A modular approach to MRI-compatible robotics: using robotic modules with interconnectable 1-DoF Stages

Image-guided prostate biopsy robots: A review

At present, the incidence of prostate cancer (PCa) in men is increasing year by year. So, the early diagnosis of PCa is of great significance. Transrectal ultrasonography (TRUS)-guided biopsy is a common method for diagnosing PCa. The biopsy process is performed manually by urologists but the diagnostic rate is only 20%-30% and its reliability and accuracy can no longer meet clinical needs. The image-guided prostate biopsy robot has the advantages of a high degree of automation, does not rely on the skills and experience of operators, reduces the work intensity and operation time of urologists and so on. Capable of delivering biopsy needles to pre-defined biopsy locations with minimal needle placement errors, it makes up for the shortcomings of traditional free-hand biopsy and improves the reliability and accuracy of biopsy. The integration of medical imaging technology and the robotic system is an important means for accurate tumor location, biopsy puncture path planning and visualization. This paper mainly reviews image-guided prostate biopsy robots. According to the existing literature, guidance modalities are divided into magnetic resonance imaging (MRI), ultrasound (US) and fusion image. First, the robot structure research by different guided methods is the main line and the actuators and material research of these guided modalities is the auxiliary line to introduce and compare. Second, the robot image-guided localization technology is discussed. Finally, the image-guided prostate biopsy robot is summarized and suggestions for future development are provided.

A Method to Improve Mounting Tolerance of Open-Type Optical Linear Encoder

Accuracy becomes progressively important in the wake of development in advanced industrial equipment. A key position sensor to such a quest is the optical linear encoder. Occasionally, inappropriate mounting can cause errors greater than the accuracy grade of the optical linear encoder itself, especially for open-type optical linear encoders, where the mounting distance between the reading head and main scale must be accurately controlled. This paper analyzes the diffraction fields of a traditional scanning reticle made by amplitude grating and a newly designed combined grating; the latter shows a more stable phase in mathematical calculation and simulations. The proposed combined gratings are fabricated in a laboratory and assembled into the reading heads. The experimental results indicate that the mounting tolerance between the reading head and the main scale of the optical linear encoder can be improved.

Challenges regarding MR compatibility of an MRgFUS robotic system

Numerous challenges are faced when employing Magnetic Resonance guided Focused Ultrasound (MRgFUS) hardware in the Magnetic Resonance Imaging (MRI) setting. The current study aimed to provide insights on this topic through a series of experiments performed in the framework of evaluating the MRI compatibility of an MRgFUS robotic device. All experiments were performed in a 1.5 T MRI scanner. The main metric for MRI compatibility assessment was the signal to noise ratio (SNR). Measurements were carried out in a tissue mimicking phantom and freshly excised pork tissue under various activation states of the system. In the effort to minimize magnetic interference and image distortion, various set-up parameters were examined. Significant SNR degradation and image distortion occurred when the FUS transducer was activated mainly owing to FUS-induced target and coil vibrations and was getting worse as the output power was increased. Proper design and stable positioning of the imaged phantom play a critical role in reducing these vibrations. Moreover, isolation of the phantom from the imaging coil was proven essential for avoiding FUS-induced vibrations from being transferred to the coil during sonication and resulted in a more than 3-fold increase in SNR. The use of a multi-channel coil increased the SNR by up to 50 % compared to a single-channel coil. Placement of the electronics outside the coil detection area increased the SNR by about 65 %. A similar SNR improvement was observed when the encoders' counting pulses were deactivated. Overall, this study raises awareness about major challenges regarding operation of an MRgFUS system in the MRI environment and proposes simple measures that could mitigate the impact of noise sources so that the monitoring value of MR imaging in FUS applications is not compromised.

