Medical Imaging of Microrobots: Toward In Vivo Applications

Multifunctional microrobot with real-time visualization and magnetic resonance imaging for chemoembolization therapy of liver cancer

Microrobots that can be precisely guided to target lesions have been studied for in vivo medical applications. However, existing microrobots have challenges in vivo such as biocompatibility, biodegradability, actuation module, and intra- and postoperative imaging. This study reports microrobots visualized with real-time x-ray and magnetic resonance imaging (MRI) that can be magnetically guided to tumor feeding vessels for transcatheter liver chemoembolization in vivo. The microrobots, composed of a hydrogel-enveloped porous structure and magnetic nanoparticles, enable targeted delivery of therapeutic and imaging agents via magnetic guidance from the actuation module under real-time x-ray imaging. In addition, the microrobots can be tracked using MRI as postoperative imaging and then slowly degrade over time. The in vivo validation of microrobot system-mediated chemoembolization was demonstrated in a rat liver with a tumor model. The proposed microrobot provides an advanced medical robotic platform that can overcome the limitations of existing microrobots and current liver chemoembolization.

Improving Swimming Performance of Photolithography-Based Microswimmers Using Curvature Structures

The emergence of robotic microswimmers and their huge potential in biomedical applications such as drug delivery, non-invasive surgery, and bio-sensing facilitates studies to improve their effectiveness. Recently, achiral microswimmers that have neither flexible nor helical structures have garnered attention because of their simple structures and fabrication process while preserving adequate swimming velocity and controllability. In this paper, the crescent shape was utilized to create photolithography-fabricated crescent-shaped achiral microswimmers. The microswimmers were actuated using rotating magnetic fields at low Reynolds numbers. Compared with the previously reported achiral microswimmers, the crescent-shaped microswimmers showed significant improvement in forward swimming speed. The effects of different curvatures, arm angles, and procession angles on the velocities of microswimmers were investigated. Moreover, the optimal swimming motion was defined by adjusting the field strength of the magnetic field. Finally, the effect of the thickness of the microswimmers on their swimming velocity was investigated.

New Degradable Semiconducting Polymers for Photoacoustic Imaging of λ-Carrageenan-Induced Arthritis Mouse Model

Semiconducting polymer has a high extinction coefficient and a long band absorption and can be used as a photoacoustic imaging contrast agent. However, nonbiodegradable semiconducting polymers may cause biosafety issues due to being retained in the body. Therefore, developing degradable semiconducting polymers is necessary for in vivo imaging. Herein, we developed three degradable semiconducting polymers with unique optical properties. We adjusted the optical properties of semiconducting polymers by designing the molecular structure of semiconducting polymers. Polymers with a donor-π-acceptor structure could easily improve the optical properties through adjusting the donor or acceptor units. Through adjusting the electron-donor and -acceptor units, three diketopyrrolopyrrole derivative polymers (DPPTz, DPPQu, and DPPWu) were synthesized and converted into nanosize particles. By introducing the degradable chemical groups in the main chain structure of semiconducting polymers, diketopyrrolopyrrole polymers could be degraded by ClO^-. Among these nanosize particles, DPPTz NPs and DPPQu NPs were used to achieve the in vivo photoacoustic imaging of λ-carrageenan-induced arthritis mouse model. This work provides a novel design idea for the designing of red-shifted semiconducting polymer with degradable properties.

3D-printed microrobots from design to translation

Microrobots have attracted the attention of scientists owing to their unique features to accomplish tasks in hard-to-reach sites in the human body. Microrobots can be precisely actuated and maneuvered individually or in a swarm for cargo delivery, sampling, surgery, and imaging applications. In addition, microrobots have found applications in the environmental sector (e.g., water treatment). Besides, recent advancements of three-dimensional (3D) printers have enabled the high-resolution fabrication of microrobots with a faster design-production turnaround time for users with limited micromanufacturing skills. Here, the latest end applications of 3D printed microrobots are reviewed (ranging from environmental to biomedical applications) along with a brief discussion over the feasible actuation methods (e.g., on- and off-board), and practical 3D printing technologies for microrobot fabrication. In addition, as a future perspective, we discussed the potential advantages of integration of microrobots with smart materials, and conceivable benefits of implementation of artificial intelligence (AI), as well as physical intelligence (PI). Moreover, in order to facilitate bench-to-bedside translation of microrobots, current challenges impeding clinical translation of microrobots are elaborated, including entry obstacles (e.g., immune system attacks) and cumbersome standard test procedures to ensure biocompatibility.

Microbots have attracted attention due to an ability to reach places and perform tasks which are not possible with conventional techniques in a wide range of applications. Here, the authors review the recent work in the field on the fabrication, application and actuation of 3D printed microbots offering a view of the direction of future microbot research.

