1
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Bloemberg J, de Vries M, van Riel LAMJG, de Reijke TM, Sakes A, Breedveld P, van den Dobbelsteen JJ. Therapeutic prostate cancer interventions: a systematic review on pubic arch interference and needle positioning errors. Expert Rev Med Devices 2024; 21:625-641. [PMID: 38946519 DOI: 10.1080/17434440.2024.2374761] [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: 03/26/2024] [Accepted: 06/27/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION This study focuses on the quantification of and current guidelines on the hazards related to needle positioning in prostate cancer treatment: (1) access restrictions to the prostate gland by the pubic arch, so-called Pubic Arch Interference (PAI) and (2) needle positioning errors. Next, we propose solution strategies to mitigate these hazards. METHODS The literature search was executed in the Embase, Medline ALL, Web of Science Core Collection*, and Cochrane Central Register of Controlled Trials databases. RESULTS The literature search resulted in 50 included articles. PAI was reported in patients with various prostate volumes. The level of reported PAI varied between 0 and 22.3 mm, depending on the patient's position and the measuring method. Low-Dose-Rate Brachytherapy induced the largest reported misplacement errors, especially in the cranio-caudal direction (up to 10 mm) and the largest displacement errors were reported for High-Dose-Rate Brachytherapy in the cranio-caudal direction (up to 47 mm), generally increasing over time. CONCLUSIONS Current clinical guidelines related to prostate volume, needle positioning accuracy, and maximum allowable PAI are ambiguous, and compliance in the clinical setting differs between institutions. Solutions, such as steerable needles, assist in mitigating the hazards and potentially allow the physician to proceed with the procedure.This systematic review was performed in accordance with the PRISMA guidelines. The review was registered at Protocols.io (DOI: dx.doi.org/10.17504/protocols.io.6qpvr89eplmk/v1).
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Affiliation(s)
- Jette Bloemberg
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Martijn de Vries
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Luigi A M J G van Riel
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Theo M de Reijke
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Aimée Sakes
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Paul Breedveld
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - John J van den Dobbelsteen
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands
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2
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Jiang W, Gao Y, Wen M, Ye Z, Liang H, Wu D, Dong W. Preliminary evaluation for ultrasound-guided targeted prostate biopsy using a portable surgical robot: Ex vivo results. Int J Med Robot 2023:e2597. [PMID: 37984069 DOI: 10.1002/rcs.2597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/17/2023] [Accepted: 10/26/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Robotic systems are increasingly used to enhance clinical outcomes in prostate intervention. To evaluate the clinical value of the proposed portable robot, the robot-assisted and robot-targeted punctures were validated experimentally. METHOD The robot registration utilising the electromagnetic tracker achieves coordinate transformation from the ultrasound (US) image to the robot. Subsequently, Transrectal ultrasound (TRUS)-guided phantom trials were conducted for robot-assisted, free-hand, and robot-targeted punctures. RESULTS The accuracy of robot registration was 0.95 mm, and the accuracy of robot-assisted, free-hand, and robot-targeted punctures was 2.38 ± 0.64 mm, 3.11 ± 0.72 mm, and 3.29 ± 0.83 mm sequentially. CONCLUSION The registration method has been successfully applied to robot-targeted puncture. Current results indicate that the accuracy of robot-targeted puncture is slightly inferior to that of manual operations. Moreover, in manual operation, robot-assisted puncture improves the accuracy of free-hand puncture. Accuracy superior to 3.5 mm demonstrates the clinical applicability of both robot-assisted and robot-targeted punctures.
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Affiliation(s)
- Wenhe Jiang
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, China
| | - Yongzhuo Gao
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, China
| | - Mingwei Wen
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Zhichao Ye
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huageng Liang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongmei Wu
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, China
| | - Wei Dong
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, China
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3
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Kato M, Higashi S, Sugino Y, Kajiwara S, Tanaka S, Kitano G, Yamashita Y, Ogura Y, Tachibana H, Kojima T, Inoue T. Clinical Efficacy and Openness to New Challenges of Low Dose Rate Brachytherapy for Prostate Cancer. Curr Oncol 2023; 30:9824-9835. [PMID: 37999133 PMCID: PMC10670683 DOI: 10.3390/curroncol30110713] [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: 08/28/2023] [Revised: 10/02/2023] [Accepted: 11/05/2023] [Indexed: 11/25/2023] Open
Abstract
Over a century ago, low-dose-rate (LDR) brachytherapy was introduced to treat prostate cancer (PCa). Since then, it has been widely applied worldwide, including in East Asia. LDR brachytherapy has been performed in 88 institutes in Japan. Beneficial clinical outcomes of LDR brachytherapy for intermediate-to-high-risk PCa have been demonstrated in large clinical trials. These clinical outcomes were achieved through advances in methods, such as urological precise needle puncture and seed placement, and the quantitative decision making regarding radiological parameters by radiation oncologists. The combined use of LDR brachytherapy with other therapeutic modalities, such as external beam radiation and androgen deprivation therapy, for the clinical risk classification of PCa has led to better anticancer treatment efficacy. In this study, we summarized basic LDR brachytherapy findings that should remain unchanged and be passed down in urology departments. We also discussed the applications of LDR brachytherapy for PCa in various clinical settings, including focal and salvage therapies. In addition, we highlighted technologies associated with brachytherapy that are under development.
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Affiliation(s)
- Manabu Kato
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Shinichiro Higashi
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
| | - Yusuke Sugino
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
| | - Shinya Kajiwara
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
| | - Shiori Tanaka
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Goshi Kitano
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | | | - Yuji Ogura
- Kuwana City Medical Center, Urology, Kuwana 511-0061, Japan;
| | - Hiroyuki Tachibana
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Takahiro Kojima
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Takahiro Inoue
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
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Jiang Z, Salcudean SE, Navab N. Robotic ultrasound imaging: State-of-the-art and future perspectives. Med Image Anal 2023; 89:102878. [PMID: 37541100 DOI: 10.1016/j.media.2023.102878] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 04/27/2023] [Accepted: 06/22/2023] [Indexed: 08/06/2023]
Abstract
Ultrasound (US) is one of the most widely used modalities for clinical intervention and diagnosis due to the merits of providing non-invasive, radiation-free, and real-time images. However, free-hand US examinations are highly operator-dependent. Robotic US System (RUSS) aims at overcoming this shortcoming by offering reproducibility, while also aiming at improving dexterity, and intelligent anatomy and disease-aware imaging. In addition to enhancing diagnostic outcomes, RUSS also holds the potential to provide medical interventions for populations suffering from the shortage of experienced sonographers. In this paper, we categorize RUSS as teleoperated or autonomous. Regarding teleoperated RUSS, we summarize their technical developments, and clinical evaluations, respectively. This survey then focuses on the review of recent work on autonomous robotic US imaging. We demonstrate that machine learning and artificial intelligence present the key techniques, which enable intelligent patient and process-specific, motion and deformation-aware robotic image acquisition. We also show that the research on artificial intelligence for autonomous RUSS has directed the research community toward understanding and modeling expert sonographers' semantic reasoning and action. Here, we call this process, the recovery of the "language of sonography". This side result of research on autonomous robotic US acquisitions could be considered as valuable and essential as the progress made in the robotic US examination itself. This article will provide both engineers and clinicians with a comprehensive understanding of RUSS by surveying underlying techniques. Additionally, we present the challenges that the scientific community needs to face in the coming years in order to achieve its ultimate goal of developing intelligent robotic sonographer colleagues. These colleagues are expected to be capable of collaborating with human sonographers in dynamic environments to enhance both diagnostic and intraoperative imaging.
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Affiliation(s)
- Zhongliang Jiang
- Computer Aided Medical Procedures, Technical University of Munich, Munich, Germany.
| | - Septimiu E Salcudean
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Nassir Navab
- Computer Aided Medical Procedures, Technical University of Munich, Munich, Germany; Computer Aided Medical Procedures, Johns Hopkins University, Baltimore, MD, USA
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5
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Design and Experimental Setup of a Robotic Medical Instrument for Brachytherapy in Non-Resectable Liver Tumors. Cancers (Basel) 2022; 14:cancers14235841. [PMID: 36497325 PMCID: PMC9736203 DOI: 10.3390/cancers14235841] [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: 10/18/2022] [Revised: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
This paper presents a study regarding the design and the experimental setup of a medical robotic system for brachytherapy using tribology analysis. The robotic system is composed of a collaborative robotic arm and a multi-needle brachytherapy instrument controlled using a unified control system embedding a haptic device and force-feedback. This work is oriented towards identifying the technical characteristics of the system components to determine the accuracy of the procedure, as well as using different scenarios for needle insertion in ex vivo porcine liver tissue in order to determine the forces required for insertion and extraction of the needle and the friction coefficient that accompanies the previously mentioned forces. Subsequent to the computation of the friction forces, the normal forces and the wear during the needle insertion are determined with the scope of predicting the lifecycle of some components of the medical device.
