjin University, Tianjin, 300392, China., Zhao J; The key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, Tianjin, 300350, China. zhaojianchang@tju.edu.cn.; The Institute of Medical Robotics and Intelligent Systems, Tianjin University, Tianjin, 300392, China. zhaojianchang@tju.edu.cn., Pan L; The key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, Tianjin, 300350, China. melzpan@tju.edu.cn.; The Institute of Medical Robotics and Intelligent Systems, Tianjin University, Tianjin, 300392, China. melzpan@tju.edu.cn.
Source:
Journal of robotic surgery [J Robot Surg] 2026 Jan 12; Vol. 20 (1), pp. 169. Date of Electronic Publication: 2026 Jan 12.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Springer Country of Publication: England NLM ID: 101300401 Publication Model: Electronic Cited Medium: Internet ISSN: 1863-2491 (Electronic) Linking ISSN: 18632483 NLM ISO Abbreviation: J Robot Surg Subsets: MEDLINE
Imprint Name(s):
Original Publication: London : Springer
MeSH Terms:
Robotic Surgical Procedures*/methods , Robotic Surgical Procedures*/instrumentation , Punctures*/methods , Punctures*/instrumentation , Tomography, X-Ray Computed*/methods , Abdomen*/surgery , Abdomen*/diagnostic imaging , Surgery, Computer-Assisted*/methods , Surgery, Computer-Assisted*/instrumentation , Multimodal Imaging*/methods , Ultrasonography, Interventional*/methods, Humans ; Phantoms, Imaging ; Ultrasonography/methods ; Imaging, Three-Dimensional/methods ; Equipment Design ; Algorithms
References:
Alken P (2022) Percutaneous nephrolithotomy – the puncture. BJU Int 129:17–24. https://doi.org/10.1111/bju.15564. (PMID: 10.1111/bju.1556434365712)
Cheng K, Li L, Du Y et al (2023) A systematic review of image-guided, surgical robot-assisted percutaneous puncture: challenges and benefits. Math Biosci Eng 20:8375–8399. https://doi.org/10.3934/mbe.2023367. (PMID: 10.3934/mbe.202336737161203)
Hu S, Lu R, Zhu Y et al (2023) Application of medical image navigation technology in minimally invasive puncture robot. Sensors 23:7196. https://doi.org/10.3390/s23167196. (PMID: 10.3390/s231671963763173310459274)
Zhang W, Xia P, Liu S et al (2022) A coordinate positioning puncture method under robot-assisted CT-guidance: phantom and animal experiments. Minim Invasive Ther Allied Technol 31:206–215. https://doi.org/10.1080/13645706.2020.1787451. (PMID: 10.1080/13645706.2020.178745132633586)
Kostrzewa M, Rothfuss A, Pätz T et al (2022) Robotic assistance system for cone-beam computed tomography-guided percutaneous needle placement. Cardiovasc Intervent Radiol 45:62–68. https://doi.org/10.1007/s00270-021-02938-7. (PMID: 10.1007/s00270-021-02938-734414495)
Ben-David E, Shochat M, Roth I et al (2018) Evaluation of a CT-guided robotic system for precise percutaneous needle insertion. J Vasc Interv Radiol 29:1440–1446. https://doi.org/10.1016/j.jvir.2018.01.002. (PMID: 10.1016/j.jvir.2018.01.00229628297)
Kim C, Chang D, Petrisor D et al (2013) Ultrasound probe and needle-guide calibration for robotic ultrasound scanning and needle targeting. IEEE Trans Biomed Eng 60:1728–1734. https://doi.org/10.1109/TBME.2013.2241430. (PMID: 10.1109/TBME.2013.224143023358940)
Lin Y, Chen S, Xu W et al (2022) Robotic system for accurate percutaneous puncture guided by 3D–2D ultrasound. Int J Comput Assist Radiol Surg 18:217–225. https://doi.org/10.1007/s11548-022-02766-1. (PMID: 10.1007/s11548-022-02766-136269509)