Smart Magnetic Microrobots Learn to Swim with Deep Reinforcement Learning

Swimming microrobots are increasingly developed with complex materials and dynamic shapes and are expected to operate in complex environments in which the system dynamics are difficult to model and positional control of the microrobot is not straightforward to achieve. Deep reinforcement learning is a promising method of autonomously developing robust controllers for creating smart microrobots, which can adapt their behavior to operate in uncharacterized environments without the need to model the system dynamics. This article reports the development of a smart helical magnetic hydrogel microrobot that uses the soft actor critic reinforcement learning algorithm to autonomously derive a control policy which allows the microrobot to swim through an uncharacterized biomimetic fluidic environment under control of a time varying magnetic field generated from a three-axis array of electromagnets. The reinforcement learning agent learned successful control policies from both state vector input and raw images, and the control policies learned by the agent recapitulated the behavior of rationally designed controllers based on physical models of helical swimming microrobots. Deep reinforcement learning applied to microrobot control is likely to significantly expand the capabilities of the next generation of microrobots.

“Motile-targeting” drug delivery platforms based on micro/nanorobots for tumor therapy

Traditional drug delivery systems opened the gate for tumor-targeted therapy, but they generally took advantage of enhanced permeability and retention or ligand-receptor mediated interaction, and thus suffered from limited recognition range (<0.5 nm) and low targeting efficiency (0.7%, median). Alternatively, micro/nanorobots (MNRs) may act as emerging “motile-targeting” drug delivery platforms to deliver therapeutic payloads, thereby making a giant step toward effective and safe cancer treatment due to their autonomous movement and navigation in biological media. This review focuses on the most recent developments of MNRs in “motile-targeting” drug delivery. After a brief introduction to traditional tumor-targeted drug delivery strategies and various MNRs, the representative applications of MNRs in “motile-targeting” drug delivery are systematically streamlined in terms of the propelling mechanisms. Following a discussion of the current challenges of each type of MNR in biomedical applications, as well as future prospects, several promising designs for MNRs that could benefit in “motile-targeting” drug delivery are proposed. This work is expected to attract and motivate researchers from different communities to advance the creation and practical application of the “motile-targeting” drug delivery platforms.

Lighting up Micro-/Nanorobots with Fluorescence

Micro-/nanorobots (MNRs) can be autonomously propelled on demand in complex biological environments and thus may bring revolutionary changes to biomedicines. Fluorescence has been widely used in real-time imaging, chemo-/biosensing, and photo-(chemo-) therapy. The integration of MNRs with fluorescence generates fluorescent MNRs with unique advantages of optical trackability, on-the-fly environmental sensitivity, and targeting chemo-/photon-induced cytotoxicity. This review provides an up-to-date overview of fluorescent MNRs. After the highlighted elucidation about MNRs of various propulsion mechanisms and the introductory information on fluorescence with emphasis on the fluorescent mechanisms and materials, we systematically illustrate the design and preparation strategies to integrate MNRs with fluorescent substances and their biomedical applications in imaging-guided drug delivery, intelligent on-the-fly sensing and photo-(chemo-) therapy. In the end, we summarize the main challenges and provide an outlook on the future directions of fluorescent MNRs. This work is expected to attract and inspire researchers from different communities to advance the creation and practical application of fluorescent MNRs on a broad horizon.

Contrast-enhanced ultrasound tracking of helical propellers with acoustic phase analysis and comparison with color Doppler

Medical microrobots (MRs) hold the potential to radically transform several interventional procedures. However, to guarantee therapy success when operating in hard-to-reach body districts, a precise and robust imaging strategy is required for monitoring and controlling MRs in real-time. Ultrasound (US) may represent a powerful technology, but MRs' visibility with US needs to be improved, especially when targeting echogenic tissues. In this context, motions of MRs have been exploited to enhance their contrast, e.g., by Doppler imaging. To exploit a more selective contrast-enhancement mechanism, in this study, we analyze in detail the characteristic motions of one of the most widely adopted MR concepts, i.e., the helical propeller, with a particular focus on its interactions with the backscattered US waves. We combine a kinematic analysis of the propeller 3D motion with an US acoustic phase analysis (APA) performed on the raw radio frequency US data in order to improve imaging and tracking in bio-mimicking environments. We validated our US-APA approach in diverse scenarios, aimed at simulating realistic in vivo conditions, and compared the results to those obtained with standard US Doppler. Overall, our technique provided a precise and stable feedback to visualize and track helical propellers in echogenic tissues (chicken breast), tissue-mimicking phantoms with bifurcated lumina, and in the presence of different motion disturbances (e.g., physiological flows and tissue motions), where standard Doppler showed poor performance. Furthermore, the proposed US-APA technique allowed for real-time estimation of MR velocity, where standard Doppler failed.

