1
|
Scharll Y, Radojicic N, Laimer G, Schullian P, Bale R. Robot-Assisted 2D Fluoroscopic Needle Placement-A Phantom Study. Diagnostics (Basel) 2024; 14:1723. [PMID: 39202211 PMCID: PMC11354198 DOI: 10.3390/diagnostics14161723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 09/03/2024] Open
Abstract
RATIONALE AND OBJECTIVES To evaluate the targeting accuracy of a novel robot-assisted guidance technique relying on one pair of 2D C-arm images. MATERIAL AND METHODS In total, 160 punctures were carried out semi-automatically by using a novel robotic device. The needle's paths were planned based on one pair of 2D fluoroscopic images from different angles. Conically shaped aluminum tips inside a gelatin-filled plexiglass phantom served as targets. The accuracy of the needle placement was assessed by taking control CTs and measuring the Euclidean distance (ED) and normal distance (ND) between the needle and the target point. In addition, the procedural time per needle placement was evaluated. RESULTS The accomplished mean NDs at the target for the 45°, 60°, 75° and 90° angles were 1.86 mm (SD ± 0.19), 2.68 mm (SD ± 0.18), 2.19 mm (SD ± 0.18) and 1.86 mm (SD ± 0.18), respectively. The corresponding mean EDs were 2.32 mm (SD ± 0.16), 2.68 mm (SD ± 0.18), 2.65 mm (SD ± 0.16) and 2.44 mm (SD ± 0.15). The mean duration of the total procedure, including image acquisition, trajectory planning and placement of four needles sequentially, was 12.7 min. CONCLUSIONS Robotic guidance based on two 2D fluoroscopy images allows for the precise placement of needle-like instruments at the first attempt without the need for using an invasive dynamic reference frame. This novel approach seems to be a valuable tool for the precise targeting of various anatomical structures that can be identified in fluoroscopic images.
Collapse
Affiliation(s)
| | | | | | | | - Reto Bale
- Interventional Oncology-Stereotaxy & Robotics (SIP), Department of Radiology, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| |
Collapse
|
2
|
Khanna R, Shah E. Robotics in Screening, Diagnosis and Treatment of Breast Cancer: A Perspective View. Clin Breast Cancer 2024; 24:17-26. [PMID: 37867115 DOI: 10.1016/j.clbc.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/24/2023]
Abstract
This perspective article aims to summarize and provide an outlook for developments around the use of robotics in the screening, diagnosis and treatment of breast cancer. We searched existing literature on the design and development of new systems and the current use of pre-existing surgical robotic systems. Robotic interventions for breast palpation and biopsy under ultrasound and MRI guidance are being developed and tested on simulated breast phantoms. Results are comparable to those achieved by clinicians; however, there are yet to be any human trials. Existing robotic surgical systems have been evaluated in human trials to perform nipple-sparing mastectomy and harvesting of autologous tissue for breast reconstruction. Results are comparable to traditional NSM and demonstrate positive short-term outcomes for patients. Robotic devices could revolutionize the clinical workflow around breast cancer through less invasive surgery, greater accuracy in biopsies and microsurgery and a potential reduction in clinicians' workload. However, more research into the practical deployment of these devices and concrete scientific evidence of better patient outcomes is needed.
Collapse
Affiliation(s)
- Raghav Khanna
- Faculty of Life Sciences and Medicine, King's College London, London, England.
| | | |
Collapse
|
3
|
Najafi G, Kreiser K, Abdelaziz MEMK, Hamady MS. Current State of Robotics in Interventional Radiology. Cardiovasc Intervent Radiol 2023; 46:549-561. [PMID: 37002481 PMCID: PMC10156773 DOI: 10.1007/s00270-023-03421-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 03/11/2023] [Indexed: 05/04/2023]
Abstract
As a relatively new specialty with a minimally invasive nature, the field of interventional radiology is rapidly growing. Although the application of robotic systems in this field shows great promise, such as with increased precision, accuracy, and safety, as well as reduced radiation dose and potential for teleoperated procedures, the progression of these technologies has been slow. This is partly due to the complex equipment with complicated setup procedures, the disruption to theatre flow, the high costs, as well as some device limitations, such as lack of haptic feedback. To further assess these robotic technologies, more evidence of their performance and cost-effectiveness is needed before their widespread adoption within the field. In this review, we summarise the current progress of robotic systems that have been investigated for use in vascular and non-vascular interventions.