Liu Y, Wang Y, Xiao J et al (2025) Computed tomography and utrasound-guided robotic assistance in percutaneous puncture in abdominal phantom and porcine liver models. IEEE Trans Med Robot Bionics 7:542–549. https://doi.org/10.1109/TMRB.2025.3550644. (PMID: 10.1109/TMRB.2025.3550644)
Hakime A, Deschamps F, De Carvalho EGM et al (2011) Clinical evaluation of spatial accuracy of a fusion imaging technique combining previously acquired computed tomography and real-time ultrasound for imaging of liver metastases. Cardiovasc Intervent Radiol 34:338–344. https://doi.org/10.1007/s00270-010-9979-7. (PMID: 10.1007/s00270-010-9979-720845039)
Gomes-Fonseca J, Queirós S, Morais P et al (2019) Surface‐based registration between CT and US for image‐guided percutaneous renal access – a feasibility study. Med Phys 46:1115–1126. https://doi.org/10.1002/mp.13369. (PMID: 10.1002/mp.1336930592311)
Lei L, Zhao B, Qi X et al (2024) Robotic needle insertion with 2D ultrasound–3D CT fusion guidance. IEEE Trans Autom Sci Eng 21:6152–6164. https://doi.org/10.1109/TASE.2023.3322710. (PMID: 10.1109/TASE.2023.3322710)
Suthakorn J, Chatrasingh M, Wiratkapun C, Ongwattanakul S (2024) M-fiducial phantom based fast automatic ultrasound calibration technique: a novel approach for 2D to 3D image registration. Heliyon 10:e40290. https://doi.org/10.1016/j.heliyon.2024.e40290. (PMID: 10.1016/j.heliyon.2024.e402903961958411605415)
Ferrante E, Paragios N (2017) Slice-to-volume medical image registration: a survey. Med Image Anal 39:101–123. https://doi.org/10.1016/j.media.2017.04.010. (PMID: 10.1016/j.media.2017.04.01028482198)
You Y, Zhang M, Li K et al (2021) Feasibility of 3D US/CEUS-US/CEUS fusion imaging-based ablation planning in liver tumors: a retrospective study. Abdom Radiol 46:2865–2874. https://doi.org/10.1007/s00261-020-02909-5. (PMID: 10.1007/s00261-020-02909-5)
Haghighat MBA, Aghagolzadeh A, Seyedarabi H (2011) A non-reference image fusion metric based on mutual information of image features. Comput Electr Eng 37:744–756. https://doi.org/10.1016/j.compeleceng.2011.07.012. (PMID: 10.1016/j.compeleceng.2011.07.012)
Berger J, Unger M, Keller J et al (2022) Design and validation of a medical robotic device system to control two collaborative robots for ultrasound-guided needle insertions. Front Robot AI 9:875845. https://doi.org/10.3389/frobt.2022.875845. (PMID: 10.3389/frobt.2022.875845362464949554707)
Welleweerd MK, Siepel FJ, Groenhuis V et al (2020) Design of an end-effector for robot-assisted ultrasound-guided breast biopsies. Int J Comput Assist Radiol Surg 15:681–690. https://doi.org/10.1007/s11548-020-02122-1. (PMID: 10.1007/s11548-020-02122-1321001777142059)
Sajadi SM, Karbasi SM, Brun H et al (2022) Towards autonomous robotic biopsy—design, modeling and control of a robot for needle insertion of a commercial full core biopsy instrument. Front Robot AI 9:896267. https://doi.org/10.3389/frobt.2022.896267. (PMID: 10.3389/frobt.2022.896267358329309272465)
Checcucci E, Amparore D, Volpi G et al (2022) Percutaneous puncture during PCNL: new perspective for the future with virtual imaging guidance. World J Urol 40:639–650. https://doi.org/10.1007/s00345-021-03820-4. (PMID: 10.1007/s00345-021-03820-434468886)
Cheng K, Li L, Du Y et al (2023) A systematic review of image-guided, surgical robot-assisted percutaneous puncture: challenges and benefits. Math Biosci Eng 20:8375–8399. https://doi.org/10.3934/mbe.2023367. (PMID: 10.3934/mbe.202336737161203)