Drug-loaded IRONSperm clusters: modeling, wireless actuation, and ultrasound imaging

Individual biohybrid microrobots have the potential to perform biomedical in vivo tasks such as remote-controlled drug and cell delivery and minimally invasive surgery. This work demonstrates the formation of biohybrid sperm-templated clusters under the influence of an external magnetic field and essential functionalities for wireless actuation and drug delivery. Ferromagnetic nanoparticles are electrostatically assembled around dead sperm cells, and the resulting nanoparticle-coated cells are magnetically assembled into threedimensional biohybrid clusters. The aim of this clustering is threefold: First, to enable rolling locomotion on a nearby solid boundary using a rotating magnetic field; second, to allow for noninvasive localization; third, to load the cells inside the cluster with drugs for targeted delivery. A magneto-hydrodynamic model captures the rotational response of the clusters in a viscous fluid, and predicts an upper bound for their step-out frequency, which is independent of their volume or aspect ratio. Below the step-out frequency, the rolling velocity of the clusters increases nonlinearly with their perimeter and actuation frequency. During rolling locomotion, the clusters are localized using ultrasound at a relatively large distance, which makes these biohybrid clusters promising for deep-tissue applications. Finally, we show that the estimated drug load scales with the number of cells in the cluster and can be retained for more than 10 hours. The aggregation of microrobots enables them to collectively roll in a predictable way in response to an external rotating magnetic field, and enhances ultrasound detectability and drug loading capacity compared to the individual microrobots. The favorable features of biohybrid microrobot clusters place emphasis on the importance of the investigation and development of collective microrobots and their potential for in vivo applications.

Visualization of micro-agents and surroundings by real-time multicolor fluorescence microscopy

Optical microscopy techniques are a popular choice for visualizing micro-agents. They generate images with relatively high spatiotemporal resolution but do not reveal encoded information for distinguishing micro-agents and surroundings. This study presents multicolor fluorescence microscopy for rendering color-coded identification of mobile micro-agents and dynamic surroundings by spectral unmixing. We report multicolor microscopy performance by visualizing the attachment of single and cluster micro-agents to cancer spheroids formed with HeLa cells as a proof-of-concept for targeted drug delivery demonstration. A microfluidic chip is developed to immobilize a single spheroid for the attachment, provide a stable environment for multicolor microscopy, and create a 3D tumor model. In order to confirm that multicolor microscopy is able to visualize micro-agents in vascularized environments, in vitro vasculature network formed with endothelial cells and ex ovo chicken chorioallantoic membrane are employed as experimental models. Full visualization of our models is achieved by sequential excitation of the fluorophores in a round-robin manner and synchronous individual image acquisition from three-different spectrum bands. We experimentally demonstrate that multicolor microscopy spectrally decomposes micro-agents, organic bodies (cancer spheroids and vasculatures), and surrounding media utilizing fluorophores with well-separated spectrum characteristics and allows image acquisition with 1280 [Formula: see text] 1024 pixels up to 15 frames per second. Our results display that real-time multicolor microscopy provides increased understanding by color-coded visualization regarding the tracking of micro-agents, morphology of organic bodies, and clear distinction of surrounding media.

Optically Manipulated Neutrophils as Native Microcrafts In Vivo

As the first line of host defense against invading pathogens, neutrophils have an inherent phagocytosis capability for the elimination of foreign agents and target loading upon activation, as well as the ability to transmigrate across blood vessels to the infected tissue, making them natural candidates to execute various medical tasks in vivo. However, most of the existing neutrophil-based strategies rely on their spontaneous chemotactic motion, lacking in effective activation, rapid migration, and high navigation precision. Here, we report an optically manipulated neutrophil microcraft in vivo through the organic integration of endogenous neutrophils and scanning optical tweezers, functioning as a native biological material and wireless remote controller, respectively. The neutrophil microcrafts can be remotely activated by light and then navigated to the target position along a designated route, followed by the fulfillment of its task in vivo, such as active intercellular connection, targeted delivery of nanomedicine, and precise elimination of cell debris, free from the extra construction or modification of the native neutrophils. On the basis of the innate immunologic function of neutrophils and intelligent optical manipulation, the proposed neutrophil microcraft might provide new insight for the construction of native medical microdevices for drug delivery and precise treatment of inflammatory diseases.

van der Waals Semiconductor Empowered Vertical Color Sensor

Biomimetic artificial vision is receiving significant attention nowadays, particularly for the development of neuromorphic electronic devices, artificial intelligence, and microrobotics. Nevertheless, color recognition, the most critical vision function, is missed in the current research due to the difficulty of downscaling of the prevailing color sensing devices. Conventional color sensors typically adopt a lateral color sensing channel layout and consume a large amount of physical space, whereas compact designs suffer from an unsatisfactory color detection accuracy. In this work, we report a van der Waals semiconductor-empowered vertical color sensing structure with the emphasis on compact device profile and precise color recognition capability. More attractive, we endow color sensor hardware with the function of chromatic aberration correction, which can simplify the design of an optical lens system and, in turn, further downscales the artificial vision systems. Also, the dimension of a multiple pixel prototype device in our study confirms the scalability and practical potentials of our developed device architecture toward the above applications.

Rolling Motion of a Soft Microsnowman under Rotating Magnetic Field

This paper demonstrates a manipulation of snowman-shaped soft microrobots under a uniform rotating magnetic field. Each microsnowman robot consists of two biocompatible alginate microspheres with embedded magnetic nanoparticles. The soft microsnowmen were fabricated using a microfluidic device by following a centrifuge-based microfluidic droplet method. Under a uniform rotating magnetic field, the microsnowmen were rolled on the substrate surface, and the velocity response for increasing magnetic field frequencies was analyzed. Then, a microsnowman was rolled to follow different paths, which demonstrated directional controllability of the microrobot. Moreover, swarms of microsnowmen and single alginate microrobots were manipulated under the rotating magnetic field, and their velocity responses were analyzed for comparison.