Collapse
Affiliation(s)
- Ghazal Najafi
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK.
| | - Kornelia Kreiser
- Department of Neuroradiology, Rehabilitations - und Universitätskliniken Ulm, 89081, Ulm, Germany
| | - Mohamed E M K Abdelaziz
- The Hamlyn Centre, Imperial College London, London, SW7 2AZ, UK
- Department of Electrical and Electronic Engineering, Faculty of Engineering, Imperial College London, London, SW7 2AZ, UK
| | - Mohamad S Hamady
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK
- The Hamlyn Centre, Imperial College London, London, SW7 2AZ, UK
| |
Collapse
|
4
|
Anvari M, Chapman T, Barlow K, Cookson T, Van Toen C, Fielding T. Clinical safety and efficacy of a fully automated robot for magnetic resonance imaging-guided breast biopsy. Int J Med Robot 2023; 19:e2472. [PMID: 36250521 DOI: 10.1002/rcs.2472] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/05/2022] [Accepted: 10/16/2022] [Indexed: 03/03/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI)-guided biopsies are an accurate, but technically challenging, method for screening and diagnosis of breast lesions. This study assesses the safety and efficacy of an Image Guided Automated Robot (IGAR) in performing breast biopsies compared to manual procedures. METHODS Safety was determined from adverse events (AEs) and device deficiencies. Efficacy was assessed using targeting accuracy, number of successful biopsies, pain and scar scores, patient discomfort, and radiologist-determined ease-of-use. RESULTS All seven procedures in phase I were successfully and safely completed with no AEs and one device deficiency. The 23 IGAR biopsies in phase II outperformed the 18 manual biopsies in 1-week pain scores (p = 0.027), scarring at 1-week (p = 0.035), 1-month (p = 0.004), and components of comfort and ease-of-use. Phase II had seven and three AEs in the IGAR and manual groups, respectively (p = 0.317), with no serious AEs and nine device deficiencies. CONCLUSIONS The IGAR system is safe and effective for breast biopsy procedures. The results from these trials indicate the IGAR system as a potentially viable alternative to manual breast biopsy procedures.
Collapse
Affiliation(s)
- Mehran Anvari
- Centre for Surgical Invention and Innovation (CSii), McMaster University, Hamilton, Ontario, Canada
| | - Trevor Chapman
- Centre for Surgical Invention and Innovation (CSii), McMaster University, Hamilton, Ontario, Canada
| | - Karen Barlow
- Centre for Surgical Invention and Innovation (CSii), McMaster University, Hamilton, Ontario, Canada
| | - Tyler Cookson
- Centre for Surgical Invention and Innovation (CSii), McMaster University, Hamilton, Ontario, Canada
| | - Carolyn Van Toen
- MCDonald Detwiller & Associates (MDA), Brampton, Ontario, Canada
| | - Tim Fielding
- MCDonald Detwiller & Associates (MDA), Brampton, Ontario, Canada
| |
Collapse
|
5
|
Li B, Yuan L, Wang C, Guo Y. Structural design and analysis of pneumatic prostate seed implantation robot applied in magnetic resonance imaging environment. Int J Med Robot 2022; 18:e2457. [DOI: 10.1002/rcs.2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/15/2022] [Accepted: 08/31/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Bing Li
- School of Mechanical Power Engineering Harbin University of Science and Technology Harbin Heilongjiang China
| | - Lipeng Yuan
- School of Mechanical Engineering Harbin Institute of Technology Harbin Heilongjiang China
| | - Chunbo Wang
- Department of Dermatology Helen People's Hospital Suihua Heilongjiang China
| | - Yuhang Guo
- School of Mechanical Power Engineering Harbin University of Science and Technology Harbin Heilongjiang China
| |
Collapse
|
6
|
A Visual Servo Controlled Robotic System for MRI-guided Breast Biopsy. J INTELL ROBOT SYST 2022. [DOI: 10.1007/s10846-022-01615-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
7
|
Su H, Kwok KW, Cleary K, Iordachita I, Cavusoglu MC, Desai JP, Fischer GS. State of the Art and Future Opportunities in MRI-Guided Robot-Assisted Surgery and Interventions. PROCEEDINGS OF THE IEEE. INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS 2022; 110:968-992. [PMID: 35756185 PMCID: PMC9231642 DOI: 10.1109/jproc.2022.3169146] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Magnetic resonance imaging (MRI) can provide high-quality 3-D visualization of target anatomy, surrounding tissue, and instrumentation, but there are significant challenges in harnessing it for effectively guiding interventional procedures. Challenges include the strong static magnetic field, rapidly switching magnetic field gradients, high-power radio frequency pulses, sensitivity to electrical noise, and constrained space to operate within the bore of the scanner. MRI has a number of advantages over other medical imaging modalities, including no ionizing radiation, excellent soft-tissue contrast that allows for visualization of tumors and other features that are not readily visible by other modalities, true 3-D imaging capabilities, including the ability to image arbitrary scan plane geometry or perform volumetric imaging, and capability for multimodality sensing, including diffusion, dynamic contrast, blood flow, blood oxygenation, temperature, and tracking of biomarkers. The use of robotic assistants within the MRI bore, alongside the patient during imaging, enables intraoperative MR imaging (iMRI) to guide a surgical intervention in a closed-loop fashion that can include tracking of tissue deformation and target motion, localization of instrumentation, and monitoring of therapy delivery. With the ever-expanding clinical use of MRI, MRI-compatible robotic systems have been heralded as a new approach to assist interventional procedures to allow physicians to treat patients more accurately and effectively. Deploying robotic systems inside the bore synergizes the visual capability of MRI and the manipulation capability of robotic assistance, resulting in a closed-loop surgery architecture. This article details the challenges and history of robotic systems intended to operate in an MRI environment and outlines promising clinical applications and associated state-of-the-art MRI-compatible robotic systems and technology for making this possible.