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6
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Secoli R, Matheson E, Pinzi M, Galvan S, Donder A, Watts T, Riva M, Zani DD, Bello L, Rodriguez y Baena F. Modular robotic platform for precision neurosurgery with a bio-inspired needle: System overview and first in-vivo deployment. PLoS One 2022; 17:e0275686. [PMID: 36260553 PMCID: PMC9581417 DOI: 10.1371/journal.pone.0275686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/22/2022] [Indexed: 11/23/2022] Open
Abstract
Over the past 10 years, minimally invasive surgery (MIS) has shown significant benefits compared to conventional surgical techniques, with reduced trauma, shorter hospital stays, and shorter patient recovery times. In neurosurgical MIS procedures, inserting a straight tool (e.g. catheter) is common practice in applications ranging from biopsy and laser ablation, to drug delivery and fluid evacuation. How to handle tissue deformation, target migration and access to deep-seated anatomical structures remain an open challenge, affecting both the preoperative planning phase and eventual surgical intervention. Here, we present the first neurosurgical platform in the literature, able to deliver an implantable steerable needle for a range of diagnostic and therapeutic applications, with a short-term focus on localised drug delivery. This work presents the system's architecture and first in vivo deployment with an optimised surgical workflow designed for pre-clinical trials with the ovine model, which demonstrate appropriate function and safe implantation.
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Affiliation(s)
- Riccardo Secoli
- The Mechatronics in Medicine Lab, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
- * E-mail:
| | - Eloise Matheson
- The Mechatronics in Medicine Lab, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - Marlene Pinzi
- The Mechatronics in Medicine Lab, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - Stefano Galvan
- The Mechatronics in Medicine Lab, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - Abdulhamit Donder
- The Mechatronics in Medicine Lab, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - Thomas Watts
- The Mechatronics in Medicine Lab, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - Marco Riva
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Humanitas Research Hospital Rozzano, Rozzano, Italy
| | - Davide Danilo Zani
- Department of Veterinary Medicine, Universitá degli Studi di Milano, Lodi, Italy
| | - Lorenzo Bello
- Department of Oncology and Hematology-Oncology, Universitá degli Studi di Milano, Milan, Italy
| | - Ferdinando Rodriguez y Baena
- The Mechatronics in Medicine Lab, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
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7
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Wang L, Zhang Y, Zuo S, Xu Y. A review of the research progress of interventional medical equipment and methods for prostate cancer. Int J Med Robot 2021; 17:e2303. [PMID: 34231317 DOI: 10.1002/rcs.2303] [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: 03/08/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Prostate cancer is a common disease in men and has a relatively high mortality rate. However, the interventional medical equipment used for prostate biopsy and brachytherapy has always been a social concern. METHODS To understand interventional medical equipment for prostate cancer, the structure of manual, semi-automatic and automatic medical equipment were considered as the mainline, while the corresponding research on these structures were the auxiliary lines. The characteristics and corresponding research status have been discussed. RESULTS Interventional medical equipment for prostate cancer with different degrees of automation and its characteristics were determined, and the imaging principles and characteristics of computed tomography, transrectal ultrasound and magnetic resonance imaging have been briefly described. CONCLUSION Certain feasible research suggestions have been proposed for future development from the perspective of structure, accuracy and safety. These include flexible and compact robot structures, high-precision image recognition and guidance, accurate dose planning and monitoring, real-time imaging monitoring without delay, high-precision needle insertion strategy, master-slave control, virtual reality and remote control.
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Affiliation(s)
- Lifeng Wang
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
| | - Yongde Zhang
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
| | - Sihao Zuo
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China.,Foshan Baikang Robot Technology Co., Ltd., Foshan, China
| | - Yong Xu
- Chinese PLA General Hospital, Beijing, China
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8
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Tan H, Rossa C. Electrical Impedance Tomography for Robot-Aided Internal Radiation Therapy. Front Bioeng Biotechnol 2021; 9:698038. [PMID: 34235139 PMCID: PMC8256893 DOI: 10.3389/fbioe.2021.698038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/27/2021] [Indexed: 12/24/2022] Open
Abstract
High dose rate brachytherapy (HDR) is an internal based radiation treatment for prostate cancer. The treatment can deliver radiation to the site of dominant tumor growth within the prostate. Imaging methods to delineate the dominant tumor are imperative to ensure the maximum success of HDR. This paper investigates the feasibility of using electrical impedance tomography (EIT) as the main imaging modality during robot-aided internal radiation therapy. A procedure utilizing brachytherapy needles in order to perform EIT for the purpose of robot-aided prostate cancer imaging is proposed. It is known that cancerous tissue exhibits different conductivity than healthy tissue. Using this information, it is hypothesized that a conductivity map of the tissue can be used to locate and delineate cancerous nodules via EIT. Multiple experiments were conducted using eight brachytherapy needle electrodes. Observations indicate that the imaging procedure is able to observe differences in tissue conductivity in a setting that approximates transperineal HDR and confirm that brachytherapy needles can be used as electrodes for this purpose. The needles can access the tissue at a specific depth that traditional EIT surface electrodes cannot. The results indicate the feasibility of using brachytherapy needles for EIT for the purpose internal radiation therapy.
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Affiliation(s)
- Hao Tan
- Faculty of Engineering and Applied Science, Ontario Tech University, Oshawa, ON, Canada
| | - Carlos Rossa
- Faculty of Engineering and Applied Science, Ontario Tech University, Oshawa, ON, Canada
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9
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Li ADR, Liu Y, Plott J, Chen L, Montgomery JS, Shih A. Multi-Bevel Needle Design Enabling Accurate Insertion in Biopsy for Cancer Diagnosis. IEEE Trans Biomed Eng 2021; 68:1477-1486. [PMID: 33507862 PMCID: PMC8104469 DOI: 10.1109/tbme.2021.3054922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To obtain definitive cancer diagnosis for suspicious lesions, accurate needle deployment and adequate tissue sampling in needle biopsy are essential. However, the single-bevel needles in current biopsy devices often induce deflection during insertion, potentially causing lesion missampling/undersampling and cancer misdiagnosis. This study aims to reveal the biopsy needle design criteria enabling both low deflection and adequate tissue sampling. METHODS A novel model capable of predicting needle deflection and tissue deformation was first established to understand needle-tissue interaction with different needle tip geometries. Experiments of needle deflection and ex-vivo tissue biopsy were conducted for model validation. RESULTS The developed model showed a reasonably good prediction on the correlation of needle tip type vs. the resultant needle deflection and tissue sampling length. A new multi-bevel needle with the tissue separation point below the needle groove face has demonstrated to be an effective design with an 87% reduction in deflection magnitude and equivalently long tissue sampling length compared to the current single-bevel needle. CONCLUSION This study has revealed two critical design criteria for biopsy needles: 1) multiple bevel faces at the needle tip can generate forces to balance bending moments during insertion to enable a low needle deflection and 2) the tissue separation point should be below the needle groove face to ensure long tissue sampling length. SIGNIFICANCE The developed methodologies and findings in this study serve as proof-of-concept and can be utilized to investigate various biopsy procedures to improve cancer diagnostic accuracy as well as other procedures requiring accurate needle insertion.
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10
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Dai X, Zhang Y, Jiang J, Li B. Image-guided robots for low dose rate prostate brachytherapy: Perspectives on safety in design and use. Int J Med Robot 2021; 17:e2239. [PMID: 33689202 DOI: 10.1002/rcs.2239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Image-guided brachytherapy (BT) robots can be used to assist urologists during seed implantation, thereby improving therapeutic effects. However, safety issues must be considered in the design of such robots, including their structure, mechanical movements, function, materials and actuators. Previous reviews focused on image-guided prostate BT robot technology (e.g., imaging and robot navigation technology and robot system introduction); however, this review is the first time that safety issues have been investigated as part of a study on low-dose-rate (LDR) prostate BT robots. METHODS Multiple electronic databases were searched for LDR prostate BT robot articles published during the last 24 years (1996-2020), with a particular focus on two aspects of robots: safety in design and use. RESULTS We retrieved a total of 26 LDR prostate BT robots. BT robots were divided into ultrasound, computed tomography, magnetic resonance imaging and fusion-guided systems. The conditions associated with each system were then analysed to develop a set of requirements for the safety of prostate BT robots. Recommendations are also provided for future BT robot development. CONCLUSIONS The transrectal approach for prostate seed implantation is safer than the traditional transperineal approach. Research into the control of a steerable needle by the urologists and robot, the needle deflection model, and robotic automated needle changing and seed injection equipment should be pursued in a future study.