A Tissue Adhesion-Controllable and Biocompatible Small-Scale Hydrogel Adhesive Robot

Recently, the realization of minimally invasive medical interventions on targeted tissues using wireless small-scale medical robots has received an increasing attention. For effective implementation, such robots should have a strong adhesion capability to biological tissues and at the same time easy controlled detachment should be possible, which has been challenging. To address such issue, a small-scale soft robot with octopus-inspired hydrogel adhesive (OHA) is proposed. Hydrogels of different Young's moduli are adapted to achieve a biocompatible adhesive with strong wet adhesion by preventing the collapse of the octopus-inspired patterns during preloading. Introduction of poly(N-isopropylacrylamide) hydrogel for dome-like protuberance structure inside the sucker wall of polyethylene glycol diacrylate hydrogel provides a strong tissue attachment in underwater and at the same time enables easy detachment by temperature changes due to its temperature-dependent volume change property. It is finally demonstrated that the small-scale soft OHA robot can efficiently implement biomedical functions owing to strong adhesion and controllable detachment on biological tissues while operating inside the body. Such robots with repeatable tissue attachment and detachment possibility pave the way for future wireless soft miniature robots with minimally invasive medical interventions.

Magnetic bio-hybrid micro actuators

Over the past two decades, there has been a growing body of work on wireless devices that can operate on the length scales of biological cells and even smaller. A class of these devices receiving increasing attention are referred to as bio-hybrid actuators: tools that integrate biological cells or subcellular parts with synthetic or inorganic components. These devices are commonly controlled through magnetic manipulation as magnetic fields and gradients can be generated with a high level of control. Recent work has demonstrated that magnetic bio-hybrid actuators can address common challenges in small scale fabrication, control, and localization. Additionally, it is becoming apparent that these magnetically driven bio-hybrid devices can display high efficiency and, in many cases, have the potential for self-repair and even self-replication. Combining these properties with magnetically driven forces and torques, which can be transmitted over significant distances, can be highly controlled, and are biologically safe, gives magnetic bio-hybrid actuators significant advantages over other classes of small scale actuators. In this review, we describe the theory and mechanisms required for magnetic actuation, classify bio-hybrid actuators by their diverse organic components, and discuss their current limitations. Insights into the future of coupling cells and cell-derived components with magnetic materials to fabricate multi-functional actuators are also provided.

Hematobiochemical, Oxidative Stress, and Histopathological Mediated Toxicity Induced by Nickel Ferrite (NiFe2O4) Nanoparticles in Rabbits

From the past few decades, attention towards the biological evaluation of nanoparticles (NPs) has increased due to the persistent and extensive application of NPs in various fields, including biomedical science, modern industry, magnetic resonance imaging, and the construction of sensors. Therefore, in the current study, magnetic nickel ferrite (NiFe₂O₄) nanoparticles (NFNPs) were synthesized and evaluated for their possible adverse effects in rabbits. The crystallinity of the synthesized NFNPs was confirmed using X-ray diffraction (XRD) technique. The saturation magnetization (46.7 emug⁻¹) was measured using vibrating sample magnetometer (VSM) and 0.35-tesla magnetron by magnetic resonance imaging (MRI). The adverse effects of NFNPs on blood biochemistry and histoarchitecture of the liver, kidneys, spleen, brain, and heart of the rabbits were determined. A total of sixteen adult rabbits, healthy and free from any apparent infection, were blindly placed in two groups. The rabbits in group A served as control, while the rabbits in group B received a single dose (via ear vein) of NFNPs for ten days. The blood and visceral tissues were collected from each rabbit at days 5 and 10 of posttreatment. The results on blood and serum biochemistry profile indicated significant variation in hematological and serum biomarkers in NFNP-treated rabbits. The results showed an increased quantity of oxidative stress and depletion of antioxidant enzymes in treated rabbits. Various serum biochemical tests exhibited significantly higher concentrations of different liver function tests, kidney function tests, and cardiac biomarkers. Histopathologically, the liver showed congestion, edema, atrophy, and degeneration of hepatocytes. The kidneys exhibited hemorrhages, atrophy of renal tubule, degeneration, and necrosis of renal tubules, whereas coagulative necrosis, neutrophilic infiltration, and severe myocarditis were seen in different sections of the heart. The brain of the treated rabbits revealed necrosis of neurons, neuron atrophy, and microgliosis. In conclusion, the current study results indicated that the highest concentration of NPs induced adverse effects on multiple tissues of the rabbits.

