1
|
Antoniou A, Nikolaou A, Evripidou N, Georgiou A, Filippou A, Zinonos V, Giannakou M, Chrysanthou A, Ioannides C, Damianou C. Phantom-based assessment of motion and needle targeting accuracy of robotic devices for magnetic resonance imaging-guided needle biopsy. Int J Med Robot 2023; 19:e2526. [PMID: 37165718 DOI: 10.1002/rcs.2526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND The current study proposes simple methods for assessing the performance of robotic devices intended for Magnetic Resonance Imaging (MRI)-guided needle biopsy. METHODS In-house made agar-based breast phantoms containing biopsy targets served as the main tool in the evaluation process of an MRI compatible positioning device comprising a needle navigator. The motion accuracy of mechanical stages was assessed by calliper measurements. Laboratory evaluation of needle targeting included a repeatability phantom test and a laser-based method. The accuracy and repeatability of needle targeting was also assessed by MRI. RESULTS The maximum error of linear motion for steps up to 10 mm was 0.1 mm. Needle navigation relative to the phantom and alignment with the various biopsy targets were performed successfully in both the laboratory and MRI settings. The proposed biopsy phantoms offered tissue-like signal in MRI and good haptic feedback during needle insertion. CONCLUSIONS The proposed methods could be valuable in the process of validating the accuracy of MRI-guided biopsy robotic devices in both laboratory and real environments.
Collapse
Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Anastasia Nikolaou
- 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
| | - Andreas Georgiou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Antria Filippou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Vasiliki Zinonos
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | | | - Antreas Chrysanthou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Cleanthis Ioannides
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| |
Collapse
|
2
|
Antoniou A, Spanoudes K, Damianou C. Treatment of mammary cancer with focused ultrasound: A pilot study in canine and feline patients. ULTRASONICS 2023; 132:106974. [PMID: 36917874 DOI: 10.1016/j.ultras.2023.106974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/30/2023] [Accepted: 02/27/2023] [Indexed: 05/29/2023]
Abstract
In recent years, veterinary medicine has expanded its practices beyond conventional methods, gradually integrating the Focused Ultrasound (FUS) technology in the care of companion animals like dogs and cats. The current study aimed to examine the feasibility and provide insights into the application of thermal FUS in canine and feline mammary cancer therapy. FUS was delivered by a 2-MHz single-element spherically focused ultrasonic transducer as integrated with an existing robotic positioning device. The functionality of the FUS system and sonication protocol in efficiently and safely ablating live tissue was initially validated in a rabbit thigh model in a laboratory environment. Nine (9) dogs and cats with superficial mammary cancer were recruited through a dedicated campaign according to specific safety criteria. The veterinary patients underwent FUS ablation followed by immediate surgical resection of the entire malignancy. Histopathology examination demonstrated well-defined regions of coagulative necrosis in all treated tumors with no off-target damage. Further study with a larger patient population is needed to confirm the current findings and demonstrate the safety and feasibility of complete FUS ablation of deep-seated tumors.
Collapse
Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus.
| | - Kyriakos Spanoudes
- 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
|
3
|
Cheng K, Li L, Du Y, Wang J, Chen Z, Liu J, Zhang X, Dong L, Shen Y, Yang Z. A systematic review of image-guided, surgical robot-assisted percutaneous puncture: Challenges and benefits. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:8375-8399. [PMID: 37161203 DOI: 10.3934/mbe.2023367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Percutaneous puncture is a common medical procedure that involves accessing an internal organ or tissue through the skin. Image guidance and surgical robots have been increasingly used to assist with percutaneous procedures, but the challenges and benefits of these technologies have not been thoroughly explored. The aims of this systematic review are to furnish an overview of the challenges and benefits of image-guided, surgical robot-assisted percutaneous puncture and to provide evidence on this approach. We searched several electronic databases for studies on image-guided, surgical robot-assisted percutaneous punctures published between January 2018 and December 2022. The final analysis refers to 53 studies in total. The results of this review suggest that image guidance and surgical robots can improve the accuracy and precision of percutaneous procedures, decrease radiation exposure to patients and medical personnel and lower the risk of complications. However, there are many challenges related to the use of these technologies, such as the integration of the robot and operating room, immature robotic perception, and deviation of needle insertion. In conclusion, image-guided, surgical robot-assisted percutaneous puncture offers many potential benefits, but further research is needed to fully understand the challenges and optimize the utilization of these technologies in clinical practice.
