PP02  Presentation Time: 3:39 PM: AAPM GEC-ESTRO TG-342: Update on the Robot-Assisted Brachytherapy

Purpose The AAPM & GEC-ESTRO Task Group No. 192 Report was published in 2014. Since then, improvements in robotic brachytherapy technology have been realized and a large number of new robotic systems were developed. In addition, progress has been made on translating some of these devices from laboratory to clinical practice. In response to these advances, the AAPM Brachytherapy subcommittee and GEC-ESTRO BRAPHYQS subcommittee convened a joint task group (TG-342) charged with updating the TG-192 report and providing comprehensive guidelines for implementation of these robotic devices in the clinic. Materials and Methods The current report (TG-342) mainly focuses on newer robotic systems available or reported since 2013. The TG-342 committee has gathered information from literature and drafted a report. There is minimal or no overlap with TG-192, so far the robotic systems are concerned. However, there are some overlaps in the methodology of clinical applications and recommendations. Results Several robotics systems described in the TG-192 Report have gone through major modifications, whereas some of them are now discontinued. Several new robotic systems (not reported in TG-192) have successfully been translated to clinical use and the reported clinical outcomes are encouraging. In TG-342, eighteen new robotic systems have been described and their specifications, status and applications have been illustrated. In TG-192 Report, 13 robotic systems were presented. Most of the new systems in TG-342 (18 in total) differ from each other with respect to available features, functionalities and levels of automation. The systems are either US guided or CT guided, only 3 systems are MRI guided. About half of the systems are needle guides with manual needle insertion, the other half accommodates autonomous needle insertion. Reported accuracy of needle tip placement in a phantom ranges from 0.9 to 2.9 mm. Few of them have been developed for other needle-based procedures such as biopsy, RFA, etc. However, these systems are also being considered for brachytherapy with minor modifications. The robotic assistance in clinical applications for LDR (permanent seed/source implantation) remains almost the same, while the applications for HDR procedures with robotic assistance have been elaborated. In addition, the recommendation section has been expanded. Conclusions International efforts in developing brachytherapy robots have been realized; the vast majority of the new systems are reported from Asia and Europe (17 out of 18). Some of those robotic systems have been used clinically. Due to the wide variability among the available robotic systems, various sections such as safety, commissioning, and recommendations have been written focusing on brachytherapy procedures rather than any specific robotic system. Current available brachytherapy robotic systems greatly vary in design, characteristics, features, and imaging modalities. Therefore, the TG-342 report provides general rather than very strict recommendations and encourages all researchers to develop and document their own calibration procedures specific for their robotic system. The final draft of TG-342 report is ready for review and approval by the parent committees. The AAPM & GEC-ESTRO Task Group No. 192 Report was published in 2014. Since then, improvements in robotic brachytherapy technology have been realized and a large number of new robotic systems were developed. In addition, progress has been made on translating some of these devices from laboratory to clinical practice. In response to these advances, the AAPM Brachytherapy subcommittee and GEC-ESTRO BRAPHYQS subcommittee convened a joint task group (TG-342) charged with updating the TG-192 report and providing comprehensive guidelines for implementation of these robotic devices in the clinic. The current report (TG-342) mainly focuses on newer robotic systems available or reported since 2013. The TG-342 committee has gathered information from literature and drafted a report. There is minimal or no overlap with TG-192, so far the robotic systems are concerned. However, there are some overlaps in the methodology of clinical applications and recommendations. Several robotics systems described in the TG-192 Report have gone through major modifications, whereas some of them are now discontinued. Several new robotic systems (not reported in TG-192) have successfully been translated to clinical use and the reported clinical outcomes are encouraging. In TG-342, eighteen new robotic systems have been described and their specifications, status and applications have been illustrated. In TG-192 Report, 13 robotic systems were presented. Most of the new systems in TG-342 (18 in total) differ from each other with respect to available features, functionalities and levels of automation. The systems are either US guided or CT guided, only 3 systems are MRI guided. About half of the systems are needle guides with manual needle insertion, the other half accommodates autonomous needle insertion. Reported accuracy of needle tip placement in a phantom ranges from 0.9 to 2.9 mm. Few of them have been developed for other needle-based procedures such as biopsy, RFA, etc. However, these systems are also being considered for brachytherapy with minor modifications. The robotic assistance in clinical applications for LDR (permanent seed/source implantation) remains almost the same, while the applications for HDR procedures with robotic assistance have been elaborated. In addition, the recommendation section has been expanded. International efforts in developing brachytherapy robots have been realized; the vast majority of the new systems are reported from Asia and Europe (17 out of 18). Some of those robotic systems have been used clinically. Due to the wide variability among the available robotic systems, various sections such as safety, commissioning, and recommendations have been written focusing on brachytherapy procedures rather than any specific robotic system. Current available brachytherapy robotic systems greatly vary in design, characteristics, features, and imaging modalities. Therefore, the TG-342 report provides general rather than very strict recommendations and encourages all researchers to develop and document their own calibration procedures specific for their robotic system. The final draft of TG-342 report is ready for review and approval by the parent committees.