Real-Time Ultrasound Doppler Tracking and Autonomous Navigation of a Miniature Helical Robot for Accelerating Thrombolysis in Dynamic Blood Flow

Untethered small-scale robots offer great promise for medical applications in complex biological environments. However, challenges remain in the control and medical imaging of a robot for targeted delivery inside a living body, especially in flowing conditions (e.g., blood vessels). In this work, we report a strategy to autonomously navigate a miniature helical robot in dynamic blood flow under ultrasound Doppler imaging guidance. A magnetic torque and force-hybrid control approach is implemented, enabling the actuation of a millimeter-scale helical robot against blood flow under a rotating magnetic field with a controllable field gradient. Experimental results demonstrate that the robot (length 7.30 mm; diameter 2.15 mm) exhibits controlled navigation in vascular environments, including upstream and downstream navigation in flowing and pulsatile flowing blood with flow rates up to 24 mL/min (mean flow velocity: 14.15 mm/s). During navigation, the rotating robot-induced Doppler signals enable real-time localization and tracking in flowing and pulsatile flowing blood environments. Moreover, the robot can be selectively navigated along different paths by actively controlling the robot's orientation. We apply this autonomous strategy for localizing thrombus and accelerating thrombolysis rate. Compared with conventional tissue plasminogen activator (tPA) thrombolysis, the robot-enhanced shear stress and tPA convection near the clot-blood interface increase the unblocking and thrombolysis efficiency up to 4.8- and 3.5-fold, respectively. Such a medical imaging-guided navigation strategy provides simultaneous robot navigation and localization in complex dynamic biological environments, providing an intelligent approach toward real-time targeted delivery and diagnostic applications in vivo.

Light-driven carbon nitride microswimmers with propulsion in biological and ionic media and responsive on-demand drug delivery

We propose two-dimensional poly(heptazine imide) (PHI) carbon nitride microparticles as light-driven microswimmers in various ionic and biological media. Their high-speed (15 to 23 micrometer per second; 9.5 ± 5.4 body lengths per second) swimming in multicomponent ionic solutions with concentrations up to 5 M and without dedicated fuels is demonstrated, overcoming one of the bottlenecks of previous light-driven microswimmers. Such high ion tolerance is attributed to a favorable interplay between the particle's textural and structural nanoporosity and optoionic properties, facilitating ionic interactions in solutions with high salinity. Biocompatibility of these microswimmers is validated by cell viability tests with three different cell lines and primary cells. The nanopores of the swimmers are loaded with a model cancer drug, doxorubicin (DOX), resulting in a high (185%) loading efficiency without passive release. Controlled drug release is reported under different pH conditions and can be triggered on-demand by illumination. Light-triggered, boosted release of DOX and its active degradation products are demonstrated under oxygen-poor conditions using the intrinsic, environmentally sensitive and light-induced charge storage properties of PHI, which could enable future theranostic applications in oxygen-deprived tumor regions. These organic PHI microswimmers simultaneously address the current light-driven microswimmer challenges of high ion tolerance, fuel-free high-speed propulsion in biological media, biocompatibility, and controlled on-demand cargo release toward their biomedical, environmental, and other potential applications.

Microemulsion-Confined Assembly of Magnetic Nanoclusters for pH/H2O2 Dual-Responsive T2-T1 Switchable MRI

In this work, a T₂-T₁ switchable superparamagnetic iron oxide nanoprobe with a pH/H₂O₂ dual response was obtained using a microemulsion method. This novel method for the controllable assembly of small iron clusters followed by their independent modification was reported, which could not be prepared by common synthetic methods. The size of the assembled nanoprobe was uniform and controllable, with a stable T₂ magnetic resonance imaging (MRI) signal under a single condition. When the nanoprobe was exposed to the tumor environment, the higher H⁺ and H₂O₂ concentrations at the tumor site could dissociate the nanoprobe and redisperse into small iron clusters. When this occurred, the T₂ MRI signal was converted into a T₁ MRI signal, achieving specific detection of tumors by a pH/H₂O₂ dual-response T₂-T₁ MRI.

Nano/Microrobots Line Up for Gastrointestinal Tract Diseases: Targeted Delivery, Therapy, and Prevention

Nano/microrobots (NMRs) are tiny devices that can convert energy into motion and operate at nano/microscales.54 Especially in biomedical research, NMRs have received much attention over the past twenty years because of their excellent capabilities and great potential in various applications, including on-demand drug delivery, gene and cell transport, and precise microsurgery. Reports published in recent years show that synthetic nano/microrobots have promising potential to function in the gastrointestinal (GI) region, particularly in terms of drug delivery. These tiny robots were able to be designed in such a way that they propel in their surroundings (biological media) with high speed, load cargo (drug) efficiently, transport it safely, and release upon request successfully. Their propulsion, retention, distribution, and toxicity in the GI tract of mice has been evaluated. The results envisage that such nano/microrobots can be further modified and developed as a new-generation treatment of GI tract diseases. In this minireview, we focus on the functionality of micro/nanorobots as a biomedical treatment system for stomach/intestinal diseases. We review the research progress from the first in vivo report in December 2014 to the latest in August 2021. Then, we discuss the treatment difficulties and challenges in vivo application (in general) and possible future development routes.