Pressure based MRI-compatible muscle fascicle length and joint angle estimation

BACKGROUND

Functional magnetic resonance imaging (fMRI) provides critical information about the neurophysiology of the central nervous systems (CNS), posing clinical significance for the understanding of neuropathologies and advancement of rehabilitation. Typical fMRI study designs include subjects performing designed motor tasks within specific time frames, in which fMRI data are then analyzed by assuming that observed functional brain activations correspond to the designed tasks. Therefore, developing MRI-compatible sensors that enable real-time monitoring of subjects' task performances would allow for highly accurate fMRI studies. While several MRI-compatible sensors have been developed, none have demonstrated the ability to measure individual muscle fascicle length during fMRI, which could help uncover the complexities of the peripheral and central nervous systems. Furthermore, previous MRI-compatible sensors have been focused on biologically intact populations, limiting accessibility to populations such as those who have undergone amputation.

METHODS

We propose a lightweight, low-cost, skin impedance-insensitive pressure-based muscular motion sensor (pMMS) that provides reliable estimates of muscle fascicle length and joint angle. The muscular motions are captured through measured pressure changes in an air pocket wrapped around the muscle of interest, corresponding to its muscular motion. The muscle fascicle length and joint angle are then estimated from the measured pressure changes based on the proposed muscle-skin-sensor interaction dynamics. Furthermore, we explore an integration method of multiple pMMS systems to expand the sensor capacity of estimating muscle fascicle length and joint angle. Ultrasound imaging paired with joint encoder measurements are utilized to assess pMMS estimation accuracy of muscle fascicle length in the tibialis anterior (TA) and ankle joint angle, respectively, of five biologically intact subjects.

RESULTS

We found that a single pMMS sufficiently provides robust and accurate estimations of TA muscle fascicle length and ankle joint angle during dorsiflexion at various speeds and amplitudes. Further, differential pressure readings from two pMMSs, in which each pMMS were proximally and distally placed, were able to mitigate errors due to perturbations, expanding pMMS capacity for muscle fascicle length and ankle joint angle estimation during the full range of plantar flexion and dorsiflexion.

CONCLUSIONS

Our results from this study demonstrate the feasibility of the pMMS system to further be incorporated in fMRI settings for real-time monitoring of subjects' task performances, allowing sophisticated fMRI study designs.

Review of Robotic Needle Guide Systems for Percutaneous Intervention

Numerous research groups in the past have designed and developed robotic needle guide systems that improve the targeting accuracy and precision by either providing a physical guidance for manual insertion or enabling a complete automated intervention. Here we review systems that have been reported in the last 11 years and limited to straight line needle interventions. Most systems fall under the category of image guided systems as they either use magnetic resonance image, computed tomography, ultrasound or a combination of these modalities for real time image feedback of the intervention path being followed. Actuation and control technology along with materials used for construction are the main aspects that differentiate these systems from each other and have been reviewed here. Image compatibility test details and results are also reviewed as they are used to ensure proper functioning of these systems under the respective imaging environments. We have also reviewed needle guide systems which either don't use any image feedback or have not reported any but provide physical guidance. Throughout this paper, we provide a comprehensive review of the technological aspects and trends in the field of robotic, straight line, needle guide intervention systems.

SpinoBot: An MRI-Guided Needle Positioning System for Spinal Cellular Therapeutics

The neurodegenerative disease amyotrophic lateral sclerosis (ALS) results in the death of motor neurons in voluntary muscles. There are no cures for ALS and few available treatments. In studies with small animal models, injection of cellular therapeutics into the anterior horn of the spinal cord has been shown to inhibit the progression of ALS. It was hypothesized that spinal injection could be made faster and less invasive with the aid of a robot. The robotic system presented-SpinoBot-uses MRI guidance to position a needle for percutaneous injection into the spinal cord. With four degrees of freedom (DOF) provided by two translation stages and two rotational axes, SpinoBot proved capable of advanced targeting with a mean error of 1.12 mm and standard deviation of 0.97 mm in bench tests, and a mean error of 2.2 mm and standard deviation of 0.85 mm in swine cadaver tests. SpinoBot has shown less than 3% signal-to-noise ratio reduction in 3T MR imaging quality, demonstrating its compliance to the MRI environment. With the aid of SpinoBot, the length of the percutaneous injection procedure is reduced to less than 60 min with 10 min for each additional insertion. Although SpinoBot is designed for ALS treatment, it could potentially be used for other procedures that require precise access to the spine.