Collapse
Affiliation(s)
- Hao Su
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
| | - Ka-Wai Kwok
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong
| | - Kevin Cleary
- Children's National Health System, Washington, DC 20010 USA
| | - Iulian Iordachita
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD 21218 USA
| | - M Cenk Cavusoglu
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH 44106 USA
| | - Jaydev P Desai
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332 USA
| | - Gregory S Fischer
- Department of Robotics Engineering, Worcester Polytechnic Institute, Worcester, MA 01609 USA
| |
Collapse
|
8
|
An integrated navigation system based on a dedicated breast support device for MRI-guided breast biopsy. Int J Comput Assist Radiol Surg 2022; 17:993-1005. [PMID: 35489007 DOI: 10.1007/s11548-022-02640-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/08/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Breast cancer is currently the cancer type with the highest incidence in the world, and it is extremely harmful to women's health. MRI-guided breast biopsy is a common method in clinical examination of breast cancer. However, traditional breast biopsy is less accurate and takes a long time. In this study, an integrated navigation system (INS) based on a dedicated breast support device (DBSD) was proposed to assist doctors in biopsy. METHODS The grid-shaped DBSD can reduce the displacement and deformation of the breast during the biopsy operation and is convenient for puncture. The robot system based on the DBSD is designed to assist doctors in performing puncture action. The software system has functions such as registration, path planning, and real-time tracking of biopsy needles based on the DBSD, which can assist doctors in completing the entire biopsy procedure. A series of experiments are designed to verify the feasibility and accuracy of the system. RESULTS Experiments prove that the robot system has reasonable structure and meets the requirements of MR compatibility. The latency of the INS during intraoperative navigation is 0.30 ± 0.03 s. In the phantom puncture experiment, the puncture error under the navigation of the INS is 1.04 ± 0.15 mm. CONCLUSION The INS proposed in this paper can be applied to assist doctors in breast biopsy in MR environment, improve the accuracy of biopsy and shorten the time of biopsy. The experimental results show that the system is feasible and accurate.
Collapse
|
9
|
Unger M, Berger J, Melzer A. Robot-Assisted Image-Guided Interventions. Front Robot AI 2021; 8:664622. [PMID: 34322519 PMCID: PMC8312560 DOI: 10.3389/frobt.2021.664622] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 07/01/2021] [Indexed: 12/23/2022] Open
Abstract
Image guidance is a common methodology of minimally invasive procedures. Depending on the type of intervention, various imaging modalities are available. Common imaging modalities are computed tomography, magnetic resonance tomography, and ultrasound. Robotic systems have been developed to enable and improve the procedures using these imaging techniques. Spatial and technological constraints limit the development of versatile robotic systems. This paper offers a brief overview of the developments of robotic systems for image-guided interventions since 2015 and includes samples of our current research in this field.
Collapse
Affiliation(s)
- Michael Unger
- Innovation Center Computer Assisted Surgery, Leipzig, Germany
| | - Johann Berger
- Innovation Center Computer Assisted Surgery, Leipzig, Germany
| | - Andreas Melzer
- Innovation Center Computer Assisted Surgery, Leipzig, Germany.,Institute for Medical Science and Technology, IMSaT, University Dundee, Dundee, United Kingdom
| |
Collapse
|
10
|
Antoniou A, Drakos T, Giannakou M, Evripidou N, Georgiou L, Christodoulou T, Panayiotou N, Ioannides C, Zamboglou N, Damianou C. Simple methods to test the accuracy of MRgFUS robotic systems. Int J Med Robot 2021; 17:e2287. [PMID: 34021694 PMCID: PMC8365756 DOI: 10.1002/rcs.2287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/21/2021] [Accepted: 05/21/2021] [Indexed: 01/09/2023]
Abstract
Background Robotic‐assisted diagnostic and therapeutic modalities require a highly accurate performance to be certified for clinical application. In this paper, three simple methods for assessing the accuracy of motion of magnetic resonance‐guided focused ultrasound (MRgFUS) robotic systems are presented. Methods The accuracy of motion of a 4 degrees of freedom robotic system intended for preclinical use of MRgFUS was evaluated by calliper‐based and magnetic resonance imaging (MRI) methods, as well as visually by performing multiple ablations on a plastic film. Results The benchtop results confirmed a highly accurate motion in all axes of operation. The spatial positioning errors estimated by MRI evaluation were defined by the size of the imaging pixels. Lesions arrangement in discrete and overlapping patterns confirmed satisfactory alignment of motion trajectories. Conclusions We believe the methods presented here should serve as a standard for evaluating the accuracy of motion of MRgFUS robotic systems.