Hu S, Lu R, Zhu Y et al (2023) Application of medical image navigation technology in minimally invasive puncture robot. Sensors 23:7196. https://doi.org/10.3390/s23167196. (PMID: 10.3390/s231671963763173310459274)
Zhang W, Xia P, Liu S et al (2022) A coordinate positioning puncture method under robot-assisted CT-guidance: phantom and animal experiments. Minim Invasive Ther Allied Technol 31:206–215. https://doi.org/10.1080/13645706.2020.1787451. (PMID: 10.1080/13645706.2020.178745132633586)
Kostrzewa M, Rothfuss A, Pätz T et al (2022) Robotic assistance system for cone-beam computed tomography-guided percutaneous needle placement. Cardiovasc Intervent Radiol 45:62–68. https://doi.org/10.1007/s00270-021-02938-7. (PMID: 10.1007/s00270-021-02938-734414495)
Ben-David E, Shochat M, Roth I et al (2018) Evaluation of a CT-guided robotic system for precise percutaneous needle insertion. J Vasc Interv Radiol 29:1440–1446. https://doi.org/10.1016/j.jvir.2018.01.002. (PMID: 10.1016/j.jvir.2018.01.00229628297)
Kim C, Chang D, Petrisor D et al (2013) Ultrasound probe and needle-guide calibration for robotic ultrasound scanning and needle targeting. IEEE Trans Biomed Eng 60:1728–1734. https://doi.org/10.1109/TBME.2013.2241430. (PMID: 10.1109/TBME.2013.224143023358940)
Lin Y, Chen S, Xu W et al (2022) Robotic system for accurate percutaneous puncture guided by 3D–2D ultrasound. Int J Comput Assist Radiol Surg 18:217–225. https://doi.org/10.1007/s11548-022-02766-1. (PMID: 10.1007/s11548-022-02766-136269509)
Liu Y, Wang Y, Xiao J et al (2025) Computed tomography and utrasound-guided robotic assistance in percutaneous puncture in abdominal phantom and porcine liver models. IEEE Trans Med Robot Bionics 7:542–549. https://doi.org/10.1109/TMRB.2025.3550644. (PMID: 10.1109/TMRB.2025.3550644)
Hakime A, Deschamps F, De Carvalho EGM et al (2011) Clinical evaluation of spatial accuracy of a fusion imaging technique combining previously acquired computed tomography and real-time ultrasound for imaging of liver metastases. Cardiovasc Intervent Radiol 34:338–344. https://doi.org/10.1007/s00270-010-9979-7. (PMID: 10.1007/s00270-010-9979-720845039)
Gomes-Fonseca J, Queirós S, Morais P et al (2019) Surface‐based registration between CT and US for image‐guided percutaneous renal access – a feasibility study. Med Phys 46:1115–1126. https://doi.org/10.1002/mp.13369. (PMID: 10.1002/mp.1336930592311)
Lei L, Zhao B, Qi X et al (2024) Robotic needle insertion with 2D ultrasound–3D CT fusion guidance. IEEE Trans Autom Sci Eng 21:6152–6164. https://doi.org/10.1109/TASE.2023.3322710. (PMID: 10.1109/TASE.2023.3322710)
Suthakorn J, Chatrasingh M, Wiratkapun C, Ongwattanakul S (2024) M-fiducial phantom based fast automatic ultrasound calibration technique: a novel approach for 2D to 3D image registration. Heliyon 10:e40290. https://doi.org/10.1016/j.heliyon.2024.e40290. (PMID: 10.1016/j.heliyon.2024.e402903961958411605415)
Ferrante E, Paragios N (2017) Slice-to-volume medical image registration: a survey. Med Image Anal 39:101–123. https://doi.org/10.1016/j.media.2017.04.010. (PMID: 10.1016/j.media.2017.04.01028482198)
You Y, Zhang M, Li K et al (2021) Feasibility of 3D US/CEUS-US/CEUS fusion imaging-based ablation planning in liver tumors: a retrospective study. Abdom Radiol 46:2865–2874. https://doi.org/10.1007/s00261-020-02909-5. (PMID: 10.1007/s00261-020-02909-5)