Collapse
Affiliation(s)
- Kai Cheng
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Lixia Li
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Yanmin Du
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Jiangtao Wang
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Zhenghua Chen
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Jian Liu
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Xiangsheng Zhang
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Lin Dong
- Center on Frontiers of Computing Studies, Peking University, Beijing 100089, China
| | - Yuanyuan Shen
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Zhenlin Yang
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| |
Collapse
|
4
|
Bex A, Mathon B. Advances, technological innovations, and future prospects in stereotactic brain biopsies. Neurosurg Rev 2022; 46:5. [PMID: 36471144 PMCID: PMC9734929 DOI: 10.1007/s10143-022-01918-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Stereotactic brain biopsy is one of the most frequently performed brain surgeries. This review aimed to expose the latest cutting-edge and updated technologies and innovations available to neurosurgeons to safely perform stereotactic brain biopsy by minimizing the risks of complications and ensuring that the procedure is successful, leading to a histological diagnosis. We also examined methods for improving preoperative, intraoperative, and postoperative workflows. We performed a comprehensive state-of-the-art literature review. Intraoperative histology, fluorescence, and imaging techniques appear as smart tools to improve the diagnostic yield of biopsy. Constant innovations such as optical methods and augmented reality are also being made to increase patient safety. Robotics and integrated imaging techniques provide an enhanced intraoperative workflow. Patients' management algorithms based on early discharge after biopsy optimize the patient's personal experience and make the most efficient possible use of the available hospital resources. Many new trends are emerging, constantly improving patient care and safety, as well as surgical workflow. A parameter that must be considered is the cost-effectiveness of these devices and the possibility of using them on a daily basis. The decision to implement a new instrument in the surgical workflow should also be dependent on the number of procedures per year, the existing stereotactic equipment, and the experience of each center. Research on patients' postbiopsy management is another mandatory approach to enhance the safety profile of stereotactic brain biopsy and patient satisfaction, as well as to reduce healthcare costs.
Collapse
Affiliation(s)
- Alix Bex
- Department of Neurosurgery, CHR Citadelle, Liege, Belgium
| | - Bertrand Mathon
- Department of Neurosurgery, Sorbonne University, APHP, La Pitié-Salpêtrière Hospital, 47-83, Boulevard de L'Hôpital, 75651 Cedex 13, Paris, France.
- ICM, INSERM U 1127, CNRS UMR 7225, UMRS, Paris Brain Institute, Sorbonne University, 1127, Paris, France.
- GRC 23, Brain Machine Interface, APHP, Sorbonne University, Paris, France.
- GRC 33, Robotics and Surgical Innovation, APHP, Sorbonne University, Paris, France.
| |
Collapse
|
5
|
Feasibility of freehand CT and 3-T MR guided brain aspiration biopsies with 18/20-gauge coaxial needles. Jpn J Radiol 2022; 40:740-748. [PMID: 35233651 DOI: 10.1007/s11604-022-01257-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/17/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND PURPOSE An accurate histopathological examination with minimal neuronal damage is essential for optimizing treatment strategies of central nervous system lesions. We investigated the feasibility and safety of CT and 3-tesla (3 T) MR-guided freehand brain aspiration biopsies with 18/20-gauge coaxial needles in performing a single imaging unit. MATERIALS AND METHODS We reviewed CT and 3 T-MR guided freehand aspiration biopsies with 18/20-gauge coaxial needles of 33 patients (11-female and 22-male, mean and median ages: 53 years, min-max 21-79 years) in our tertiary hospital within an 8-year-period were included in this retrospective study. Lesion sizes, diagnostic yield, morbidity, and mortality rates of these biopsies without a scalp incision, surgical burr-hole, or stereotactic-instrumentation/neuro-navigation guidance were assessed. All biopsies were performed with local anesthesia and sedation within a single imaging unit of our radiology department. All free-hand biopsies were done as in-patient procedures and the patients were closely observed after the biopsies. RESULTS The mean diameter of the lesions was 27 mm (median 25; range 15-46 mm). The diagnostic yield of all free-hand brain biopsies was 88% [one inconclusive result (90%) for 3 T-MR; three inconclusive results (87%) for CT]. There was no major hemorrhage or hematoma, no clinical deterioration, or no infection in our patients on early- and late-phase examinations. Postprocedural minor hemorrhage with a ≤ 2 cm diameter was observed in two patients. The morbidity rate of the study population is 6%. There was no procedure-related infection or mortality in the post-procedural 3 weeks. CONCLUSIONS Freehand CT or 3 T-MR guided aspiration biopsy was a safe and feasible method for pathological diagnosis of intracranial lesions. Biopsy workflow was simplified with this technique. It could be considered a valuable alternative for stereotaxic biopsies, especially for centers that do not have stereotaxic equipment or experience.
