A magnetic resonance image-guided breast needle intervention robot system: overview and design considerations

Robotics in Screening, Diagnosis and Treatment of Breast Cancer: A Perspective View

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.

An integrated navigation system based on a dedicated breast support device for MRI-guided breast biopsy

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.

Design and control of a novel magnetic resonance imaging-compatible breast intervention robot

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.

Recent Progress for the Techniques of MRI-Guided Breast Interventions and their applications on Surgical Strategy

With a high sensitivity of breast lesions, MRI can detect suspicious lesions which are occult in traditional breast examination equipment. However, the lower and variable specificity of MRI makes the MRI-guided intervention, including biopsies and localizations, necessary before surgery, especially for patients who need the treatment of breast-conserving surgery (BCS). MRI techniques and patient preparation should be first carefully considered before the intervention to avoid lengthening the procedure time and compromising targeting accuracy. Doctors and radiologists need to reconfirm the target of the lesion and be very familiar with the process approach and equipment techniques involving the computer-aided diagnosis (CAD) tools and the biopsy system and follow a correct way. The basic steps of MRI-guided biopsy and localization are nearly the same regardless of the vendor or platform, and this article systematically introduces detailed methods and techniques of MRI-guided intervention. The two interventions both face different challenging situations during procedures with solutions given in the article. Post-operative statistics show that the complications of MRI-guided intervention are infrequent and mild, and MRI-guided biopsy provides the pathological information for the subsequent surgical decisions and MRI-guided localization fully prepared for follow-up surgical biopsy. New techniques for MRI-guided intervention are also elaborated in the article, which leads to future development. In a word, MRI-guided intervention is a safe, accurate, and effective technique with a low complication rate and successful MRI-guided intervention is truly teamwork with efforts from patients to surgeons, radiologists, MRI technologists, and nurses.

Review of Robotic Needle Guide Systems for Percutaneous Intervention

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.

MRI Robots for Needle-Based Interventions: Systems and Technology

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.