Clinical Feasibility and Accuracy of Rosa Robotic-Assisted Brachytherapy for Glioblastoma Multiforme (GBM) Using Custom Coordinate Transformation
Abstract
Purpose
The primary objective of this study is to evaluate the clinical application of the ROSA robotic system in facilitating high-precision interstitial applicator placement for patients with Glioblastoma Multiforme (GBM), ensuring targeted radiation delivery to the tumor volume.
Methods
A specialized workflow was developed integrating dosimetric planning with robotic navigation. Initial pre-plans were generated using the Nucletron Plato Treatment Planning System (TPS) to define target coverage. To bridge the systems, a proprietary homemade software based on coordinate transformation was utilized to translate TPS coordinates into optimized ROSA trajectories. Intraoperatively, the ROSA robotic arm guided the insertion of plastic applicators along these pre-calculated vectors under frameless stereotactic conditions.
Results
The integrated workflow was successfully implemented in five patients with GBM. Quantitative analysis of the placement accuracy demonstrated a mean targeting error of 0.9 ± 0.6 mm. No procedural complications related to robotic navigation were observed, and the robotic-guided approach allowed for consistent replication of the pre-planned trajectories.
Conclusion
The ROSA robotic system, supported by custom coordinate transformation algorithms, provides a reliable and highly accurate platform for brachytherapy in GBM patients. The sub-millimeter precision achieved in this study ensures optimal dose distribution, highlighting the potential of robotic assistance to improve the technical standards of interstitial intracranial brachytherapy.