Stratified Disk Microrobots with Dynamic Maneuverability and Proton-Activatable Luminescence for in Vivo Imaging

Microrobots can expand our abilities to access remote, confined, and enclosed spaces. Their potential applications inside our body are obvious, e.g., to diagnose diseases, deliver medicine, and monitor treatment efficacy. However, critical requirements exist in relation to their operations in gastrointestinal environments, including resistance to strong gastric acid, responsivity to a narrow proton variation window, and locomotion in confined cavities with hierarchical terrains. Here, we report a proton-activatable microrobot to enable real-time, repeated, and site-selective pH sensing and monitoring in physiological relevant environments. This is achieved by stratifying a hydrogel disk to combine a range of functional nanomaterials, including proton-responsive molecular switches, upconversion nanoparticles, and near-infrared (NIR) emitters. By leveraging the 3D magnetic gradient fields and the anisotropic composition, the microrobot can be steered to locomote as a gyrating "Euler's disk", i.e., aslant relative to the surface and along its low-friction outer circumference, exhibiting a high motility of up to 60 body lengths/s. The enhanced magnetomotility can boost the pH-sensing kinetics by 2-fold. The fluorescence of the molecular switch can respond to pH variations with over 600-fold enhancement when the pH decreases from 8 to 1, and the integration of upconversion nanoparticles further allows both the efficient sensitization of NIR light through deep tissue and energy transfer to activate the pH probes. Moreover, the embedded down-shifting NIR emitters provide sufficient contrast for imaging of a single microrobot inside a live mouse. This work suggests great potential in developing multifunctional microrobots to perform generic site-selective tasks in vivo.

Dynamic tracking of a magnetic micro-roller using ultrasound phase analysis

Microrobots (MRs) have attracted significant interest for their potentialities in diagnosis and non-invasive intervention in hard-to-reach body areas. Fine control of biomedical MRs requires real-time feedback on their position and configuration. Ultrasound (US) imaging stands as a mature and advantageous technology for MRs tracking, but it suffers from disturbances due to low contrast resolution. To overcome these limitations and make US imaging suitable for monitoring and tracking MRs, we propose a US contrast enhancement mechanism for MR visualization in echogenic backgrounds (e.g., tissue). Our technique exploits the specific acoustic phase modulation produced by the MR characteristic motions. By applying this principle, we performed real-time visualization and position tracking of a magnetic MR rolling on a lumen boundary, both in static flow and opposing flow conditions, with an average error of 0.25 body-lengths. Overall, the reported results unveil countless possibilities to exploit the proposed approach as a robust feedback strategy for monitoring and tracking biomedical MRs in-vivo.

Dual Ultrasound and Photoacoustic Tracking of Magnetically Driven Micromotors: From In Vitro to In Vivo

The fast evolution of medical micro- and nanorobots in the endeavor to perform non-invasive medical operations in living organisms has boosted the use of diverse medical imaging techniques in the last years. Among those techniques, photoacoustic imaging (PAI), considered a functional technique, has shown to be promising for the visualization of micromotors in deep tissue with high spatiotemporal resolution as it possesses the molecular specificity of optical methods and the penetration depth of ultrasound. However, the precise maneuvering and function's control of medical micromotors, in particular in living organisms, require both anatomical and functional imaging feedback. Therefore, herein, the use of high-frequency ultrasound and PAI is reported to obtain anatomical and molecular information, respectively, of magnetically-driven micromotors in vitro and under ex vivo tissues. Furthermore, the steerability of the micromotors is demonstrated by the action of an external magnetic field into the uterus and bladder of living mice in real-time, being able to discriminate the micromotors' signal from one of the endogenous chromophores by multispectral analysis. Finally, the successful loading and release of a model cargo by the micromotors toward non-invasive in vivo medical interventions is demonstrated.

A Review of Microrobot's System: Towards System Integration for Autonomous Actuation In Vivo

Microrobots have received great attention due to their great potential in the biomedical field, and there has been extraordinary progress on them in many respects, making it possible to use them in vivo clinically. However, the most important question is how to get microrobots to a given position accurately. Therefore, autonomous actuation technology based on medical imaging has become the solution receiving the most attention considering its low precision and efficiency of manual control. This paper investigates key components of microrobot’s autonomous actuation systems, including actuation systems, medical imaging systems, and control systems, hoping to help realize system integration of them. The hardware integration has two situations according to sharing the transmitting equipment or not, with the consideration of interference, efficiency, microrobot’s material and structure. Furthermore, system integration of hybrid actuation and multimodal imaging can improve the navigation effect of the microrobot. The software integration needs to consider the characteristics and deficiencies of the existing actuation algorithms, imaging algorithms, and the complex 3D working environment in vivo. Additionally, considering the moving distance in the human body, the autonomous actuation system combined with rapid delivery methods can deliver microrobots to specify position rapidly and precisely.

