Initial experiments toward automated robotic implantation of skew-line needle arrangements for HDR brachytherapy

Automation seeks to improve the reliability and quality of processes. This study aims to automate high dose rate brachytherapy (HDR-BT), a radiation therapy that places radioactive sources at the site of the tumor using needles. Although HDR-BT has a high rate of clinical success in curing prostate cancer, it also has several side effects related to needle and dose trauma. A new planning algorithm from previous work optimizes needle arrangements using skew-lines (non-parallel, non-intersecting lines). This paper presents initial experiments towards an automated system for implanting skew-line needle arrangements computed from a planning system. We describe the interface, calibration and integration of the robotic hardware with the planning system, and present experiments using our robotic system to implant needles into anatomically-correct tissue phantoms. Results suggest that this system can achieve HDR-BT treatment objectives with reduced trauma to organs and low demands on operator skill, thus making the procedure more reliable and repeatable. In the future, we believe that robotic HDR-BT will improve overall treatment quality with reduced dependence on physician skill.