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McDonald-Bowyer A, Dietsch S, Dimitrakakis E, Coote JM, Lindenroth L, Stoyanov D, Stilli A. Organ curvature sensing using pneumatically attachable flexible rails in robotic-assisted laparoscopic surgery. Front Robot AI 2023; 9:1099275. [PMID: 36686214 PMCID: PMC9849801 DOI: 10.3389/frobt.2022.1099275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
In robotic-assisted partial nephrectomy, surgeons remove a part of a kidney often due to the presence of a mass. A drop-in ultrasound probe paired to a surgical robot is deployed to execute multiple swipes over the kidney surface to localise the mass and define the margins of resection. This sub-task is challenging and must be performed by a highly-skilled surgeon. Automating this sub-task may reduce cognitive load for the surgeon and improve patient outcomes. The eventual goal of this work is to autonomously move the ultrasound probe on the surface of the kidney taking advantage of the use of the Pneumatically Attachable Flexible (PAF) rail system, a soft robotic device used for organ scanning and repositioning. First, we integrate a shape-sensing optical fibre into the PAF rail system to evaluate the curvature of target organs in robotic-assisted laparoscopic surgery. Then, we investigate the impact of the PAF rail's material stiffness on the curvature sensing accuracy, considering that soft targets are present in the surgical field. We found overall curvature sensing accuracy to be between 1.44% and 7.27% over the range of curvatures present in adult kidneys. Finally, we use shape sensing to plan the trajectory of the da Vinci surgical robot paired with a drop-in ultrasound probe and autonomously generate an Ultrasound scan of a kidney phantom.
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Affiliation(s)
- A. McDonald-Bowyer
- Welcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - S. Dietsch
- Welcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - E. Dimitrakakis
- Welcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - J. M. Coote
- Welcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - L. Lindenroth
- Department of Surgical & Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - D. Stoyanov
- Welcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - A. Stilli
- Welcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
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A survey of catheter tracking concepts and methodologies. Med Image Anal 2022; 82:102584. [DOI: 10.1016/j.media.2022.102584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/01/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022]
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Bertsche D, Rasche V, Rottbauer W, Vernikouskaya I. 3D localization from 2D X-ray projection. Int J Comput Assist Radiol Surg 2022; 17:1553-1558. [PMID: 35819654 PMCID: PMC9463320 DOI: 10.1007/s11548-022-02709-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 06/21/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Most cardiology procedures are guided using X-ray (XR) fluoroscopy. However, the projective nature of the XR fluoroscopy does not allow for true depth perception as required for safe and efficient intervention guidance in structural heart diseases. For improving guidance, different methods have been proposed often being radiation-intensive, time-consuming, or expensive. We propose a simple 3D localization method based on a single monoplane XR projection using a co-registered centerline model. METHODS The method is based on 3D anatomic surface models and corresponding centerlines generated from preprocedural imaging. After initial co-registration, 2D working points identified in monoplane XR projections are localized in 3D by minimizing the angle between the projection lines of the centerline points and the working points. The accuracy and reliability of the located 3D positions were assessed in 3D using phantom data and in patient data projected to 2D obtained during placement of embolic protection system in interventional procedures. RESULTS With the proposed methods, 2D working points identified in monoplane XR could be successfully located in the 3D phantom and in the patient-specific 3D anatomy. Accuracy in the phantom (3D) resulted in 1.6 mm (± 0.8 mm) on average, and 2.7 mm (± 1.3 mm) on average in the patient data (2D). CONCLUSION The use of co-registered centerline models allows reliable and accurate 3D localization of devices from a single monoplane XR projection during placement of the embolic protection system in TAVR. The extension to different vascular interventions and combination with automatic methods for device detection and registration might be promising.
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Affiliation(s)
- Dagmar Bertsche
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Volker Rasche
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Wolfgang Rottbauer
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Ina Vernikouskaya
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
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Wilby S, Palmer A, Polak W, Bucchi A. A review of brachytherapy physical phantoms developed over the last 20 years: clinical purpose and future requirements. J Contemp Brachytherapy 2021; 13:101-115. [PMID: 34025743 PMCID: PMC8117707 DOI: 10.5114/jcb.2021.103593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/13/2020] [Indexed: 12/04/2022] Open
Abstract
Within the brachytherapy community, many phantoms are constructed in-house, and less commercial development is observed as compared to the field of external beam. Computational or virtual phantom design has seen considerable growth; however, physical phantoms are beneficial for brachytherapy, in which quality is dependent on physical processes, such as accuracy of source placement. Focusing on the design of physical phantoms, this review paper presents a summary of brachytherapy specific phantoms in published journal articles over the last twenty years (January 1, 2000 - December 31, 2019). The papers were analyzed and tabulated by their primary clinical purpose, which was deduced from their associated publications. A substantial body of work has been published on phantom designs from the brachytherapy community, but a standardized method of reporting technical aspects of the phantoms is lacking. In-house phantom development demonstrates an increasing interest in magnetic resonance (MR) tissue mimicking materials, which is not yet reflected in commercial phantoms available for brachytherapy. The evaluation of phantom design provides insight into the way, in which brachytherapy practice has changed over time, and demonstrates the customised and broad nature of treatments offered.