Collapse
Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | | | | | - Nikolas Evripidou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | | | | | | | | | | | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| |
Collapse
|
11
|
Zhang W, Zhang Y, Liu Y. Design and control of a bionic needle puncture robot. Int J Med Robot 2020; 17:e2200. [PMID: 33150656 DOI: 10.1002/rcs.2200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND The application of minimally invasive interventional breast surgery is becoming more and more widespread. The accurate puncture of breast cancer needs to solve the problems of tissue deformation and target displacement. METHODS In this study, we analysed the process of leech blood absorption and developed a robotic needle insertion method based on bionic technology to improve the accuracy of breast cancer diagnosis and treatment. Among them, the design purpose of the sucker manipulator is to adjust and fix the breast tissue. We use uncalibrated visual servo to control soft tissue deformation. RESULTS We compare the puncture effect of bionic needle puncture robot and common needle puncture on breast prosthesis and in vitro tissue. Experimental data shows that, compared with ordinary needle insertion, the robotic needle insertion method based on bionic technology greatly reduces the targeting error. CONCLUSIONS This method is expected to provide a safe and effective alternative to traditional puncture for breast cancer diagnosis and treatment.
Collapse
Affiliation(s)
- Weixi Zhang
- Intelligent Machinery Research Institute, Harbin University of Science and Technology, Harbin, China
| | - Yongde Zhang
- Intelligent Machinery Research Institute, Harbin University of Science and Technology, Harbin, China
| | - Yunhui Liu
- The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
12
|
Li G, Patel NA, Wang Y, Dumoulin C, Loew W, Loparo O, Schneider K, Sharma K, Cleary K, Fritz J, Iordachita I. Fully Actuated Body-Mounted Robotic System for MRI-Guided Lower Back Pain Injections: Initial Phantom and Cadaver Studies. IEEE Robot Autom Lett 2020; 5:5245-5251. [PMID: 33748414 PMCID: PMC7971162 DOI: 10.1109/lra.2020.3007459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This paper reports the improved design, system integration, and initial experimental evaluation of a fully actuated body-mounted robotic system for real-time MRI-guided lower back pain injections. The 6-DOF robot is composed of a 4-DOF needle alignment module and a 2-DOF remotely actuated needle driver module, which together provide a fully actuated manipulator that can operate inside the scanner bore during imaging. The system minimizes the need to move the patient in and out of the scanner during a procedure, and thus may shorten the procedure time and streamline the clinical workflow. The robot is devised with a compact and lightweight structure that can be attached directly to the patient's lower back via straps. This approach minimizes the effect of patient motion by allowing the robot to move with the patient. The robot is integrated with an image-based surgical planning module. A dedicated clinical workflow is proposed for robot-assisted lower back pain injections under real-time MRI guidance. Targeting accuracy of the system was evaluated with a real-time MRI-guided phantom study, demonstrating the mean absolute errors (MAE) of the tip position to be 1.50±0.68mm and of the needle angle to be 1.56±0.93°. An initial cadaver study was performed to validate the feasibility of the clinical workflow, indicating the maximum error of the position to be less than 1.90mm and of the angle to be less than 3.14°.
Collapse
Affiliation(s)
- Gang Li
- Gang Li, Niravkumar A. Patel, Yanzhou Wang, and Iulian Iordachita are with Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Niravkumar A Patel
- Gang Li, Niravkumar A. Patel, Yanzhou Wang, and Iulian Iordachita are with Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Yanzhou Wang
- Gang Li, Niravkumar A. Patel, Yanzhou Wang, and Iulian Iordachita are with Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Charles Dumoulin
- Charles Dumoulin, Wolfgang Loew, Olivia Loparo, and Katherine Schneider are with Cincinnati Childrens Hospital Medical Center, Cincinnati, OH, USA
| | - Wolfgang Loew
- Charles Dumoulin, Wolfgang Loew, Olivia Loparo, and Katherine Schneider are with Cincinnati Childrens Hospital Medical Center, Cincinnati, OH, USA
| | - Olivia Loparo
- Charles Dumoulin, Wolfgang Loew, Olivia Loparo, and Katherine Schneider are with Cincinnati Childrens Hospital Medical Center, Cincinnati, OH, USA
| | - Katherine Schneider
- Charles Dumoulin, Wolfgang Loew, Olivia Loparo, and Katherine Schneider are with Cincinnati Childrens Hospital Medical Center, Cincinnati, OH, USA
| | - Karun Sharma
- Karun Sharma and Kevin Cleary are with the Sheikh Zayed Institute for Pediatric Surgical Innovation, Childrens National Hospital, Washington, DC, USA
| | - Kevin Cleary
- Karun Sharma and Kevin Cleary are with the Sheikh Zayed Institute for Pediatric Surgical Innovation, Childrens National Hospital, Washington, DC, USA
| | - Jan Fritz
- Jan Fritz is with Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Iulian Iordachita
- Gang Li, Niravkumar A. Patel, Yanzhou Wang, and Iulian Iordachita are with Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
13
|
Lu M, Zhang Y, Du H. Design and control of a novel magnetic resonance imaging-compatible breast intervention robot. INT J ADV ROBOT SYST 2020. [DOI: 10.1177/1729881420927853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Breast cancer is one of the most frequent cancers and a major cause of cancer death in women. In this article, the design and control of a novel magnetic resonance imaging-compatible breast intervention robot are proposed. The dimensions and tolerance of the robot system are considered, and a novel pitching mechanism is designed to achieve a dexterous operation in the limited space. The magnetic resonance imaging compatibility of the robot materials is tested. The nonmagnetic structure and compact Cartesian mechanism of the robot allow it to operate safely in a magnetic resonance imaging scanner. According to the robot’s structure, a kinematics analysis based on a coupled motions model is established. The workspace simulation analysis of the robot proves that it is suitable for the whole breast surgery. To control the needle insertion tasks, the overall control system in the form of “personal computer (PC) + single-chip micyoco (SCM)” is designed. Finally, the motion control experiment is carried out, and the robot positioning error is 0.37 mm, which proves that the breast intervention robot and its control system designed in this article can meet the requirements of breast intervention.