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Affiliation(s)
- Xuesong Dai
- Robotics & Engineering Research Center, Harbin University of Science and Technology, Harbin, China
| | - Yongde Zhang
- Robotics & Engineering Research Center, Harbin University of Science and Technology, Harbin, China.,Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, China
| | - Jingang Jiang
- Robotics & Engineering Research Center, Harbin University of Science and Technology, Harbin, China.,Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, China
| | - Bing Li
- Robotics & Engineering Research Center, Harbin University of Science and Technology, Harbin, China
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11
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Design and Kinematics of a Comanipulated Robot Dedicated to Prostate Brachytherapy. ROBOTICA 2021. [DOI: 10.1017/s026357472000051x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARYIn brachytherapy, the manual implantation of seeds is not accurate leading to side effects and limiting the use of new procedures. Robotics solutions have to be fully suitable for medical applications especially considering the operating room. This paper investigates a delta robot solution for improving the accuracy of the prostate brachytherapy procedure by proposing a compact and lightweight robot. In addition, the design was thought as a comanipulated robot for a better acceptability and human–machine interaction. The robot kinematics and singularities were determined and the theoretical capability in term of resolution and force feedback was evaluated. A prototype was built in order to experimentally measure the capability of this first prototype.
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12
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Design and Experiment of Assistive Mechanism for Adjustment of Transrectal Ultrasound Probe. Appl Bionics Biomech 2020; 2020:8846073. [PMID: 33123218 PMCID: PMC7584937 DOI: 10.1155/2020/8846073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/09/2020] [Accepted: 10/03/2020] [Indexed: 11/17/2022] Open
Abstract
Transrectal ultrasound prostate biopsy is the most commonly used method for the diagnosis of prostate cancer. During the operation, the doctor needs to manually adjust the ultrasound probe for repeated adjustments, which is difficult to ensure the efficiency, accuracy, and safety of the operation. This paper presents a passive posture adjusting mechanism of transrectal ultrasound probe. The overall mechanism has 7 degrees of freedom, consisting of a position adjustment module, a posture adjustment module, and an ultrasonic probe rotation and feed module. In order to achieve the centering function, the posture adjustment module is designed based on the double parallelogram. Centering performance is verified based on SimMechanics, and remote center point error of physical prototypes is evaluated. The maximum error of the azimuth remote center point motion and the maximum error of the remote center point motion of the ultrasonic probe are 4 mm and 3.4 mm, respectively, which are less than the anus that can withstand 6 mm. Meanwhile, the analysis of measurement error shows that the random error correlation is weak in different directions, the systematic error confidence intervals of azimuth and elevation angle are less than 2.5 mm, and the maximum relative fixed point error and the maximum relative standard error are 14.73% and 14.98%, respectively. The simulation and testing results have shown the effectiveness and reliability of the propose mechanism.
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13
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Zhang Y, Liang D, Sun L, Guo X, Jiang J, Zuo S, Zhang Y. Design and experimental study of a novel 7-DOF manipulator for transrectal ultrasound probe. Sci Prog 2020; 103:36850420970366. [PMID: 33225864 PMCID: PMC10358554 DOI: 10.1177/0036850420970366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Traditional hand-held ultrasound probe has some limitations in prostate biopsy. Improving the localization and accuracy of ultrasound probe will increase the detection rate of prostate cancer while biopsy techniques remain unchanged. This paper designs a manipulator for transrectal ultrasound probe, which assists doctors in performing prostate biopsy and improves the efficiency and accuracy of biopsy procedure. The ultrasound probe manipulator includes a position adjustment module that can lock four joints at the same time. It reduces operating time and improves the stability of the mechanism. We use the attitude adjustment module designed by double parallelogram RCM mechanism, the ultrasound probe can realize centering and prevent its radial motion. The self-weight balance design helps doctors operate ultrasound probe without weight. Using MATLAB to analyze the manipulator, the results show that the workspace of the mechanism can meet the biopsy requirements. And simulate the centering effect of the ultrasound probe when the attitude is adjusted at different feeding distances, the results show that the ultrasound probe is centering stability. Finally, the centering and joint interlocking tests of the physical prototype are completed. In this paper, a 7-DOF manipulator for transrectal ultrasound probe is designed. The mechanism is analyzed for kinematics, workspace analysis, simulation of centering effects, development of a physical prototype and related experimental research. The results show that the surgical demand workspace is located inside the reachable workspace of the mechanism and the joint locking of the manipulator is reliable.
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Affiliation(s)
- Yongde Zhang
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
| | - Dexian Liang
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
| | - Liyi Sun
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
| | - Xiaowei Guo
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
| | - Jingang Jiang
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
| | - Sihao Zuo
- Intelligent Machine Institute, Harbin University of Science and Technology, Harbin, China
- Foshan Baikang Robot Technology Co. Ltd, Foshan, China
| | - Yanhua Zhang
- Departmet of Ultrasound Imaging, The Affiliated Tumour Hospital of Harbin Medical University, Harbin, China
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14
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Needle deflection and tissue sampling length in needle biopsy. J Mech Behav Biomed Mater 2020; 104:103632. [PMID: 32174391 DOI: 10.1016/j.jmbbm.2020.103632] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 10/01/2019] [Accepted: 01/08/2020] [Indexed: 01/07/2023]
Abstract
This study investigates the effect of needle tip geometry on the needle deflection and tissue sampling length in biopsy. Advances in medical imaging have allowed the identification of suspicious cancerous lesions which then require needle biopsy for tissue sampling and subsequent confirmatory pathological analysis. Precise needle insertion and adequate tissue sampling are essential for accurate cancer diagnosis and individualized treatment decisions. However, the single-bevel needles in current hand-held biopsy devices often deflect significantly during needle insertion, causing variance in the targeted and actual locations of the sampled tissue. This variance can lead to inaccurate sampling and false-negative results. There is also a limited understanding of factors affecting the tissue sampling length which is a critical component of accurate cancer diagnosis. This study compares the needle deflection and tissue sampling length between the existing single-bevel and exploratory multi-bevel needle tip geometries. A coupled Eulerian-Lagrangian finite element analysis was applied to understand the needle-tissue interaction during needle insertion. The needle deflection and tissue sampling length were experimentally studied using tissue-mimicking phantoms and ex-vivo tissue, respectively. This study reveals that the tissue separation location at the needle tip affects both needle deflection and tissue sampling length. By varying the tissue separation location and creating a multi-bevel needle tip geometry, the bending moments induced by the insertion forces can be altered to reduce the needle deflection. However, the tissue separation location also affects the tissue contact inside the needle groove, potentially reducing the tissue sampling length. A multi-bevel needle tip geometry with the tissue separation point below the needle groove face may reduce the needle deflection while maintaining a long tissue sampling length. Results from this study can guide needle tip design to enable the precise needle deployment and adequate tissue sampling for the needle biopsy procedures.
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15
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Risk Management for the Reliability of Robotic Assisted Treatment of Non-resectable Liver Tumors. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app10010052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Hepatic cancers represent an important worldwide health issue where surgery alone in most cases is not a feasible therapeutic solution since most tumors are non-resectable. Despite targeted therapies showing positive results in other areas of cancer treatment, in the case of liver tumors, no low-risk delivery methods have been identified. Based on a risk assessment approach, this paper proposes a technical solution in the form of a robotic system capable of achieving a reliable delivery method for targeted treatment, focusing on the patient safety and therapeutic efficiency. The design of the robotic system starts from the definition of the design constraints with respect to the medical protocol. An analytical hierarchy process is used to prioritize the data correlated with the technical characteristics of a new robotic system, aiming to minimize risks associated with the medical procedure. In a four-phase quality function deployment, the technical solution is evaluated with respect to the quality characteristics, functions, subsystems, and components aiming to achieve a safe and reliable system with high therapeutic efficiency. The results lead to the concept of HeRo, a parallel robotic system for the reliable targeted treatment of non-resectable liver tumors.