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Affiliation(s)
- Sarah Wilby
- Department of Radiotherapy Physics, Clinical Hematology, and Oncology Centre, Portsmouth Hospitals NHS Trust, Cosham, Portsmouth, United Kingdom
- Department of Mechanical Engineering, Faculty of Technology University of Portsmouth, Portsmouth, United Kingdom
| | - Antony Palmer
- Department of Radiotherapy Physics, Clinical Hematology, and Oncology Centre, Portsmouth Hospitals NHS Trust, Cosham, Portsmouth, United Kingdom
- Department of Mechanical Engineering, Faculty of Technology University of Portsmouth, Portsmouth, United Kingdom
| | - Wojciech Polak
- Department of Radiotherapy Physics, Clinical Hematology, and Oncology Centre, Portsmouth Hospitals NHS Trust, Cosham, Portsmouth, United Kingdom
- Department of Mechanical Engineering, Faculty of Technology University of Portsmouth, Portsmouth, United Kingdom
| | - Andrea Bucchi
- Department of Mechanical Engineering, Faculty of Technology University of Portsmouth, Portsmouth, United Kingdom
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Martell K, Law C, Hasan Y, Taggar A, Barnes E, Ravi A, Leung E. Using infrared depth-sensing technology to improve the brachytherapy operating room experience. Brachytherapy 2020; 19:323-327. [PMID: 32220519 DOI: 10.1016/j.brachy.2020.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to discuss the merits of using depth-sensing infrared camera technology in the brachytherapy operating room during interstitial brachytherapy for gynecologic malignancies. MATERIALS AND METHODS The infrared depth-sensing camera from a Microsoft Kinect that had been adapted for surgical use was introduced into a high-volume interstitial brachytherapy operating room. Brachytherapists then used the touchless, gestural interface to review preoperative MRI in real time to guide needle insertion. RESULTS The interface was used for 10 consecutive procedures by 4 separate brachytherapists. The initial training and adjustment to the technology was variable among brachytherapists. All brachytherapists found the controls intuitive and were able to successfully navigate MRI on the system after 1, 30, 30, and 45 min. Qualitatively, brachytherapists found the system helpful for interpretation of intraoperative ultrasound imaging. Furthermore, it ensured adequate needle positioning and deposition was maintained for large tumors. Surgeons involved in its use agreed on potential for considerable benefit when performing interstitial brachytherapy. CONCLUSIONS Adapting this technology for use in the brachytherapy suite provided a higher level of comfort with interstitial catheter placement. This novel tool or similar technology might be considered within other brachytherapy suites.
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Affiliation(s)
- Kevin Martell
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario; Department of Oncology, University of Calgary, Calgary, Alberta; Tom Baker Cancer Centre, Calgary, Alberta
| | - Calvin Law
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Yaser Hasan
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Amandeep Taggar
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Elizabeth Barnes
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Ananth Ravi
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Eric Leung
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario.
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Dynamic Modulated Brachytherapy (DMBT) Balloon Applicator for Accelerated Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2019; 104:953-961. [PMID: 30910767 DOI: 10.1016/j.ijrobp.2019.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/07/2019] [Accepted: 03/17/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To propose a novel high-dose-rate brachytherapy applicator for balloon-based dynamic modulated brachytherapy (DMBT) for accelerated partial breast irradiation (APBI) and to demonstrate its dosimetric advantage compared to the widely used Contura applicator. METHODS AND MATERIALS The DMBT balloon device consists of a fixed central channel enabling real-time, in vivo dosimetry and an outer motion-dynamic, adjustable-radius channel capable of moving to any angular position within the balloon. This design allows placement of dwell positions anywhere within the balloon volume, guaranteeing optimal placement and generation of the applicator and treatment plan, respectively. Thirteen clinical treatment plans for patients with early-stage breast cancer receiving APBI after lumpectomy using Contura were retrospectively obtained under institutional review board approval. New treatment plans were created by replacing the Contura with the DMBT device. DMBT plans were limited to 4 angular positions and an outer channel radius of 1.5 cm. The new plans were optimized to limit dose to ribs and skin while maintaining target coverage similar to that of the clinical plan. RESULTS Similar target coverage was obtained for the DMBT plans compared with clinical Contura plans. Across all patients the mean (standard deviation) reductions in D0.1 cc to the ribs and skin were 6.70% (6.28%) and 5.13% (6.54%), respectively. A threshold separation distance between the balloon surface and the organ at risk (OAR), below which dosimetric changes of greater than 5% were obtained, was observed to be 12 mm for ribs and skin. When both OARs were far from the balloon, DMBT plans were of similar quality to Contura plans, as expected. CONCLUSIONS This study demonstrates the superior ability of the APBI DMBT applicator to spare OARs while achieving target coverage comparable to current treatment plans, especially when in close proximity. The DMBT balloon may enable new modes of dynamic high-dose-rate treatment delivery and allow for ultrahypofractionated dose regimens to be safely used.