Collapse
Affiliation(s)
- Mingyue Lu
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
- Foshan Baikang Robot Technology Co., Ltd., Foshan, China
| | - Yongde Zhang
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
| | - Haiyan Du
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
| |
Collapse
|
14
|
Li G, Patel NA, Liu W, Wu D, Sharma K, Cleary K, Fritz J, Iordachita I. A Fully Actuated Body-Mounted Robotic Assistant for MRI-Guided Low Back Pain Injection. IEEE INTERNATIONAL CONFERENCE ON ROBOTICS AND AUTOMATION : ICRA : [PROCEEDINGS]. IEEE INTERNATIONAL CONFERENCE ON ROBOTICS AND AUTOMATION 2020; 2020:10.1109/icra40945.2020.9197534. [PMID: 34422445 PMCID: PMC8375549 DOI: 10.1109/icra40945.2020.9197534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
This paper reports the development of a fully actuated body-mounted robotic assistant for MRI-guided low back pain injection. The robot is designed with a 4-DOF needle alignment module and a 2-DOF remotely actuated needle driver module. The 6-DOF fully actuated robot can operate inside the scanner bore during imaging; hence, minimizing the need of moving the patient in or out of the scanner during the procedure, and thus potentially reducing the procedure time and streamlining the workflow. The robot is built with a lightweight and compact structure that can be attached directly to the patient's lower back using straps; therefore, attenuating the effect of patient motion by moving with the patient. The novel remote actuation design of the needle driver module with beaded chain transmission can reduce the weight and profile on the patient, as well as minimize the imaging degradation caused by the actuation electronics. The free space positioning accuracy of the system was evaluated with an optical tracking system, demonstrating the mean absolute errors (MAE) of the tip position to be 0.99±0.46 mm and orientation to be 0.99±0.65°. Qualitative imaging quality evaluation was performed on a human volunteer, revealing minimal visible image degradation that should not affect the procedure. The mounting stability of the system was assessed on a human volunteer, indicating the 3D position variation of target movement with respect to the robot frame to be less than 0.7 mm.
Collapse
Affiliation(s)
- Gang Li
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Niravkumar A Patel
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Weiqiang Liu
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Di Wu
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Karun Sharma
- Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, USA
| | - Kevin Cleary
- Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, USA
| | - Jan Fritz
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Iulian Iordachita
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
15
|
Li G, Patel NA, Hagemeister J, Yan J, Wu D, Sharma K, Cleary K, Iordachita I. Body-mounted robotic assistant for MRI-guided low back pain injection. Int J Comput Assist Radiol Surg 2020; 15:321-331. [PMID: 31625021 PMCID: PMC7027988 DOI: 10.1007/s11548-019-02080-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE This paper presents the development of a body-mounted robotic assistant for magnetic resonance imaging (MRI)-guided low back pain injection. Our goal was to eliminate the radiation exposure of traditional X-ray guided procedures while enabling the exquisite image quality available under MRI. The robot is designed with a compact and lightweight profile that can be mounted directly on the patient's lower back via straps, thus minimizing the effect of patient motion by moving along with the patient. The robot was built with MR-conditional materials and actuated with piezoelectric motors so it can operate inside the MRI scanner bore during imaging and therefore streamline the clinical workflow by utilizing intraoperative MR images. METHODS The robot is designed with a four degrees of freedom parallel mechanism, stacking two identical Cartesian stages, to align the needle under intraoperative MRI-guidance. The system targeting accuracy was first evaluated in free space with an optical tracking system, and further assessed with a phantom study under live MRI-guidance. Qualitative imaging quality evaluation was performed on a human volunteer to assess the image quality degradation caused by the robotic assistant. RESULTS Free space positioning accuracy study demonstrated that the mean error of the tip position to be [Formula: see text] mm and needle angle to be [Formula: see text]. MRI-guided phantom study indicated the mean errors of the target to be [Formula: see text] mm, entry point to be [Formula: see text] mm, and needle angle to be [Formula: see text]. Qualitative imaging quality evaluation validated that the image degradation caused by the robotic assistant in the lumbar spine anatomy is negligible. CONCLUSIONS The study demonstrates that the proposed body-mounted robotic system is able to perform MRI-guided low back injection in a phantom study with sufficient accuracy and with minimal visible image degradation that should not affect the procedure.