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16
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JIANG JINGANG, MIN ZHAOWEI, ZHANG YONGDE, GUO XIAOWEI, XU YONG. DESIGN AND PERFORMANCE EVALUATION OF PASSIVE INTERLOCKING POSTURE ADJUSTMENT MECHANISM FOR TRANSRECTAL ULTRASOUND PROBE. J MECH MED BIOL 2019. [DOI: 10.1142/s0219519419400359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In the current prostate biopsy procedure, it is necessary for the doctor to hold the ultrasonic probe during the entire process. This increases the fatigue degree of the doctor, and the motion of the ultrasonic probe is more likely to cause damage to the anus of the patient. A medical device that can assist doctors in prostate scans and biopsy puncture devices was developed. We focused on the passive interlocking transrectal ultrasonic probe posture adjustment mechanism. Based on the posture adjustment mechanism, a passive interlocking transrectal ultrasound probe position and posture adjustment mechanism capable of assisting the doctor in prostate scanning and puncture intervention was designed. The passive interlocking posture adjustment mechanism with a seven-degree-of-freedom (DOF) interlocking mechanism was designed and can meet the requirements of doctors. The physical prototype of the passive interlocking transrectal ultrasonic probe posture adjustment mechanism was developed and commissioned. The locking torque and braking torque of the mechanism were measured. The results showed that the ultrasonic probe can achieve reliable locking and effectively meet the operation requirements.
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Affiliation(s)
- JINGANG JIANG
- Robotics & its Engineering Research Center, Harbin University of Science and Technology Harbin 150080, P. R. China
- Intelligent Machine Institute, Harbin University of Science and Technology Harbin 150080, P. R. China
| | - ZHAOWEI MIN
- Robotics & its Engineering Research Center, Harbin University of Science and Technology Harbin 150080, P. R. China
| | - YONGDE ZHANG
- Robotics & its Engineering Research Center, Harbin University of Science and Technology Harbin 150080, P. R. China
- Intelligent Machine Institute, Harbin University of Science and Technology Harbin 150080, P. R. China
| | - XIAOWEI GUO
- Robotics & its Engineering Research Center, Harbin University of Science and Technology Harbin 150080, P. R. China
| | - YONG XU
- Urinary Surgery, The General Hospital of Chinese People’s Liberation, Army Beijing 100039, P. R. China
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17
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Antico M, Sasazawa F, Wu L, Jaiprakash A, Roberts J, Crawford R, Pandey AK, Fontanarosa D. Ultrasound guidance in minimally invasive robotic procedures. Med Image Anal 2019; 54:149-167. [DOI: 10.1016/j.media.2019.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/01/2019] [Accepted: 01/09/2019] [Indexed: 12/20/2022]
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18
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Li R, Xu S, Pritchard WF, Karanian JW, Krishnasamy VP, Wood BJ, Tse ZTH. AngleNav: MEMS Tracker to Facilitate CT-Guided Puncture. Ann Biomed Eng 2018; 46:452-463. [PMID: 29305735 DOI: 10.1007/s10439-017-1968-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/21/2017] [Indexed: 12/20/2022]
Abstract
As a low-cost needle navigation system, AngleNav may be used to improve the accuracy, speed, and ease of CT-guided needle punctures. The AngleNav hardware includes a wireless device with a microelectromechanical (MEMS) tracker that can be attached to any standard needle. The physician defines the target, desired needle path and skin entry point on a CT slice image. The accuracy of AngleNav was first tested in a 3D-printed calibration platform in a benchtop setting. An abdominal phantom study was then performed in a CT scanner to validate the accuracy of the device's angular measurement. Finally, an in vivo swine study was performed to guide the needle towards liver targets (n = 8). CT scans of the targets were used to quantify the angular errors and needle tip-to-targeting distance errors between the planned needle path and the final needle position. The MEMS tracker showed a mean angular error of 0.01° with a standard deviation (SD) of 0.62° in the benchtop setting. The abdominal phantom test showed a mean angular error of 0.87° with an SD of 1.19° and a mean tip-to-target distance error of 4.89 mm with an SD of 1.57 mm. The animal experiment resulted in a mean angular error of 6.6° with an SD of 1.9° and a mean tip-to-target distance error of 8.7 mm with an SD of 3.1 mm. These results demonstrated the feasibility of AngleNav for CT-guided interventional workflow. The angular and distance errors were reduced by 64.4 and 54.8% respectively if using AngleNav instead of freehand insertion, with a limited number of operators. AngleNav assisted the physicians to deliver accurate needle insertion during CT-guided intervention. The device could potentially reduce the learning curve for physicians to perform CT-guided needle targeting.
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Affiliation(s)
- Rui Li
- School of Electrical and Computer Engineering, The University of Georgia, Athens, GA, 30602, USA
| | - Sheng Xu
- Center for Interventional Oncology, National Institute of Health, Bethesda, MD, USA
| | - William F Pritchard
- Center for Interventional Oncology, National Institute of Health, Bethesda, MD, USA
| | - John W Karanian
- Center for Interventional Oncology, National Institute of Health, Bethesda, MD, USA
| | | | - Bradford J Wood
- Center for Interventional Oncology, National Institute of Health, Bethesda, MD, USA
| | - Zion Tsz Ho Tse
- School of Electrical and Computer Engineering, The University of Georgia, Athens, GA, 30602, USA. .,3T Technologies, LLC, Marietta, GA, 30067, USA.
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19
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Lehmann T, Sloboda R, Usmani N, Tavakoli M. Human–Machine Collaboration Modalities for Semi-Automated Needle Insertion Into Soft Tissue. IEEE Robot Autom Lett 2018. [DOI: 10.1109/lra.2017.2768123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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20
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Gonenc B, Song DY, Burdette EC, Iordachita I, Kazanzides P. Needle release mechanism enabling multiple insertions with an ultrasound-guided prostate brachytherapy robot. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:4339-4342. [PMID: 29060857 DOI: 10.1109/embc.2017.8037816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We present a robotic system for transrectal ultrasound-guided prostate brachytherapy that employs a quick release mechanism to enable multiple needles to be inserted into the prostate prior to plan optimization. The mechanism consists of two actuated fingers that act as needle guides, thereby allowing insertion of both parallel and angled needles. Path planning, including reordering of needles within a batch, is required to avoid collisions with previously inserted needles. We perform two phantom experiments using clinical implant plans. The extra time required for the robotic motions, including finger actuation, is less than three minutes for the entire procedure. Mean position error is measured to be less than 0.5 mm, presumably due to the design of the needle guides, which have a toroidal shape to enable needle angulation.
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21
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Muradore R, Fiorini P, Akgun G, Barkana DE, Bonfe M, Boriero F, Caprara A, De Rossi G, Dodi R, Elle OJ, Ferraguti F, Gasperotti L, Gassert R, Mathiassen K, Handini D, Lambercy O, Li L, Kruusmaa M, Manurung AO, Meruzzi G, Nguyen HQP, Preda N, Riolfo G, Ristolainen A, Sanna A, Secchi C, Torsello M, Yantac AE. Development of a Cognitive Robotic System for Simple Surgical Tasks. INT J ADV ROBOT SYST 2017. [DOI: 10.5772/60137] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Paolo Fiorini
- Department of Computer Science, University of Verona, Italy
| | - Gokhan Akgun
- Cognitive Science Department, Yeditepe University, Istanbul, Turkey
| | - Duygun Erol Barkana
- Electrical and Electronics Engineering Department, Yeditepe University, Istanbul, Turkey
| | | | | | - Andrea Caprara
- Department of Legal Studies, School of Law, University of Verona, Italy
| | | | - Riccardo Dodi
- e-Services for Life and Health Research Department, Fondazione Centro San Raffaele, Italy
| | - Ole Jakob Elle
- Department of Informatics, University of Oslo, and The Intervention Center, Oslo University Hospital, Oslo, Norway
| | - Federica Ferraguti
- Department of Sciences and Methods for Engineering, University of Modena and Reggio Emilia, Italy
| | | | - Roger Gassert
- Rehabilitation Engineering Lab, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Kim Mathiassen
- Department of Informatics, University of Oslo, and The Intervention Center, Oslo University Hospital, Oslo, Norway
| | - Dilla Handini
- The Intervention Center, Oslo University Hospital, Rikshospitalet, Norway
| | - Olivier Lambercy
- Rehabilitation Engineering Lab, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Lin Li
- Tallinn University of Technology, Faculty of Information Technology, Centre for Biorobotics, Tallinn, Estonia
| | - Maarja Kruusmaa
- Tallinn University of Technology, Faculty of Information Technology, Centre for Biorobotics, Tallinn, Estonia
| | - Auralius Oberman Manurung
- Rehabilitation Engineering Lab, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Giovanni Meruzzi
- Department of Legal Studies, School of Law, University of Verona, Italy
| | | | - Nicola Preda
- Engineering Department, University of Ferrara, Italy
| | - Gianluca Riolfo
- Department of Legal Studies, School of Law, University of Verona, Italy
| | - Asko Ristolainen
- Tallinn University of Technology, Faculty of Information Technology, Centre for Biorobotics, Tallinn, Estonia
| | - Alberto Sanna
- e-Services for Life and Health Research Department, Fondazione Centro San Raffaele, Italy
| | - Cristian Secchi
- Department of Sciences and Methods for Engineering, University of Modena and Reggio Emilia, Italy
| | - Marco Torsello
- Department of Legal Studies, School of Law, University of Verona, Italy
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22
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Minchev G, Kronreif G, Martínez-Moreno M, Dorfer C, Micko A, Mert A, Kiesel B, Widhalm G, Knosp E, Wolfsberger S. A novel miniature robotic guidance device for stereotactic neurosurgical interventions: preliminary experience with the iSYS1 robot. J Neurosurg 2017; 126:985-996. [DOI: 10.3171/2016.1.jns152005] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Robotic devices have recently been introduced in stereotactic neurosurgery in order to overcome the limitations of frame-based and frameless techniques in terms of accuracy and safety. The aim of this study is to evaluate the feasibility and accuracy of the novel, miniature, iSYS1 robotic guidance device in stereotactic neurosurgery.
