Multimodal Image-guided Surgical Robot Versus 3D-printed Template for Brachytherapy of Malignant Tumours in the Skull Base and Deep Facial Region: a Clinical Comparative Study

This study compared a multimodal image-guided robot and three-dimensionally (3D) printed templates for implanting iodine-125 (I) radioactive seeds in patients with malignant tumours in the skull base and deep facial region. Seventeen patients who underwent I radioactive seed implantation between December 2018 and December 2019 were included. The operation time, intraoperative blood loss, and accuracy of seed implantation were compared between the multimodal image-guided robot-assisted implantation (experimental) group (n = 7) and 3D-printed template-assisted implantation (control) group (n = 10). In total, 291 seeds were implanted in the experimental group and 436 in the control group; the mean error of seed implantation accuracy was 1.95 ± 0.13 mm and 1.90 ± 0.08 mm, respectively (P = 0.309). The preparation time was 26.13 ± 5.28 min in the experimental group and 0 min in the control group, while the average operation time was 34.44 ± 6.39 min versus 43.70 ± 6.06 min, respectively. The intraoperative blood loss was 4.96 ± 1.76 ml (experimental) versus 8.97 ± 2.99 ml (control) (P = 0.123). Multimodal image-guided robot-assisted I radioactive seed implantation met the clinical requirements for treating malignant tumours in the skull base and deep facial regions.