Collapse
Affiliation(s)
- Gang Li
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA.
| | - Niravkumar A Patel
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Jan Hagemeister
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Jiawen Yan
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Di Wu
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| | - Karun Sharma
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, USA
| | - Kevin Cleary
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, USA
| | - Iulian Iordachita
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
16
|
Liu W, Yang Z, Jiang S, Feng D, Zhang D. Design and implementation of a new cable-driven robot for MRI-guided breast biopsy. Int J Med Robot 2019; 16:e2063. [PMID: 31830358 DOI: 10.1002/rcs.2063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 11/07/2019] [Accepted: 12/04/2019] [Indexed: 11/05/2022]
Abstract
BACKGROUND Breast cancer is one of the most common cancer diagnosed among US women. Early and accurate diagnosis using breast biopsy techniques is essential in detecting cancer. METHODS In this paper, we present a new cable-driven robot for MRI-guided breast biopsy. A compact three degree-of-freedom (DOF) semi-automated robot driven by ultrasonic motors is designed with non-magnetic materials. Next, a novel insertion trajectory planning algorithm based on the breast holder that we created is proposed and designed, which can help radiologists locate the lesion and calculate the insertion trajectory. To improve the accuracy of insertion, kinematic analysis and accuracy compensation methods are introduced. RESULTS An experimental study based on image recognition and positioning is performed to validate the performance of the new robot. The results show that the mean position accuracy is 0.7 ± 0.04 mm. CONCLUSIONS Application of the new robot can improve breast biopsy accuracy and reduce surgery time.
Collapse
Affiliation(s)
- Wenxuan Liu
- School of Mechanical Engineering, Tianjin University, Tianjin, China
| | - Zhiyong Yang
- School of Mechanical Engineering, Tianjin University, Tianjin, China
| | - Shan Jiang
- School of Mechanical Engineering, Tianjin University, Tianjin, China
| | - Di Feng
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Daguang Zhang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| |
Collapse
|
17
|
Zhao B, Fu Y, Yang Y, Zhang P, Hu Y. Design and control of a MRI-compatible pneumatic needle puncture robot. Comput Assist Surg (Abingdon) 2019; 24:87-93. [PMID: 31448960 DOI: 10.1080/24699322.2019.1649067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Percutaneous needle puncture operation is widely used in the image-guided interventions, including biopsy and ablation. MRI guidance has the advantages of high-resolution soft tissue imaging and thermal monitoring during energy-based ablation. This paper proposes the design of a 5-DOF pneumatic needle puncture robot, with all the cylinders, sensors and structure material MRI-compatible. Also, a hybrid fuzzy-PID controller is designed for the pneumatic driven system to adjust the PID parameters adaptively. The experiment validation result shows that, compared with the traditional fix-parameter PID control, the proposed hybrid fuzzy-PID control has no overshoot, and the settle time/steady state error remains low even with increasing load. This proves that the hybrid fuzzy-PID control strategy can increases the positioning accuracy and robustness of the pneumatic driven needle puncture robot, which is significant for the safety of percutaneous needle puncture operation.
Collapse
Affiliation(s)
- Baoliang Zhao
- Shenzhen Key Laboratory of Minimally Invasive Surgical Robotics and System, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences , Shenzhen , China
| | - Yi Fu
- Department of Mechanical Engineering, Harbin Institute of Technology at Shenzhen , Shenzhen , China
| | - Yuanyuan Yang
- Shenzhen Key Laboratory of Minimally Invasive Surgical Robotics and System, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences , Shenzhen , China
| | - Peng Zhang
- Shenzhen Key Laboratory of Minimally Invasive Surgical Robotics and System, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences , Shenzhen , China
| | - Ying Hu
- Shenzhen Key Laboratory of Minimally Invasive Surgical Robotics and System, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences , Shenzhen , China
| |
Collapse
|
18
|
Kulkarni P, Sikander S, Biswas P, Frawley S, Song SE. Review of Robotic Needle Guide Systems for Percutaneous Intervention. Ann Biomed Eng 2019; 47:2489-2513. [PMID: 31372856 DOI: 10.1007/s10439-019-02319-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/02/2019] [Indexed: 01/24/2023]
Abstract
Numerous research groups in the past have designed and developed robotic needle guide systems that improve the targeting accuracy and precision by either providing a physical guidance for manual insertion or enabling a complete automated intervention. Here we review systems that have been reported in the last 11 years and limited to straight line needle interventions. Most systems fall under the category of image guided systems as they either use magnetic resonance image, computed tomography, ultrasound or a combination of these modalities for real time image feedback of the intervention path being followed. Actuation and control technology along with materials used for construction are the main aspects that differentiate these systems from each other and have been reviewed here. Image compatibility test details and results are also reviewed as they are used to ensure proper functioning of these systems under the respective imaging environments. We have also reviewed needle guide systems which either don't use any image feedback or have not reported any but provide physical guidance. Throughout this paper, we provide a comprehensive review of the technological aspects and trends in the field of robotic, straight line, needle guide intervention systems.