METHODS
A preclinical phantom trial was conducted to compare the accuracy and duration of needle positioning between the robotic and manual technique in 162 cadaver biopsies. Second, 25 consecutive cases of tumor biopsies and intracranial catheter placements were performed with robotic guidance to evaluate the feasibility, accuracy, and duration of system setup and application in a clinical setting.
RESULTS
The preclinical phantom trial revealed a mean target error of 0.6 mm (range 0.1–0.9 mm) for robotic guidance versus 1.2 mm (range 0.1–2.6 mm) for manual positioning of the biopsy needle (p < 0.001). The mean duration was 2.6 minutes (range 1.3–5.5 minutes) with robotic guidance versus 3.7 minutes (range 2.0–10.5 minutes) with manual positioning (p < 0.001). Clinical application of the iSYS1 robotic guidance device was feasible in all but 1 case. The median real target error was 1.3 mm (range 0.2–2.6 mm) at entry and 0.9 mm (range 0.0–3.1 mm) at the target point. The median setup and instrument positioning times were 11.8 minutes (range 4.2–26.7 minutes) and 4.9 minutes (range 3.1–14.0 minutes), respectively.
CONCLUSIONS
According to the preclinical data, application of the iSYS1 robot can significantly improve accuracy and reduce instrument positioning time. During clinical application, the robot proved its high accuracy, short setup time, and short instrument positioning time, as well as demonstrating a short learning curve.
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Affiliation(s)
- Georgi Minchev
- 1Department of Neurosurgery, Medical University of Vienna, Vienna; and
| | - Gernot Kronreif
- 2Austrian Center of Medical Innovation and Technology, Wiener Neustadt, Austria
| | | | - Christian Dorfer
- 1Department of Neurosurgery, Medical University of Vienna, Vienna; and
| | - Alexander Micko
- 1Department of Neurosurgery, Medical University of Vienna, Vienna; and
| | - Aygül Mert
- 1Department of Neurosurgery, Medical University of Vienna, Vienna; and
| | - Barbara Kiesel
- 1Department of Neurosurgery, Medical University of Vienna, Vienna; and
| | - Georg Widhalm
- 1Department of Neurosurgery, Medical University of Vienna, Vienna; and
| | - Engelbert Knosp
- 1Department of Neurosurgery, Medical University of Vienna, Vienna; and
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23
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Li M, Li G, Gonenc B, Duan X, Iordachita I. Towards human-controlled, real-time shape sensing based flexible needle steering for MRI-guided percutaneous therapies. Int J Med Robot 2016; 13. [PMID: 27487833 DOI: 10.1002/rcs.1762] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 06/05/2016] [Accepted: 06/18/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND Accurate needle placement into soft tissue is essential to percutaneous prostate cancer diagnosis and treatment procedures. METHODS This paper discusses the steering of a 20 gauge (G) FBG-integrated needle with three sets of Fiber Bragg Grating (FBG) sensors. A fourth-order polynomial shape reconstruction method is introduced and compared with previous approaches. To control the needle, a bicycle model based navigation method is developed to provide visual guidance lines for clinicians. A real-time model updating method is proposed for needle steering inside inhomogeneous tissue. A series of experiments were performed to evaluate the proposed needle shape reconstruction, visual guidance and real-time model updating methods. RESULTS Targeting experiments were performed in soft plastic phantoms and in vitro tissues with insertion depths ranging between 90 and 120 mm. Average targeting errors calculated based upon the acquired camera images were 0.40 ± 0.35 mm in homogeneous plastic phantoms, 0.61 ± 0.45 mm in multilayer plastic phantoms and 0.69 ± 0.25 mm in ex vivo tissue. CONCLUSIONS Results endorse the feasibility and accuracy of the needle shape reconstruction and visual guidance methods developed in this work. The approach implemented for the multilayer phantom study could facilitate accurate needle placement efforts in real inhomogeneous tissues. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Meng Li
- School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, China.,Hackerman 200, Johns Hopkins University, Baltimore, MD, USA
| | - Gang Li
- 100 Institute Road, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Berk Gonenc
- Hackerman 200, Johns Hopkins University, Baltimore, MD, USA
| | - Xingguang Duan
- School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, China
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24
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Hungr N, Bricault I, Cinquin P, Fouard C. Design and Validation of a CT- and MRI-Guided Robot for Percutaneous Needle Procedures. IEEE T ROBOT 2016. [DOI: 10.1109/tro.2016.2588884] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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25
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Prostate biopsies assisted by comanipulated probe-holder: first in man. Int J Comput Assist Radiol Surg 2016; 11:1153-61. [PMID: 27072834 DOI: 10.1007/s11548-016-1399-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 03/19/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE A comanipulator for assisting endorectal prostate biopsies is evaluated through a first-in-man clinical trial. This lightweight system, based on conventional robotic components, possesses six degrees of freedom. It uses three electric motors and three brakes. It features a free mode, where its low friction and inertia allow for natural manipulation of the probe and a locked mode, exhibiting both a very low stiffness and a high steady-state precision. METHODS Clinical trials focusing on the free mode and the locked mode of the robot are presented. The objective was to evaluate the practical usability and performance of the robot during clinical procedures. A research protocol for a prospective randomized clinical trial has been designed. Its specific goal was to compare the accuracy of biopsies performed with and without the assistance of the comanipulator. RESULTS The accuracy is compared between biopsies performed with and without the assistance of the comanipulator, across the 10 first patients included in the trial. Results show a statistically significant increase in the precision.
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26
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Waine M, Rossa C, Sloboda R, Usmani N, Tavakoli M. Needle Tracking and Deflection Prediction for Robot-Assisted Needle Insertion Using 2D Ultrasound Images. ACTA ACUST UNITED AC 2016. [DOI: 10.1142/s2424905x16400018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In many types of percutaneous needle insertion surgeries, tissue deformation and needle deflection can create significant difficulties for accurate needle placement. In this paper, we present a method for automatic needle tracking in 2D ultrasound (US) images, which is used in a needle–tissue interaction model to estimate current and future needle tip deflection. This is demonstrated using a semi-automatic needle steering system. The US probe can be controlled to follow the needle tip or it can be stopped at an appropriate position to avoid tissue deformation of the target area. US images are used to fully parameterize the needle-tissue model. Once the needle deflection reaches a pre-determined threshold, the robot rotates the needle to correct the tip’s trajectory. Experimental results show that the final needle tip deflection can be estimated with average accuracies between 0.7[Formula: see text]mm and 1.0[Formula: see text]mm for insertions with and without rotation. The proposed method provides surgeons with improved US feedback of the needle tip deflection and minimizes the motion of the US probe to reduce tissue deformation of the target area.
