IR down by even 3 seconds, no one will use it.” These devices and interfaces are still early iterations, he said—though he feels confident that as user interface improves, the technology will solidify its role in practice.
Robotics Robotics and IR go hand in hand, so it’s not surprising that many IR practices have already folded robotic- assisted care into their toolbox. Several sessions at SIR 2024 were dedicated to sharing use-case experiences, such as with robotic-assisted ablation or interventional oncology applications.
“We expect, when using a robot, to have better outcomes and accuracy as well as higher degrees of freedom,” said Thierry De Baerre, MD, who has used robotic assistance for ablation procedures. According to Dr. De Baerre, robotics can improve treatment planning, assist with probe placement, ensure a single push from skin to target and even provide spacing and ablation confirmation.
According to Dr. Dhanaliwala, XR— specifically XR headsets that can be worn during procedures—offers a solution to common inconveniences such as having to navigate a line of site to monitors that may be across the room during procedures. XR headsets can also provide real-time maps of the body and higher image registration, rather than navigating imaging through a 2D monitor. Recording features can improve reporting, eliminating memory lapses that come from doing dictation several hours after a procedure. Headsets can even provide live updates on inventory. But convincing someone to wear a headset on the possibility that they may need to look up inventory mid-procedure can be a hard sell, said Zachary L. Bercu, MD, FSIR. “To make XR worth it, you have to wear the headset,” he said, “and to make the headset worth wearing, it has to be as indispensable as a cell phone.”
28 IRQ | SPRING 2024
In his practice, Dr. Bercu has built and used a variety of XR apps. They range from simple, such as a life-size ruler app, to complex—a floating virtual monitor with EMR access that can provide prior imaging, labs and clinical notes and is controlled by voice, gesture or eye movement. Another application allows the user to stream ultrasound and fluoroscopy imaging to a virtual slate.
“Using this, you can look at your hands and imaging at the same time,” Dr. Bercu said.
Though these applications are designed to improve outcomes and experience, Dr. Bercu acknowledged that there is a barrier to implementation of XR in practice.
“People are naturally hesitant,” he said. “Some people think the headset looks stupid, and don’t want to look stupid in front of a patient. And if it slows an
Meanwhile, researchers and engineers at the University of Maryland and Johns Hopkins Hospital have developed soft robotic microcatheters—made of multi- lumen tubing and 3D-microprinted soft robotic unidirectional microcatheter tips—to aid IRs navigating tortuous or complex anatomy that challenges conventional microcatheters. These soft robotic microcatheters were able to accurately navigate complex and delicate vasculature. According to presenter Christopher Bailey, MD, this initial trial shows huge promise for the future of steerable robotic microcatheters, which may improve success rates, decrease intervention time and reduce complications.
Another presentation looked at the feasibility and safety of CT-guided bone biopsies performed on cancer patients via a robotic system. In reviewing data from 40 biopsies where the robot advanced the needle on demand, there was a 100% technical success rate. According to presenting author Agnieszka Witkowska, MD, the robotic assistance meant that the operators did not have to wear lead, and the median procedure time was 30 minutes—a low procedure time, which also reduced patient radiation exposure.
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