Collapse
Affiliation(s)
- Pankaj Kulkarni
- Department of Mechanical and Aerospace Engineering, University of Central Florida, 12760 Pegasus Dr., ENGR 1, Room 307, Orlando, FL, 32816-2450, USA
| | - Sakura Sikander
- Department of Mechanical and Aerospace Engineering, University of Central Florida, 12760 Pegasus Dr., ENGR 1, Room 307, Orlando, FL, 32816-2450, USA
| | - Pradipta Biswas
- Department of Mechanical and Aerospace Engineering, University of Central Florida, 12760 Pegasus Dr., ENGR 1, Room 307, Orlando, FL, 32816-2450, USA
| | - Shawn Frawley
- Department of Mechanical and Aerospace Engineering, University of Central Florida, 12760 Pegasus Dr., ENGR 1, Room 307, Orlando, FL, 32816-2450, USA
| | - Sang-Eun Song
- Department of Mechanical and Aerospace Engineering, University of Central Florida, 12760 Pegasus Dr., ENGR 1, Room 307, Orlando, FL, 32816-2450, USA.
| |
Collapse
|
19
|
Patel N, Yan J, Monfaredi R, Sharma K, Cleary K, Iordachita I. Preclinical evaluation of an integrated robotic system for magnetic resonance imaging guided shoulder arthrography. J Med Imaging (Bellingham) 2019; 6:025006. [PMID: 31131290 PMCID: PMC6519665 DOI: 10.1117/1.jmi.6.2.025006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/15/2019] [Indexed: 11/14/2022] Open
Abstract
Shoulder arthrography is a diagnostic procedure which involves injecting a contrast agent into the joint space for enhanced visualization of anatomical structures. Typically, a contrast agent is injected under fluoroscopy or computed tomography (CT) guidance, resulting in exposure to ionizing radiation, which should be avoided especially in pediatric patients. The patient then waits for the next available magnetic resonance imaging (MRI) slot for obtaining high-resolution anatomical images for diagnosis, which can result in long procedure times. Performing the contrast agent injection under MRI guidance could overcome both these issues. However, it comes with the challenges of the MRI environment including high magnetic field strength, limited ergonomic patient access, and lack of real-time needle guidance. We present the development of an integrated robotic system to perform shoulder arthrography procedures under intraoperative MRI guidance, eliminating fluoroscopy/CT guidance and patient transportation from the fluoroscopy/CT room to the MRI suite. The average accuracy of the robotic manipulator in benchtop experiments is 0.90 mm and 1.04 deg, whereas the average accuracy of the integrated system in MRI phantom experiments is 1.92 mm and 1.28 deg at the needle tip. Based on the American Society for Testing and Materials (ASTM) tests performed, the system is classified as MR conditional.
Collapse
Affiliation(s)
- Niravkumar Patel
- Johns Hopkins University, Laboratory for Computational Sensing and Robotics, Baltimore, Maryland, United States
| | - Jiawen Yan
- Johns Hopkins University, Laboratory for Computational Sensing and Robotics, Baltimore, Maryland, United States
| | - Reza Monfaredi
- Children’s National Medical Center, Washington, DC, United States
| | - Karun Sharma
- Children’s National Medical Center, Washington, DC, United States
| | - Kevin Cleary
- Children’s National Medical Center, Washington, DC, United States
| | - Iulian Iordachita
- Johns Hopkins University, Laboratory for Computational Sensing and Robotics, Baltimore, Maryland, United States
| |
Collapse
|
20
|
Giannakou M, Yiallouras C, Menikou G, Ioannides C, Damianou C. MRI-guided frameless biopsy robotic system with the inclusion of unfocused ultrasound transducer for brain cancer ablation. Int J Med Robot 2018; 15:e1951. [PMID: 30157310 DOI: 10.1002/rcs.1951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 08/04/2018] [Accepted: 08/06/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND A magnetic resonance image (MRI) guided robotic system dedicated for brain biopsy was developed. The robotic system carries a biopsy needle and a small rectangular unfocused, single element, planar ultrasonic transducer which can be potentially utilized to ablate small and localized brain cancer. MATERIALS AND METHODS The robotic device includes six computer-controlled axes. An agar-based phantom was developed which included an olive that mimics brain target. A rectangular ultrasonic transducer operated at 4 MHz was used. RESULTS The functionality of the robotic system was assessed by means of ultrasound imaging, MRI imaging, and MR thermometry, demonstrating effective targeting. The heating capabilities of the ultrasonic transducer were also evaluated. CONCLUSIONS A functional MRI-guided robotic system was produced which can perform frameless brain biopsy. In the future, if a tumour is proven malignant, the needle can be pulled-out and a small ultrasonic transducer can be inserted to ablate the tumour.