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Lugez E, Sadjadi H, Joshi CP, Hashtrudi-Zaad K, Akl SG, Fichtinger G. Field distortion compensation for electromagnetic tracking of ultrasound probes with application in high-dose-rate prostate brachytherapy. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab12b6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Esposito M, Hennersperger C, Gobl R, Demaret L, Storath M, Navab N, Baust M, Weinmann A. Total Variation Regularization of Pose Signals with an Application to 3D Freehand Ultrasound. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:2245-2258. [PMID: 30762538 DOI: 10.1109/tmi.2019.2898480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Three-dimensional freehand imaging techniques are gaining wider adoption due to their ?exibility and cost ef?ciency. Typical examples for such a combination of a tracking system with an imaging device are freehand SPECT or freehand 3D ultrasound. However, the quality of the resulting image data is heavily dependent on the skill of the human operator and on the level of noise of the tracking data. The latter aspect can introduce blur or strong artifacts, which can signi?cantly hamper the interpretation of image data. Unfortunately, the most commonly used tracking systems to date, i.e. optical and electromagnetic, present a trade-off between invading the surgeon's workspace (due to line-of-sight requirements) and higher levels of noise and sensitivity due to the interference of surrounding metallic objects. In this work, we propose a novel approach for total variation regularization of data from tracking systems (which we term pose signals) based on a variational formulation in the manifold of Euclidean transformations. The performance of the proposed approach was evaluated using synthetic data as well as real ultrasound sweeps executed on both a Lego phantom and human anatomy, showing signi?cant improvement in terms of tracking data quality and compounded ultrasound images. Source code can be found at https://github.com/IFL-CAMP/pose_regularization.
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Richart J, Carmona-Meseguer V, García-Martínez T, Herreros A, Otal A, Pellejero S, Tornero-López A, Pérez-Calatayud J. Review of strategies for MRI based reconstruction of endocavitary and interstitial applicators in brachytherapy of cervical cancer. Rep Pract Oncol Radiother 2018; 23:547-561. [PMID: 30534019 PMCID: PMC6277512 DOI: 10.1016/j.rpor.2018.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/04/2018] [Accepted: 06/23/2018] [Indexed: 12/14/2022] Open
Abstract
Brachytherapy plays an essential role in the curative intent management of locally advanced cervical cancer. The introduction of the magnetic resonance (MR) as a preferred image modality and the development of new type of applicators with interstitial components have further improved its benefits. The aim of this work is to review the current status of one important aspect in the cervix cancer brachytherapy procedure, namely catheter reconstruction. MR compatible intracavitary and interstitial applicators are described. Considerations about the use of MR imaging (MRI) regarding appropriate strategies for applicator reconstruction, technical requirements, MR sequences, patient preparation and applicator commissioning are included. It is recommendable to perform the reconstruction process in the same image study employed by the physician for contouring, that is, T2 weighted (T2W) sequences. Nevertheless, a clear identification of the source path inside the catheters and the applicators is a challenge when using exclusively T2W sequences. For the intracavitary component of the implant, sometimes the catheters may be filled with some substance that produces a high intensity signal on MRI. However, this strategy is not feasible for plastic tubes or titanium needles, which, moreover, induce magnetic susceptibility artifacts. In these situations, the use of applicator libraries available in the treatment planning system (TPS) is useful, since they not only include accurate geometrical models of the intracavitary applicators, but also recent developments have made possible the implementation of the interstitial component. Another strategy to improve the reconstruction process is based on the incorporation of MR markers, such as small pellets, to be used as anchor points. Many institutions employ computed tomography (CT) as a supporting image modality. The registration of CT and MR image sets should be carefully performed, and its uncertainty previously assessed. Besides, an important research work is being carried out regarding the use of ultrasound and electromagnetic tracking technologies.
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Affiliation(s)
- José Richart
- Hospital Clínica Benidorm, Medical Physics Department, Alicante, Spain
| | - Vicente Carmona-Meseguer
- Hospital La Fe-IRIMED, Department of Radiation Oncology, Medical Physics Section, Valencia, Spain
| | | | - Antonio Herreros
- Hospital Clínic, Department of Radiation Oncology, Medical Physics Section, Barcelona, Spain
| | - Antonio Otal
- Hospital Arnau de Vilanova, Medical Physics Department, Lleida, Spain
| | - Santiago Pellejero
- Complejo Hospitalario de Navarra, Medical Physics Department, Pamplona, Spain
| | - Ana Tornero-López
- Hospital Dr. Negrín, Medical Physics Department, Las Palmas de Gran Canaria, Spain
| | - José Pérez-Calatayud
- Hospital La Fe-IRIMED, Department of Radiation Oncology, Medical Physics Section, Valencia, Spain
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Real-time microrobot posture recognition via biplane X-ray imaging system for external electromagnetic actuation. Int J Comput Assist Radiol Surg 2018; 13:1843-1852. [DOI: 10.1007/s11548-018-1846-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
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Kallis K, Kreppner S, Lotter M, Fietkau R, Strnad V, Bert C. Introduction of a hybrid treatment delivery system used for quality assurance in multi-catheter interstitial brachytherapy. ACTA ACUST UNITED AC 2018; 63:095008. [DOI: 10.1088/1361-6560/aabb5a] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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