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Affiliation(s)
- Michael Waine
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, Canada T6G 2V4, Canada
| | - Carlos Rossa
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, Canada T6G 2V4, Canada
| | - Ron Sloboda
- Department of Oncology, University of Alberta, Edmonton, AB, Canada T6G 1Z2, Canada
| | - Nawaid Usmani
- Department of Oncology, University of Alberta, Edmonton, AB, Canada T6G 1Z2, Canada
| | - Mahdi Tavakoli
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, Canada T6G 2V4, Canada
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27
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Maria Joseph FO, Hutapea P, Dicker A, Yu Y, Podder T. Closed loop control of a robot assisted smart flexible needle for percutaneous intervention. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:3663-6. [PMID: 26737087 DOI: 10.1109/embc.2015.7319187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This paper presents the experimental evaluation of a coordinated control system for a robot and robot-driven shape memory alloy (SMA) actuated smart flexible needle capable of following a curved path for percutaneous intervention. The robot driving the needle is considered the outer loop and the non-linear SMA actuated flexible needle system comprises the inner loop. The two feedback control loops are coordinated in such a way that the robot drives the needle while monitoring the needle's actual deflection against a preplanned ideal trajectory, so that the needle tip reaches the target location within an acceptable accuracy. In air and in water experimental results are presented to validate the ability of the proposed coordinated controller to track the overall desired trajectory which includes the combined trajectory of the robot driver and the needle.
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28
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Woo HS, Cho JH, Kim CS, Lee HJ. Master device for teleoperated needle insertion-type interventional robotic system. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:4849-52. [PMID: 26737379 DOI: 10.1109/embc.2015.7319479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This paper proposes a new master device for teleoperated needle insertion-type interventional robotic system. The 5-DOF master device is optimally designed based on the newly defined interventional procedures and the physicians' requirements. It comprises a 2-DOF rotational mechanism for adjustment of needle orientation, a 2-DOF translational mechanism for fine-tuning of needle entry point, and a handle assembly. The handle assembly includes a 1-DOF translational mechanism for needle insertion and buttons for operation mode selection. The passive actuation modules of the rotational mechanism and the active actuation modules of the translational mechanism are controlled appropriately for the selected mode according to the procedure phase. The needle insertion mechanism also warns the user by vibrating the shaft when the needle reaches the dangerous region.
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29
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Design, testing and modelling of a novel robotic system for trans-oesophageal ultrasound. Int J Med Robot 2015; 12:342-54. [DOI: 10.1002/rcs.1691] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/09/2015] [Accepted: 06/18/2015] [Indexed: 11/07/2022]
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30
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Eslami S, Shang W, Li G, Patel N, Fischer GS, Tokuda J, Hata N, Tempany CM, Iordachita I. In-bore prostate transperineal interventions with an MRI-guided parallel manipulator: system development and preliminary evaluation. Int J Med Robot 2015; 12:199-213. [PMID: 26111458 DOI: 10.1002/rcs.1671] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 04/15/2015] [Accepted: 04/22/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND Robot-assisted minimally-invasive surgery is well recognized as a feasible solution for diagnosis and treatment of prostate cancer in humans. METHODS This paper discusses the kinematics of a parallel 4 Degrees-of-Freedom (DOF) surgical manipulator designed for minimally invasive in-bore prostate percutaneous interventions through the patient's perineum. The proposed manipulator takes advantage of four sliders actuated by MRI-compatible piezoelectric motors and incremental rotary encoders. Errors, mostly originating from the design and manufacturing process, need to be identified and reduced before the robot is deployed in clinical trials. RESULTS The manipulator has undergone several experiments to evaluate the repeatability and accuracy (about 1 mm in air (in x or y direction) at the needle's reference point) of needle placement, which is an essential concern in percutaneous prostate interventions. CONCLUSION The acquired results endorse the sustainability, precision and reliability of the manipulator. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Sohrab Eslami
- Laboratory for Computational Sensing and Robotics (LCSR) at the Johns Hopkins University, Baltimore, MD, USA
| | - Weijian Shang
- Automation and Interventional Medicine (AIM) Laboratory in the Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Gang Li
- Automation and Interventional Medicine (AIM) Laboratory in the Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Nirav Patel
- Automation and Interventional Medicine (AIM) Laboratory in the Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Gregory S Fischer
- Automation and Interventional Medicine (AIM) Laboratory in the Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Junichi Tokuda
- Surgical Navigation and Robotics Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Nobuhiko Hata
- Surgical Navigation and Robotics Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Clare M Tempany
- Surgical Navigation and Robotics Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Iulian Iordachita
- Laboratory for Computational Sensing and Robotics (LCSR) at the Johns Hopkins University, Baltimore, MD, USA
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Podder TK, Beaulieu L, Caldwell B, Cormack RA, Crass JB, Dicker AP, Fenster A, Fichtinger G, Meltsner MA, Moerland MA, Nath R, Rivard MJ, Salcudean T, Song DY, Thomadsen BR, Yu Y. AAPM and GEC-ESTRO guidelines for image-guided robotic brachytherapy: report of Task Group 192. Med Phys 2015; 41:101501. [PMID: 25281939 DOI: 10.1118/1.4895013] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In the last decade, there have been significant developments into integration of robots and automation tools with brachytherapy delivery systems. These systems aim to improve the current paradigm by executing higher precision and accuracy in seed placement, improving calculation of optimal seed locations, minimizing surgical trauma, and reducing radiation exposure to medical staff. Most of the applications of this technology have been in the implantation of seeds in patients with early-stage prostate cancer. Nevertheless, the techniques apply to any clinical site where interstitial brachytherapy is appropriate. In consideration of the rapid developments in this area, the American Association of Physicists in Medicine (AAPM) commissioned Task Group 192 to review the state-of-the-art in the field of robotic interstitial brachytherapy. This is a joint Task Group with the Groupe Européen de Curiethérapie-European Society for Radiotherapy & Oncology (GEC-ESTRO). All developed and reported robotic brachytherapy systems were reviewed. Commissioning and quality assurance procedures for the safe and consistent use of these systems are also provided. Manual seed placement techniques with a rigid template have an estimated in vivo accuracy of 3-6 mm. In addition to the placement accuracy, factors such as tissue deformation, needle deviation, and edema may result in a delivered dose distribution that differs from the preimplant or intraoperative plan. However, real-time needle tracking and seed identification for dynamic updating of dosimetry may improve the quality of seed implantation. The AAPM and GEC-ESTRO recommend that robotic systems should demonstrate a spatial accuracy of seed placement ≤1.0 mm in a phantom. This recommendation is based on the current performance of existing robotic brachytherapy systems and propagation of uncertainties. During clinical commissioning, tests should be conducted to ensure that this level of accuracy is achieved. These tests should mimic the real operating procedure as closely as possible. Additional recommendations on robotic brachytherapy systems include display of the operational state; capability of manual override; documented policies for independent check and data verification; intuitive interface displaying the implantation plan and visualization of needle positions and seed locations relative to the target anatomy; needle insertion in a sequential order; robot-clinician and robot-patient interactions robustness, reliability, and safety while delivering the correct dose at the correct site for the correct patient; avoidance of excessive force on radioactive sources; delivery confirmation of the required number or position of seeds; incorporation of a collision avoidance system; system cleaning, decontamination, and sterilization procedures. These recommendations are applicable to end users and manufacturers of robotic brachytherapy systems.
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Affiliation(s)
- Tarun K Podder
- Department of Radiation Oncology, University Hospitals, Case Western Reserve University, Cleveland, Ohio 44122
| | - Luc Beaulieu
- Department of Radiation Oncology, Centre Hospitalier Univ de Quebec, Quebec G1R 2J6, Canada
| | - Barrett Caldwell
- Schools of Industrial Engineering and Aeronautics and Astronautics, Purdue University, West Lafayette, Indiana 47907
| | - Robert A Cormack
- Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts 02115
| | - Jostin B Crass
- Department of Radiation Oncology, Vanderbilt University, Nashville, Tennessee 37232
| | - Adam P Dicker
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107
| | - Aaron Fenster
- Department of Imaging Research, Robarts Research Institute, London, Ontario N6A 5K8, Canada
| | - Gabor Fichtinger
- School of Computer Science, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | | | - Marinus A Moerland
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, 3508 GA, The Netherlands
| | - Ravinder Nath
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06520
| | - Mark J Rivard
- Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts 02111
| | - Tim Salcudean
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - Danny Y Song
- Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Bruce R Thomadsen
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin 53705
| | - Yan Yu
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107
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Pai A, Rogers P, Jones A. The Matador Technique: A technique to improve prostatic brachytherapy seed placement. AFRICAN JOURNAL OF UROLOGY 2015. [DOI: 10.1016/j.afju.2014.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ayvali E, Desai JP. Optical Flow-Based Tracking of Needles and Needle-Tip Localization Using Circular Hough Transform in Ultrasound Images. Ann Biomed Eng 2014; 43:1828-40. [PMID: 25503523 DOI: 10.1007/s10439-014-1208-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 11/29/2014] [Indexed: 11/24/2022]
Abstract
Image-guided interventions have become the standard of care for needle-based procedures. The success of the image-guided procedures depends on the ability to precisely locate and track the needle. This work is primarily focused on 2D ultrasound-based tracking of a hollow needle (cannula) that is composed of straight segments connected by shape memory alloy actuators. An in-plane tracking algorithm based on optical flow was proposed to track the cannula configuration in real-time. Optical flow is a robust tracking algorithm that can easily run on a CPU. However, the algorithm does not perform well when it is applied to the ultrasound images directly due to the intensity variation in the images. The method presented in this work enables using the optical flow algorithm on ultrasound images to track features of the needle. By taking advantage of the bevel tip, Circular Hough transform was used to accurately locate the needle tip when the imaging is out-of-plane. Through experiments inside tissue phantom and ex-vivo experiments in bovine kidney, the success of the proposed tracking methods were demonstrated. Using the methods presented in this work, quantitative information about the needle configuration is obtained in real-time which is crucial for generating control inputs for the needle and automating the needle insertion.