Design of a Magnetic Resonance-Safe Haptic Wrist Manipulator for Movement Disorder Diagnostics

Tremor, characterized by involuntary and rhythmical movements, is the most common movement disorder. Tremor can have peripheral and central oscillatory components which properly assessed may improve diagnostics. A magnetic resonance (MR)-safe haptic wrist manipulator enables simultaneous measurement of proprioceptive reflexes (peripheral components) and brain activations (central components) through functional magnetic resonance imaging (fMRI). The presented design for an MR-safe haptic wrist manipulator has electrohydraulic closed-circuit actuation, optical position and force sensing, and consists of exclusively nonconductive and magnetically compatible materials inside the MR-environment (Zone IV). The MR-safe hydraulic actuator, a custom-made plastic vane motor, is connected to the magnetic parts and electronics located in the shielded control room (Zone III) via hydraulic hoses and optical fibers. Deliberate internal leakage provides backdriveability, damping, and circumvents friction. The manipulator is completely MR-safe and therefore operates safely in any MR-environment while ensuring fMRI imaging quality. Undesired external leakage in the actuator prevented the use of prepressure, limiting the control bandwidth. The compact end effector design fits in the MR-scanner, is easily setup, and can be clamped to the MR-scanner bed. This enables use of the manipulator with the subject at the optimal fMRI location and allows it to be setup quickly, saving costly MR-scanner time. The actuation and sensor solutions performed well inside the MR-environment and did not deteriorate image quality, which allows for various motor control experiments. Enabling prepressure by carrying out the recommendations on fabrication and sealing should improve the bandwidth and fulfill the requirements for proprioceptive reflex identification.

The Magnetohydrodynamic Effect and its Associated Material Designs for Biomedical Applications: A State-of-the-Art Review

The presented article discusses recent advances in biomedical applications of classical Magnetohydrodynamics (MHD), with a focus on operating principles and associated material considerations. These applications address novel approaches to common biomedical problems from micro-particle sorting for lab-on-a-chip devices to advanced physiological monitoring techniques. 100 papers in the field of MHDs were reviewed with a focus on studies with direct biomedical applications. The body of literature was categorized into three primary areas of research including Material Considerations for MHD Applications, MHD Actuation Devices, and MHD Sensing Techniques. The state of the art in the field was examined and research topics were connected to provide a wide view of the field of biomedical MHDs. As this field develops, the need for advanced simulation and material design will continue to increase in importance in order to further expand its reach to maturity. As the field of biomedical MHDs continues to grow, advances towards micro-scale transitions will continue to be made, maintaining its clinically driven nature and moving towards real-world applications.

Development of an MRI-Compatible, Compact, Rotary-Linear Piezoworm Actuator

A piezoelectric actuator was developed to operate safely deep inside the magnetic resonance imaging (MRI) machine bore. It is based on novel design that produces linear and rotary motion simultaneously increasing the accuracy of medical needle insertion procedures. The actuation method is based on the piezoworm principle, minimizing the actuator size, maximizing output force, and permitting micrometer scale insertion accuracy. Beryllium copper with high stiffness and strength was used in constructing the actuator to minimize image distortion and to achieve the targeted performance. Performance tests were performed by controlling the frequency input and observing the effect on speed, force and torque. The device achieved a linear speed of 5.4 mm/s and a rotary speed of 10.5 rpm.