Magnetically Driven Micro and Nanorobots

Manipulation and navigation of micro and nanoswimmers in different fluid environments can be achieved by chemicals, external fields, or even motile cells. Many researchers have selected magnetic fields as the active external actuation source based on the advantageous features of this actuation strategy such as remote and spatiotemporal control, fuel-free, high degree of reconfigurability, programmability, recyclability, and versatility. This review introduces fundamental concepts and advantages of magnetic micro/nanorobots (termed here as “MagRobots”) as well as basic knowledge of magnetic fields and magnetic materials, setups for magnetic manipulation, magnetic field configurations, and symmetry-breaking strategies for effective movement. These concepts are discussed to describe the interactions between micro/nanorobots and magnetic fields. Actuation mechanisms of flagella-inspired MagRobots (i.e., corkscrew-like motion and traveling-wave locomotion/ciliary stroke motion) and surface walkers (i.e., surface-assisted motion), applications of magnetic fields in other propulsion approaches, and magnetic stimulation of micro/nanorobots beyond motion are provided followed by fabrication techniques for (quasi-)spherical, helical, flexible, wire-like, and biohybrid MagRobots. Applications of MagRobots in targeted drug/gene delivery, cell manipulation, minimally invasive surgery, biopsy, biofilm disruption/eradication, imaging-guided delivery/therapy/surgery, pollution removal for environmental remediation, and (bio)sensing are also reviewed. Finally, current challenges and future perspectives for the development of magnetically powered miniaturized motors are discussed.

Artificial Intelligence in Medical Sensors for Clinical Decisions

Due to the limited ability of conventional methods and the limited perspective of human diagnostics, patients are often diagnosed incorrectly or at a late stage as their disease condition progresses. They may then undergo unnecessary treatments due to inaccurate diagnoses. In this Perspective, we offer a brief overview on the integration of nanotechnology-based medical sensors and artificial intelligence (AI) for advanced clinical decision support systems to help decision-makers and healthcare systems improve how they approach information, insights, and the surrounding contexts, as well as to promote the uptake of personalized medicine on an individualized basis. Relying on these milestones, wearable sensing devices could enable interactive and evolving clinical decisions that could be used for evidence-based analysis and recommendations as well as for personalized monitoring of disease progress and treatment. We present and discuss the ongoing challenges and future opportunities associated with AI-enabled medical sensors in clinical decisions.

Recent Progress in Magnetically Actuated Microrobots for Targeted Delivery of Therapeutic Agents

Therapeutic agents, such as drugs and cells, play an essential role in virtually every treatment of injury, illness, or disease. However, the conventional practices of drug delivery often result in undesirable side effects caused by drug overdose and off-target delivery. In the case of cell delivery, the survival rate of the transplanted cells is extremely low and difficulties with the administration route of cells remain a problem. Recently, magnetically actuated microrobots have started offering unique opportunities in targeted therapeutic delivery due to their tiny size and ability to access hard-to-reach lesions in a minimally invasive manner; considerable advances in this regard have been made over the past decade. Here, recent progress in magnetically actuated microrobots, developed for targeted drug/cell delivery, is presented, with a focus on their design features and mechanisms for controlled therapeutic release. Additionally, the practical challenges faced by the microrobots, and future research directions toward the swift bench-to-bedside translation of the microrobots are addressed.

Dual-Propelled Lanbiotic Based Janus Micromotors for Selective Inactivation of Bacterial Biofilms

Graphene oxide/PtNPs/Fe₂ O₃ "dual-propelled" catalytic and fuel-free rotary actuated magnetic Janus micromotors modified with the lanbiotic Nisin are used for highly selective capture/inactivation of gram-positive bacteria units and biofilms. Specific interaction of Nisin with the Lipid II unit of Staphylococcus Aureus bacteria in connection with the enhanced micromotor movement and generated fluid flow result in a 2-fold increase of the capture/killing ability (both in bubble and magnetic propulsion modes) as compared with free peptide and static counterparts. The high stability of Nisin along with the high towing force of the micromotors allow for efficient operation in untreated raw media (tap water, juice and serum) and even in blood and in flowing blood in magnetic mode. The high selectivity of the approach is illustrated by the dramatically lower interaction with gram-negative bacteria (Escherichia Coli). The double-propulsion (catalytic or fuel-free magnetic) mode of the micromotors and the high biocompatibility holds considerable promise to design micromotors with tailored lanbiotics that can response to the changes that make the bacteria resistant in a myriad of clinical, environmental remediation or food safety applications.

Ultrasound Doppler-guided real-time navigation of a magnetic microswarm for active endovascular delivery

Swarming micro/nanorobots offer great promise in performing targeted delivery inside diverse hard-to-reach environments. However, swarm navigation in dynamic environments challenges delivery capability and real-time swarm localization. Here, we report a strategy to navigate a nanoparticle microswarm in real time under ultrasound Doppler imaging guidance for active endovascular delivery. A magnetic microswarm was formed and navigated near the boundary of vessels, where the reduced drag of blood flow and strong interactions between nanoparticles enable upstream and downstream navigation in flowing blood (mean velocity up to 40.8 mm/s). The microswarm-induced three-dimensional blood flow enables Doppler imaging from multiple viewing configurations and real-time tracking in different environments (i.e., stagnant, flowing blood, and pulsatile flow). We also demonstrate the ultrasound Doppler-guided swarm formation and navigation in the porcine coronary artery ex vivo. Our strategy presents a promising connection between swarm control and real-time imaging of microrobotic swarms for localized delivery in dynamic environments.