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Affiliation(s)
- Elif Ayvali
- Robotics, Automation and Medical Systems (RAMS) Laboratory, Maryland Robotics Center, Institute for Systems Research, University of Maryland, College Park, MD, USA,
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Kettenbach J, Kronreif G. Robotic systems for percutaneous needle-guided interventions. MINIM INVASIV THER 2014; 24:45-53. [DOI: 10.3109/13645706.2014.977299] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cornelis F, Takaki H, Laskhmanan M, Durack JC, Erinjeri JP, Getrajdman GI, Maybody M, Sofocleous CT, Solomon SB, Srimathveeravalli G. Comparison of CT Fluoroscopy-Guided Manual and CT-Guided Robotic Positioning System for In Vivo Needle Placements in Swine Liver. Cardiovasc Intervent Radiol 2014; 38:1252-60. [PMID: 25376924 DOI: 10.1007/s00270-014-1016-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 09/08/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE To compare CT fluoroscopy-guided manual and CT-guided robotic positioning system (RPS)-assisted needle placement by experienced IR physicians to targets in swine liver. MATERIALS AND METHODS Manual and RPS-assisted needle placement was performed by six experienced IR physicians to four 5 mm fiducial seeds placed in swine liver (n = 6). Placement performance was assessed for placement accuracy, procedure time, number of confirmatory scans, needle manipulations, and procedure radiation dose. Intra-modality difference in performance for each physician was assessed using paired t test. Inter-physician performance variation for each modality was analyzed using Kruskal-Wallis test. RESULTS Paired comparison of manual and RPS-assisted placements to a target by the same physician indicated accuracy outcomes was not statistically different (manual: 4.53 mm; RPS: 4.66 mm; p = 0.41), but manual placement resulted in higher total radiation dose (manual: 1075.77 mGy/cm; RPS: 636.4 mGy/cm; p = 0.03), required more confirmation scans (manual: 6.6; RPS: 1.6; p < 0.0001) and needle manipulations (manual: 4.6; RPS: 0.4; p < 0.0001). Procedure time for RPS was longer than manual placement (manual: 6.12 min; RPS: 9.7 min; p = 0.0003). Comparison of inter-physician performance during manual placement indicated significant differences in the time taken to complete placements (p = 0.008) and number of repositions (p = 0.04) but not in other study measures (p > 0.05). Comparison of inter-physician performance during RPS-assisted placement suggested statistically significant differences in procedure time (p = 0.02) and not in other study measures (p > 0.05). CONCLUSIONS CT-guided RPS-assisted needle placement reduced radiation dose, number of confirmatory scans, and needle manipulations when compared to manual needle placement by experienced IR physicians, with equivalent accuracy.
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Affiliation(s)
- F Cornelis
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.,Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - H Takaki
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - M Laskhmanan
- Perfint Healthcare Inc, Chennai, Tamil Nadu, India
| | - J C Durack
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - J P Erinjeri
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - G I Getrajdman
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - M Maybody
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - C T Sofocleous
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - S B Solomon
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - G Srimathveeravalli
- Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
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Chang WC, Chen CS, Tai HC, Liu CY, Chen YJ. Integration of multidisciplinary technologies for real time target visualization and verification for radiotherapy. Onco Targets Ther 2014; 7:1143-50. [PMID: 25028559 PMCID: PMC4077863 DOI: 10.2147/ott.s64161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The current practice of radiotherapy examines target coverage solely from digitally reconstructed beam's eye view (BEV) in a way that is indirectly accessible and that is not in real time. We aimed to visualize treatment targets in real time from each BEV. The image data of phantom or patients from ultrasound (US) and computed tomography (CT) scans were captured to perform image registration. We integrated US, CT, US/CT image registration, robotic manipulation of US, a radiation treatment planning system, and a linear accelerator to constitute an innovative target visualization system. The performance of this algorithm segmented the target organ in CT images, transformed and reconstructed US images to match each orientation, and generated image registration in real time mode with acceptable accuracy. This image transformation allowed physicians to visualize the CT image-reconstructed target via a US probe outside the BEV that was non-coplanar to the beam's plane. It allowed the physicians to remotely control the US probe that was equipped on a robotic arm to dynamically trace and real time monitor the coverage of the target within the BEV during a simulated beam-on situation. This target visualization system may provide a direct remotely accessible and real time way to visualize, verify, and ensure tumor targeting during radiotherapy.
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Affiliation(s)
- Wen-Chung Chang
- Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Chin-Sheng Chen
- Graduate Institute of Automation Technology, National Taipei University of Technology, Taipei, Taiwan
| | - Hung-Chi Tai
- Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chia-Yuan Liu
- Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan ; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Yu-Jen Chen
- Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan
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Tutkun Şen H, Lediju Bell MA, Iordachita I, Wong J, Kazanzides P. A Cooperatively Controlled Robot for Ultrasound Monitoring of Radiation Therapy. PROCEEDINGS OF THE ... IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS. IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS 2013; 2013:3071-3076. [PMID: 26823988 DOI: 10.1109/iros.2013.6696791] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Image-guided radiation therapy (IGRT) involves two main procedures, performed in different rooms on different days: (1) treatment planning in the simulator room on the first day, and (2) radiotherapy in the linear accelerator room over multiple subsequent days. Both the simulator and the linear accelerator include CT imaging capabilities, which enables both treatment planning and reproducible patient setup, but does not provide good soft tissue contrast or allow monitoring of the target during treatment. We propose a cooperatively-controlled robot to reproducibly position an ultrasound (US) probe on the patient during simulation and treatment, thereby improving soft tissue visualization and allowing real-time monitoring of the target. A key goal of the robotic system is to produce consistent tissue deformations for both CT and US imaging, which simplifies registration of these two modalities. This paper presents the robotic system design and describes a novel control algorithm that employs virtual springs to implement guidance virtual fixtures during "hands on" cooperative control.
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Affiliation(s)
- H Tutkun Şen
- H. Tutkun Şen, Muyinatu A. Lediju Bell and Peter Kazanzides are with the Dept. of Computer Science, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD, USA
| | - Muyinatu A Lediju Bell
- H. Tutkun Şen, Muyinatu A. Lediju Bell and Peter Kazanzides are with the Dept. of Computer Science, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD, USA
| | - Iulian Iordachita
- Iulian Iordachita is with the Dept. of Mechanical Engineering, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD USA
| | - John Wong
- John Wong is with the Dept. of Radiation Oncology, The Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD USA
| | - Peter Kazanzides
- H. Tutkun Şen, Muyinatu A. Lediju Bell and Peter Kazanzides are with the Dept. of Computer Science, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD, USA
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Robot-assisted radiofrequency ablation of primary and secondary liver tumours: early experience. Eur Radiol 2013; 24:79-85. [PMID: 23928933 PMCID: PMC3889281 DOI: 10.1007/s00330-013-2979-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/01/2013] [Accepted: 07/10/2013] [Indexed: 12/19/2022]
Abstract
Objective Computed tomography (CT)-compatible robots, both commercial and research-based, have been developed with the intention of increasing the accuracy of needle placement and potentially improving the outcomes of therapies in addition to reducing clinical staff and patient exposure to radiation during CT fluoroscopy. In the case of highly inaccessible lesions that require multiple plane angulations, robotically assisted needles may improve biopsy access and targeted drug delivery therapy by avoidance of the straight line path of normal linear needles. Methods We report our preliminary experience of performing radiofrequency ablation of the liver using a robotic-assisted CT guidance system on 11 patients (17 lesions). Results/Conclusion Robotic-assisted planning and needle placement appears to have high accuracy, is technically easier than the non-robotic-assisted procedure, and involves a significantly lower radiation dose to both patient and support staff. Key Points • An early experience of robotic-assisted radiofrequency ablation is reported • Robotic-assisted RFA improves accuracy of hepatic lesion targeting • Robotic-assisted RFA makes the procedure technically easier with significant lower radiation dose
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Abstract
Robotic prostatectomy is a common surgical treatment for men with prostate cancer, with some studies estimating that 80% of prostatectomies now performed in the USA are done so robotically. Despite the technical advantages offered by robotic systems, functional and oncological outcomes of prostatectomy can still be improved further. Alternative minimally invasive treatments that have also adopted robotic platforms include brachytherapy and high-intensity focused ultrasonography (HIFU). These techniques require real-time image guidance--such as ultrasonography or MRI--to be truly effective; issues with software compatibility as well as image registration and tracking currently limit such technologies. However, image-guided robotics is a fast-growing area of research that combines the improved ergonomics of robotic systems with the improved visualization of modern imaging modalities. Although the benefits of a real-time image-guided robotic system to improve the precision of surgical interventions are being realized, the clinical usefulness of many of these systems remains to be seen.
