Clinical Performance of Robotic-Assisted CT and PET/ CT-Guided Biopsy Across Multiple Organs: A Multicenter Observational Study

Abstract

Background: Percutaneous image-guided biopsy is widely used for tissue diagnosis in oncology and interventional radiology Conventional freehand biopsy is highly operator-dependent and may require repeated needle repositioning, increasing procedure duration, radiation exposure, and complication risk. Robotic-assisted navigation systems such as MAXIO have been developed to improve targeting precision and workflow efficiency in CT and PET/CT-guided interventions. Objective: To evaluate targeting accuracy, radiation exposure, workflow efficiency, and diagnostic success of robotic-assisted CT/PET-CT-guided biopsy across multiple anatomical targets. Methods: This observational study included 50 robotic-assisted biopsy procedures performed across multiple hospitals in India between April 2026 and June 2026. Procedures included lung (n=15), prostate (n=15), liver (n=10), and abdominal lesions (n=10). Outcomes assessed were targeting accuracy (mm), radiation dose (DLP, mGy·cm), needle manipulation count, procedure duration (minutes), and diagnostic success rate. Results: A total of 50 procedures were analyzed. Mean targeting accuracy was 1.31 ± 1.16 mm. Mean procedural radiation dose was 186.16 ± 35.89 mGy·cm. Mean needle manipulation count was 0.38 ± 0.60. Mean procedure duration was 19.94 ± 2.54 minutes. Diagnostic success was achieved in 47 of 50 cases (94%). Organ-wise analysis demonstrated high performance across all target regions, with diagnostic success ranging from 90 to 100%. Conclusion: Robotic-assisted CT/PET-CT-guided biopsy demonstrated promising targeting accuracy, low needle manipulation, efficient workflow, and high diagnostic yield across multiple organ systems. These findings suggest robotic assistance as a promising adjunct for improving procedural consistency in image-guided interventions