Intraoperative magnetic resonance imaging–conditional robotic devices for therapy and diagnosis

Magnetic resonance imaging presents high-resolution preoperative scans of target tissue and allows for the availability of intraoperative real-time images without the exposure of patients to ionizing radiation. This has motivated scientists and engineers to integrate medical robotics with the magnetic resonance imaging modality to allow robot-assisted, image-guided diagnosis and therapy. This article provides a review of the state-of-the-art medical robotic systems available for use in conjunction with intraoperative magnetic resonance imaging. The robot functionalities and mechanical designs for a wide range of magnetic resonance imaging interventions are presented, including their magnetic resonance imaging compatibility, actuation, kinematics and the mechanical and electrical designs of the robots. Classification and comparative study of various intraoperative magnetic resonance image guided robotic systems are provided. The robotic systems reviewed are summarized in a table in detail. Current technologies for magnetic resonance imaging–conditional robotics are reviewed and their potential future directions are sketched.

Bra.Di.P.O. and P.I.G.R.O.: Innovative Devices for Motor Learning Programs

Two mechatronics prototypes, useful for robotic neurotreatments and new clinical trainings, are here presented. P.I.G.R.O. (pneumatic interactive gait rehabilitation orthosis) is an active exoskeleton with an electropneumatic control. It imposes movements on lower limbs in order to produce in the patient’s brain proper motor cortex activation. Bra.Di.P.O. (brain discovery pneumatic orthosis) is an MR-compatible device, designed to improve fMRI (functional magnetic resonance imaging) analysis. The two devices are presented together because both are involved in the study of new robotic treatments of patients affected by ictus or brain stroke or in some motor learning experimental investigations carried out on healthy subjects.

Design of an active-passive device for human ankle movement during functional magnetic resonance imaging analysis

Functional magnetic resonance imaging analysis has made major strides in recent years, both because of the development of new scanners and owing to magnetic resonance compatible systems that make it possible to stimulate parts of the human body during analysis. The significant gains in our knowledge of the brain that can thus be achieved justify efforts to construct machines with control circuits suitable for this purpose. This paper presents a magnetic resonance compatible mechatronic device with electropneumatic control that can be used to move one or both feet during functional magnetic resonance imaging analysis of the cerebral motor zones. The system is innovative and original. The results obtained at the end of the investigation were good, and demonstrated that the design is feasible.

Reconfigurable MRI-guided robotic surgical manipulator: prostate brachytherapy and neurosurgery applications

This paper describes a modular design approach for robotic surgical manipulator under magnetic resonance imaging (MRI) guidance. The proposed manipulator provides 2 degree of freedom (DOF) Cartesian motion and 2-DOF pitch and yaw motion. Primarily built up with dielectric materials, it utilizes parallel mechanism and is compact in size to fit into the limited space of close-bore MRI scanner. It is ideal for needle based surgical procedures which usually require positioning and orientation control for accurate imaging plane alignment. Specifically, this mechanism is easily reconfigurable to over constrained manipulator structure which provides 2-DOF Cartesian motion by simple structure modification. This modular manipulator integrated with different end-effector modules is investigated for prostate brachytherapy and neurosurgery applications as preliminary evaluation.

Approaches to creating and controlling motion in MRI

Magnetic Resonance Imaging (MRI) can provide three dimensional (3D) imaging with excellent resolution and sensitivity making it ideal for guiding and monitoring interventions. The development of MRI-compatible interventional devices is complicated by factors including: the high magnetic field strength, the requirement that such devices should not degrade image quality, and the confined physical space of the scanner bore. Numerous MRI guided actuated devices have been developed or are currently being developed utilizing piezoelectric actuators as their primary means of mechanical energy generation to enable better interventional procedure performance. While piezoelectric actuators are highly desirable for MRI guided actuation for their precision, high holding force, and non-magnetic operation they are often found to cause image degradation on a large enough to scale to render live imaging unusable. This paper describes a newly developed piezoelectric actuator driver and control system designed to drive a variety of both harmonic and non-harmonic motors that has been demonstrated to be capable of operating both harmonic and non-harmonic piezoelectric actuators with less than 5% SNR loss under closed loop control. The proposed system device allows for a single controller to control any supported actuator and feedback sensor without any physical hardware changes.