Collapse
|
6
|
Wagner CR, Phillips T, Roux S, Corrigan JP. Future Directions in Robotic Neurosurgery. Oper Neurosurg (Hagerstown) 2021; 21:173-180. [PMID: 34051701 DOI: 10.1093/ons/opab135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/18/2020] [Indexed: 12/20/2022] Open
Abstract
In this paper, we highlight promising technologies in each phase of a robotic neurosurgery operation, and identify key factors affecting how quickly these technologies will mature into products in the operating room. We focus on specific technology trends in image-guided cranial and spinal procedures, including advances in imaging, machine learning, robotics, and novel interfaces. For each technology, we discuss the required effort to overcome safety or implementation challenges, as well as identifying example regulatory approved products in related fields for comparison. The goal is to provide a roadmap for clinicians as to which robotic and automation technologies are in the developmental pipeline, and which ones are likely to impact their practice sooner, rather than later.
Collapse
Affiliation(s)
| | | | - Serge Roux
- Cambridge Consultants Ltd, Cambridge, UK
| | | |
Collapse
|
7
|
Teng G, Wang Q, Yang H, Qi X, Zhang H, Cui X, Idrees BS, Xiangli W, Wei K, Khan MN. Pathological identification of brain tumors based on the characteristics of molecular fragments generated by laser ablation combined with a spiking neural network. BIOMEDICAL OPTICS EXPRESS 2020; 11:4276-4289. [PMID: 32923042 PMCID: PMC7449739 DOI: 10.1364/boe.397268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/14/2020] [Accepted: 07/07/2020] [Indexed: 05/31/2023]
Abstract
Quick and accurate diagnosis helps shorten intraoperative waiting time and make a correct plan for the brain tumor resection. The common cryostat section method costs more than 10 minutes and the diagnostic accuracy depends on the sliced and frozen process and the experience of the pathologist. We propose the use of molecular fragment spectra (MFS) in laser-induced breakdown spectroscopy (LIBS) to identify different brain tumors. Formation mechanisms of MFS detected from brain tumors could be generalized into 3 categories, for instance, combination, reorganization and break. Four kinds of brain tumors (glioma, meningioma, hemangiopericytoma, and craniopharyngioma) from different patients were used as investigated samples. The spiking neural network (SNN) classifier was proposed to combine with the MFS (MFS-SNN) for the identification of brain tumors. SNN performed better than conventional machine learning methods for the analysis of similar and limited MFS information. With the ratio data type, the identification accuracy achieved 88.62% in 2 seconds.
Collapse
Affiliation(s)
- Geer Teng
- School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
- Key Laboratory of Photonic Information Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China
| | - Qianqian Wang
- School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
- Key Laboratory of Photonic Information Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China
| | - Haifeng Yang
- Department of Neurosurgery, Kunming Sanbo Brain Hospital, Kunming, 650010, China
| | - Xueling Qi
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China
| | - Hongwei Zhang
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China
| | - Xutai Cui
- School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
- Key Laboratory of Photonic Information Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China
| | - Bushra Sana Idrees
- School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
- Key Laboratory of Photonic Information Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China
| | - Wenting Xiangli
- School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
- Key Laboratory of Photonic Information Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China
| | - Kai Wei
- School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
- Key Laboratory of Photonic Information Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China
| | - M. Nouman Khan
- School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
- Key Laboratory of Photonic Information Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China
| |
Collapse
|