Collapse
Affiliation(s)
- Marinos Giannakou
- Electrical Engineering Department, Cyprus University of Technology, Cyprus
| | | | - Georgios Menikou
- Department of Bioengineering, City University, London, UK.,R&D, MEDSONIC LTD, Limassol, Cyprus
| | | | | |
Collapse
|
21
|
Monfaredi R, Cleary K, Sharma K. MRI Robots for Needle-Based Interventions: Systems and Technology. Ann Biomed Eng 2018; 46:1479-1497. [PMID: 29922958 DOI: 10.1007/s10439-018-2075-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 06/11/2018] [Indexed: 01/13/2023]
Abstract
Magnetic resonance imaging (MRI) provides high-quality soft-tissue images of anatomical structures and radiation free imaging. The research community has focused on establishing new workflows, developing new technology, and creating robotic devices to change an MRI room from a solely diagnostic room to an interventional suite, where diagnosis and intervention can both be done in the same room. Closed bore MRI scanners provide limited access for interventional procedures using intraoperative imaging. MRI robots could improve access and procedure accuracy. Different research groups have focused on different technology aspects and anatomical structures. This paper presents the results of a systematic search of MRI robots for needle-based interventions. We report the most recent advances in the field, present relevant technologies, and discuss possible future advances. This survey shows that robotic-assisted MRI-guided prostate biopsy has received the most interest from the research community to date. Multiple successful clinical experiments have been reported in recent years that show great promise. However, in general the field of MRI robotic systems is still in the early stage. The continued development of these systems, along with partnerships with commercial vendors to bring this technology to market, is encouraged to create new and improved treatment opportunities for future patients.
Collapse
Affiliation(s)
- Reza Monfaredi
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan ave. NW, Washington, DC, 20010, USA.
| | - Kevin Cleary
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan ave. NW, Washington, DC, 20010, USA
| | - Karun Sharma
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan ave. NW, Washington, DC, 20010, USA.,Diagnostic Imaging and Radiology Department, Children's National Health System, 111 Michigan ave. NW, Washington, DC, 20010, USA
| |
Collapse
|
22
|
Busse H, Kahn T, Moche M. Techniques for Interventional MRI Guidance in Closed-Bore Systems. Top Magn Reson Imaging 2018; 27:9-18. [PMID: 29406410 DOI: 10.1097/rmr.0000000000000150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Efficient image guidance is the basis for minimally invasive interventions. In comparison with X-ray, computed tomography (CT), or ultrasound imaging, magnetic resonance imaging (MRI) provides the best soft tissue contrast without ionizing radiation and is therefore predestined for procedural control. But MRI is also characterized by spatial constraints, electromagnetic interactions, long imaging times, and resulting workflow issues. Although many technical requirements have been met over the years-most notably magnetic resonance (MR) compatibility of tools, interventional pulse sequences, and powerful processing hardware and software-there is still a large variety of stand-alone devices and systems for specific procedures only.Stereotactic guidance with the table outside the magnet is common and relies on proper registration of the guiding grids or manipulators to the MR images. Instrument tracking, often by optical sensing, can be added to provide the physicians with proper eye-hand coordination during their navigated approach. Only in very short wide-bore systems, needles can be advanced at the extended arm under near real-time imaging. In standard magnets, control and workflow may be improved by remote operation using robotic or manual driving elements.This work highlights a number of devices and techniques for different interventional settings with a focus on percutaneous, interstitial procedures in different organ regions. The goal is to identify technical and procedural elements that might be relevant for interventional guidance in a broader context, independent of the clinical application given here. Key challenges remain the seamless integration into the interventional workflow, safe clinical translation, and proper cost effectiveness.
Collapse
Affiliation(s)
- Harald Busse
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
| | | | | |
Collapse
|
23
|
Navarro-Alarcon D, Singh S, Zhang T, Chung HL, Ng KW, Chow MK, Liu Y. Developing a Compact Robotic Needle Driver for MRI-Guided Breast Biopsy in Tight Environments. IEEE Robot Autom Lett 2017. [DOI: 10.1109/lra.2017.2678542] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|