Robotic system for transrectal biopsy of the prostate: real-time guidance under MRI

In this paper, to harness the possibility of real-time guidance of MRI, a robotic system has been developed to perform transrectal prostate biopsy inside a 1.5-T closed bore scanner. A specially developed MR pulse sequence is capable of tracking the needle location in real time while dynamically updating the scan planes to always include the needle and target.

Magnetic resonance elastography: a general overview of its current and future applications in brain imaging

Magnetic resonance elastography (MRE) has been developed over the last few years as a non-invasive means of evaluating the elasticity of biological tissues. The presence of the skull has always prevented semeiotic palpation of the brain, but MRE now offers the possibility of "palpating by imaging" in order to detect brain consistency under physiological and pathological conditions. The aim of this article is to review the current state-of-the-art of MRE imaging and discuss its possible future diagnostic applications in neuroscience.

Magnetic resonance elastography hardware design: A survey

Magnetic resonance elastography (MRE) is an emerging technique capable of measuring the shear modulus of tissue. A suspected tumour can be identified by comparing its properties with those of tissues surrounding it; this can be achieved even in deep-lying areas as long as mechanical excitation is possible. This would allow non-invasive methods for cancer-related diagnosis in areas not accessible with conventional palpation. An actuating mechanism is required to generate the necessary tissue displacements directly on the patient in the scanner and three different approaches, in terms of actuator action and position, exist to derive stiffness measurements. However, the magnetic resonance (MR) environment places considerable constraints on the design of such devices, such as the possibility of mutual interference between electrical components, the scanner field, and radio frequency pulses, and the physical space restrictions of the scanner bore. This paper presents a review of the current solutions that have been developed for MRE devices giving particular consideration to the design criteria including the required vibration frequency and amplitude in different applications, the issue of MR compatibility, actuation principles, design complexity, and scanner synchronization issues. The future challenges in this field are also described.

Applying tactile sensing with piezoelectric materials for minimally invasive surgery and magnetic-resonance-guided interventions

Medical technologies have undergone significant development to overcome the problems inherent in minimally invasive surgery such as inhibited manual dexterity, reduced visual information, and lack of direct touch feedback to make it easier for surgeons to operate. A minimally invasive tool incorporating haptic feedback is being developed to increase the effectiveness of diagnostic procedures by providing force feedback. Magnetic resonance imaging guidance is possible to allow tool localization; however, this engenders the requirement of magnetic resonance compatibility on the device. This paper describes the work done towards developing a sensing device using piezoelectric sensor elements to locate subsurface inclusions in soft substrates, with its magnetic resonance compatibility tested in a 1.5 T scanner. Results show that the position of a hard inclusion can be determined.

A haptic unit designed for magnetic-resonance-guided biopsy

The magnetic fields present in the magnetic resonance (MR) environment impose severe constraints on any mechatronic device present in its midst, requiring alternative actuators, sensors, and materials to those conventionally used in traditional system engineering. In addition the spatial constraints of closed-bore scanners require a physical separation between the radiologist and the imaged region of the patient. This configuration produces a loss of the sense of touch from the target anatomy for the clinician, which often provides useful information. To recover the force feedback from the tissue, an MR-compatible haptic unit, designed to be integrated with a five-degrees-of-freedom mechatronic system for MR-guided prostate biopsy, has been developed which incorporates position control and force feedback to the operator. The haptic unit is designed to be located inside the scanner isocentre with the master console in the control room. MR compatibility of the device has been demonstrated, showing a negligible degradation of the signal-to-noise ratio and virtually no geometric distortion. By combining information from the position encoder and force sensor, tissue stiffness measurement along the needle trajectory is demonstrated in a lamb liver to aid diagnosis of suspected cancerous tissue.