Multifunctional Biodegradable Microrobot with Programmable Morphology for Biomedical Applications

We described a magnetic chitosan microscaffold tailored for applications requiring high biocompatibility, biodegradability, and monitoring by real-time imaging. Such magnetic microscaffolds exhibit adjustable pores and sizes depending on the target application and provide various functions such as magnetic actuation and enhanced cell adhesion using biomaterial-based magnetic particles. Subsequently, we fabricated the magnetic chitosan microscaffolds with optimized shape and pore properties to specific target diseases. As a versatile tool, the capability of the developed microscaffold was demonstrated through in vitro laboratory tasks and in vivo therapeutic applications for liver cancer therapy and knee cartilage regeneration. We anticipate that the optimal design and fabrication of the presented microscaffold will advance the technology of biopolymer-based microscaffolds and micro/nanorobots.

External Power-Driven Microrobotic Swarm: From Fundamental Understanding to Imaging-Guided Delivery

Untethered micro/nanorobots have been widely investigated owing to their potential in performing various tasks in different environments. The significant progress in this emerging interdisciplinary field has benefited from the distinctive features of those tiny active agents, such as wireless actuation, navigation under feedback control, and targeted delivery of small-scale objects. In recent studies, collective behaviors of these tiny machines have received tremendous attention because swarming agents can enhance the delivery capability and adaptability in complex environments and the contrast of medical imaging, thus benefiting the imaging-guided navigation and delivery. In this review, we summarize the recent research efforts on investigating collective behaviors of external power-driven micro/nanorobots, including the fundamental understanding of swarm formation, navigation, and pattern transformation. The fundamental understanding of swarming tiny machines provides the foundation for targeted delivery. We also summarize the swarm localization using different imaging techniques, including the imaging-guided delivery in biological environments. By highlighting the critical steps from understanding the fundamental interactions during swarm control to swarm localization and imaging-guided delivery applications, we envision that the microrobotic swarm provides a promising tool for delivering agents in an active, controlled manner.

A Journey of Nanomotors for Targeted Cancer Therapy: Principles, Challenges, and a Critical Review of the State-of-the-Art

A nanomotor is a miniaturized device that converts energy stored in the environment into mechanical motion. The last two decades have witnessed a surge of research interests in the biomedical applications of nanomotors, but little clinical translation. To accelerate this process, targeted cancer therapy is used as an example to describe a "survive, locate, operate, and terminate" (SLOT) mission of a nanomotor, where it must 1) survive in the unfriendly in vivo environment, 2) locate its target as well as be located by human operators, 3) carry out specific operations, and 4) terminate after the mission is completed. Along this journey, the challenges presented to a nanomotor, including to power, navigate, steer, target, release, control, image, and communicate are discussed, and how state-of-the-art nanomotors meet or fall short of these requirements is critically reviewed. These discussions are then condensed into a table for easy reference. In particular, it is argued that chemically powered nanomotors are intrinsically ill-positioned for targeted cancer therapy, while nanomotors powered by magnetic fields or ultrasound show more promises. Following this argument, a tentative nanomotor design is then presented in the end to conform to the SLOT guideline, and to inspire practical, functional nanorobots that are yet to come.

Recent Advances in Microswimmers for Biomedical Applications

Microswimmers are a rapidly developing research area attracting enormous attention because of their many potential applications with high societal value. A particularly promising target for cleverly engineered microswimmers is the field of biomedical applications, where many interesting examples have already been reported for e.g., cargo transport and drug delivery, artificial insemination, sensing, indirect manipulation of cells and other microscopic objects, imaging, and microsurgery. Pioneered only two decades ago, research studies on the use of microswimmers in biomedical applications are currently progressing at an incredibly fast pace. Given the recent nature of the research, there are currently no clinically approved microswimmer uses, and it is likely that several years will yet pass before any clinical uses can become a reality. Nevertheless, current research is laying the foundation for clinical translation, as more and more studies explore various strategies for developing biocompatible and biodegradable microswimmers fueled by in vivo-friendly means. The aim of this review is to provide a summary of the reported biomedical applications of microswimmers, with focus on the most recent advances. Finally, the main considerations and challenges for clinical translation and commercialization are discussed.

Engineering microrobots for targeted cancer therapies from a medical perspective

Systemic chemotherapy remains the backbone of many cancer treatments. Due to its untargeted nature and the severe side effects it can cause, numerous nanomedicine approaches have been developed to overcome these issues. However, targeted delivery of therapeutics remains challenging. Engineering microrobots is increasingly receiving attention in this regard. Their functionalities, particularly their motility, allow microrobots to penetrate tissues and reach cancers more efficiently. Here, we highlight how different microrobots, ranging from tailor-made motile bacteria and tiny bubble-propelled microengines to hybrid spermbots, can be engineered to integrate sophisticated features optimised for precision-targeting of a wide range of cancers. Towards this, we highlight the importance of integrating clinicians, the public and cancer patients early on in the development of these novel technologies.