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40
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Kobayashi Y, Hamano R, Watanabe H, Hong J, Toyoda K, Hashizume M, Fujie MG. Use of puncture force measurement to investigate the conditions of blood vessel needle insertion. Med Eng Phys 2013; 35:684-9. [DOI: 10.1016/j.medengphy.2012.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 11/13/2012] [Accepted: 12/11/2012] [Indexed: 11/16/2022]
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Jahya A, Herink M, Misra S. A framework for predicting three-dimensional prostate deformation in real time. Int J Med Robot 2013; 9:e52-60. [DOI: 10.1002/rcs.1493] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Alex Jahya
- Institute for Biomedical Technology and Technical Medicine (MIRA); University of Twente; The Netherlands
| | - Mark Herink
- Institute for Biomedical Technology and Technical Medicine (MIRA); University of Twente; The Netherlands
| | - Sarthak Misra
- Institute for Biomedical Technology and Technical Medicine (MIRA); University of Twente; The Netherlands
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Priester AM, Natarajan S, Culjat MO. Robotic ultrasound systems in medicine. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2013; 60:507-523. [PMID: 23475917 DOI: 10.1109/tuffc.2013.2593] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Robots ultrasound (RUS) can be defined as the combination of ultrasound imaging with a robotic system in medical interventions. With their potential for high precision, dexterity, and repeatability, robots are often uniquely suited for ultrasound integration. Although the field is relatively young, it has already generated a multitude of robotic systems for application in dozens of medical procedures. This paper reviews the robotic ultrasound systems that have been developed over the past two decades and describes their potential impact on modern medicine. The RUS projects reviewed include extracorporeal devices, needle guidance systems, and intraoperative systems.
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Affiliation(s)
- Alan M Priester
- Biomedical Engineering Interdepartmental Program and the Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, CA, USA.
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Assaad W, Misra S. Combining ultrasound-based elasticity estimation and FE models to predict 3D target displacement. Med Eng Phys 2012; 35:549-54. [PMID: 23218758 DOI: 10.1016/j.medengphy.2012.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 10/16/2012] [Accepted: 11/04/2012] [Indexed: 11/26/2022]
Abstract
During minimally invasive surgical procedures (e.g., needle insertion during interventional radiological procedures), needle-tissue interactions and physiological processes cause tissue deformation. Target displacement is caused by soft-tissue deformation, which results in misplacement of the surgical tool (needle). This study presents a technique to predict target displacement in three-dimensions (3D) by combining soft-tissue elasticity estimation using an ultrasound-based acoustic radiation force impulse (ARFI) technique and finite element (FE) models. Three different phantoms with targets are manufactured, and subjected to varying loading and boundary conditions. Ultrasound images are acquired using a 3D probe during loading and unloading of each phantom, and subsequently target displacement is calculated. 3D FE models of the phantoms are developed, and they are used to predict target displacement. The maximum absolute error in target displacement between the experiments and FE analyses is found to be 1.39mm. This error is less than the smallest tumor diameter (2.0-3.0mm) which can be detected in breast tissue. This study shows that the combination of soft-tissue elasticity estimation using the ARFI technique and 3D FE models can accurately predict target displacement, and could be used to develop patient-specific plans for surgical interventions.
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Affiliation(s)
- Wissam Assaad
- MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, 7500AE Enschede, The Netherlands
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Hungr N, Baumann M, Long JA, Troccaz J. A 3-D Ultrasound Robotic Prostate Brachytherapy System With Prostate Motion Tracking. IEEE T ROBOT 2012. [DOI: 10.1109/tro.2012.2203051] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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45
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Siauw T, Cunha A, Berenson D, Atamturk A, Hsu IC, Goldberg K, Pouliot J. NPIP: A skew line needle configuration optimization system for HDR brachytherapy. Med Phys 2012; 39:4339-46. [PMID: 22830767 DOI: 10.1118/1.4728226] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE In this study, the authors introduce skew line needle configurations for high dose rate (HDR) brachytherapy and needle planning by integer program (NPIP), a computational method for generating these configurations. NPIP generates needle configurations that are specific to the anatomy of the patient, avoid critical structures near the penile bulb and other healthy structures, and avoid needle collisions inside the body. METHODS NPIP consisted of three major components: a method for generating a set of candidate needles, a needle selection component that chose a candidate needle subset to be inserted, and a dose planner for verifying that the final needle configuration could meet dose objectives. NPIP was used to compute needle configurations for prostate cancer data sets from patients previously treated at our clinic. NPIP took two user-parameters: a number of candidate needles, and needle coverage radius, δ. The candidate needle set consisted of 5000 needles, and a range of δ values was used to compute different needle configurations for each patient. Dose plans were computed for each needle configuration. The number of needles generated and dosimetry were analyzed and compared to the physician implant. RESULTS NPIP computed at least one needle configuration for every patient that met dose objectives, avoided healthy structures and needle collisions, and used as many or fewer needles than standard practice. These needle configurations corresponded to a narrow range of δ values, which could be used as default values if this system is used in practice. The average end-to-end runtime for this implementation of NPIP was 286 s, but there was a wide variation from case to case. CONCLUSIONS The authors have shown that NPIP can automatically generate skew line needle configurations with the aforementioned properties, and that given the correct input parameters, NPIP can generate needle configurations which meet dose objectives and use as many or fewer needles than the current HDR brachytherapy workflow. Combined with robot assisted brachytherapy, this system has the potential to reduce side effects associated with treatment. A physical trial should be done to test the implant feasibility of NPIP needle configurations.
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Affiliation(s)
- Timmy Siauw
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA.
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Ryu B, Bax J, Edirisinge C, Lewis C, Chen J, D’Souza D, Fenster A, Wong E. Prostate Brachytherapy With Oblique Needles to Treat Large Glands and Overcome Pubic Arch Interference. Int J Radiat Oncol Biol Phys 2012; 83:1463-72. [DOI: 10.1016/j.ijrobp.2011.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 09/27/2011] [Accepted: 10/04/2011] [Indexed: 10/14/2022]
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Accuracy and speed of robotic assisted needle interventions using a modern cone beam computed tomography intervention suite: a phantom study. Eur Radiol 2012; 23:198-204. [DOI: 10.1007/s00330-012-2585-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 06/22/2012] [Indexed: 12/18/2022]
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Jahya A, Schouten MG, Fütterer JJ, Misra S. On the importance of modelling organ geometry and boundary conditions for predicting three-dimensional prostate deformation. Comput Methods Biomech Biomed Engin 2012; 17:497-506. [DOI: 10.1080/10255842.2012.694876] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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49
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Enhanced Targeting in Breast Tissue Using a Robotic Tissue Preloading-Based Needle Insertion System. IEEE T ROBOT 2012. [DOI: 10.1109/tro.2012.2183055] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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50
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Kobayashi Y, Hong J, Hamano R, Okada K, Fujie MG, Hashizume M. Development of a needle insertion manipulator for central venous catheterization. Int J Med Robot 2011; 8:34-44. [DOI: 10.1002/rcs.420] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 07/06/2011] [Accepted: 07/07/2011] [Indexed: 11/09/2022]
Affiliation(s)
- Yo Kobayashi
- Faculty of Science and Engineering; Waseda University; Japan
| | - Jaesung Hong
- Department of Robotics Engineering; Daegu Gyeongbuk Institute of Science and Technology (DGIST); Korea
| | - Ryutaro Hamano
- Graduate School of Science and Engineering; Waseda University; Japan
| | - Kaoru Okada
- Graduate School of Science and Engineering; Waseda University; Japan
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