Haghighat MBA, Aghagolzadeh A, Seyedarabi H (2011) A non-reference image fusion metric based on mutual information of image features. Comput Electr Eng 37:744–756. https://doi.org/10.1016/j.compeleceng.2011.07.012. (PMID: 10.1016/j.compeleceng.2011.07.012)
Berger J, Unger M, Keller J et al (2022) Design and validation of a medical robotic device system to control two collaborative robots for ultrasound-guided needle insertions. Front Robot AI 9:875845. https://doi.org/10.3389/frobt.2022.875845. (PMID: 10.3389/frobt.2022.875845362464949554707)
Welleweerd MK, Siepel FJ, Groenhuis V et al (2020) Design of an end-effector for robot-assisted ultrasound-guided breast biopsies. Int J Comput Assist Radiol Surg 15:681–690. https://doi.org/10.1007/s11548-020-02122-1. (PMID: 10.1007/s11548-020-02122-1321001777142059)
Sajadi SM, Karbasi SM, Brun H et al (2022) Towards autonomous robotic biopsy—design, modeling and control of a robot for needle insertion of a commercial full core biopsy instrument. Front Robot AI 9:896267. https://doi.org/10.3389/frobt.2022.896267. (PMID: 10.3389/frobt.2022.896267358329309272465)
Checcucci E, Amparore D, Volpi G et al (2022) Percutaneous puncture during PCNL: new perspective for the future with virtual imaging guidance. World J Urol 40:639–650. https://doi.org/10.1007/s00345-021-03820-4. (PMID: 10.1007/s00345-021-03820-434468886)
Grant Information:
52475027 the National Natural Science Foundation of China
Contributed Indexing:
Keywords: CT-ultrasound fusion; Image-guided robotic puncture; Percutaneous abdominal intervention; Percutaneous surgical robot
Entry Date(s):
Date Created: 20260111 Date Completed: 20260111 Latest Revision: 20260111
Update Code:
20260112
DOI:
10.1007/s11701-025-03138-y
PMID:
41521349
Database:
MEDLINE
Weitere Informationen
Computed tomography (CT) and ultrasound provide complementary strengths for image-guided interventions, yet single-modality guidance cannot deliver high spatial resolution, soft-tissue contrast, and real-time feedback simultaneously. This study introduces a multimodal image-guided robotic system designed for precision abdominal puncture based on CT-ultrasound fusion, which aligns preoperative three-dimensional CT images with intraoperative two-dimensional ultrasound images. Optical tracking is adopted to extract CT slices that spatially correspond to the live ultrasound plane, and the spatial alignment between them is achieved via a mutual information algorithm. A compact three-degree-of-freedom puncture actuator is designed, involving entry-point positioning, orientation adjustment, and needle advancement. The actuator rigidly integrates a probe clamping mechanism to preserve image-actuator co-registration. Phantom validation proved anatomically consistent fused displays and reliable guidance of the proposed system, and the puncture trials targeting renal calyces yielded a mean positional error of 1.17 mm and a mean angular error of 0.43°. The compact puncture actuator reduces footprint in the operating room and simplifies the calibration and clinical workflow. The proposed design provides a practical route toward safer and more reproducible minimally invasive abdominal interventions.
(© 2026. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Declarations. Conflict of interest: The authors declare no competing interests. Ethics approval: This article does not contain any studies with human participants performed by any of the authors. Consent for publication: Not applicable. Informed consent: Not applicable.