2D array imaging system for mechanically-steered, forward-viewing ultrasound guidewire

Approximately 4 million people with peripheral artery disease (PAD) present with critical limb ischemia each year, requiring urgent revascularization to avoid loss of limb. Minimally-invasive (i.e. endovascular) revascularization is preferable due to increased recovery time and increased risk of complications associated with open surgery. However, 40% of people with PAD also have chronic total occlusions (CTOs), resulting in > 20% of revascularization procedures failing when CTOs are present. A steerable robotic guidewire with integrated forward-viewing imaging capabilities would allow the guidewire to navigate through tortuous vasculature and facilitate crossing CTOs in revascularization procedures that currently fail due to inability to route the guidewire. The robotic steering capabilities of the guidewire can be leveraged for 3D synthetic aperture imaging with a simplified, low element count, forward-viewing 2D array on the tip of the mechanically-steered guidewire. Images can then be formed using a hybrid beamforming approach, with focal delays calculated for each element on the tip of the guidewire and for each physical location to which the robotically-steered guidewire is steered. Unlike synthetic aperture imaging with a steerable guidewire having only a single element transducer, an array with even a small number of elements can allow estimation of blood flow and physiological motion in vivo. A miniature, low element count 2D array transducer with 9 total elements (3 × 3) having total dimensions of 1.5 mm × 1.5 mm was designed to operate at 17 MHz. A proof-of-concept 2D array transducer was fabricated and characterized acoustically. The developed array was then used to image a wire target, a peripheral stent, and an ex vivo porcine iliac artery. Images were formed using the described synthetic aperture beamforming strategy. Acoustic characterization showed a mean resonance frequency of 17.6 MHz and a -6 dB bandwidth of 35%. Lateral and axial resolution were 0.271 mm and 0.122 mm, respectively, and an increase in SNR of 4.8 dB was observed for the 2D array relative to the single element case. The first 2D array imaging system utilizing both mechanical and electronic steering for guidewire-based imaging was developed and demonstrated. A 2D array imaging system operating on the tip of the mechanically-steered guidewire provides improved frame rate and increases field of view relative to a single element transducer. Finally, 2D array and single element imaging were compared for introduced motion errors, with the 2D array providing a 46.1% increase in SNR, and 58.5% and 17.3% improvement in lateral and axial resolution, respectively, relative to single element guidewire imaging.

How AI and Robotics Will Advance Interventional Radiology: Narrative Review and Future Perspectives

The rapid advancement of artificial intelligence (AI) and robotics has led to significant progress in various medical fields including interventional radiology (IR). This review focuses on the research progress and applications of AI and robotics in IR, including deep learning (DL), machine learning (ML), and convolutional neural networks (CNNs) across specialties such as oncology, neurology, and cardiology, aiming to explore potential directions in future interventional treatments. To ensure the breadth and depth of this review, we implemented a systematic literature search strategy, selecting research published within the last five years. We conducted searches in databases such as PubMed and Google Scholar to find relevant literature. Special emphasis was placed on selecting large-scale studies to ensure the comprehensiveness and reliability of the results. This review summarizes the latest research directions and developments, ultimately analyzing their corresponding potential and limitations. It furnishes essential information and insights for researchers, clinicians, and policymakers, potentially propelling advancements and innovations within the domains of AI and IR. Finally, our findings indicate that although AI and robotics technologies are not yet widely applied in clinical settings, they are evolving across multiple aspects and are expected to significantly improve the processes and efficacy of interventional treatments.

Design and hierarchical analysis of magnetic actuated robot: A governing equation based approach

As the alternative solution to the conventional guidewire, the magnetic robot can help interventionists perform percutaneous coronary intervention (PCI) because magnetic fields are transparent and safe for biological tissues. Despite extensive research on magnetic robots, the exploration of their deflection control for practical applications still requires further research. In this paper, a hierarchical analysis framework (HAF) is proposed to control the magnetic robot's deflection. Six deflection subpatterns are analyzed through HAF, incorporating statistical and regression analyses to establish governing equations of magnetic robots. The performance of the control equations is validated through precise control of the magnetic continuum robot (MCR) and magnet-tipped robot (MTR) in both uniform and gradient magnetic fields. Experimental results show that under the uniform magnetic field, the average root mean square error (RMSE) of governing equation of MCR is 0.08±0.05°, 0.41±0.34°, 1.47±0.49° and 1.07±0.66° for four-types horizontal deflection, 0.19±0.07mm and 0.16±0.10mm for two-types vertical deflection, respectively. Based on the governing equations, the MTR is able to precisely navigate to coronary arteries with various degrees of stenosis (30%, 52%, and 60%), and successfully pass through a series of rings, with an average error of 1.05 mm. The research successfully demonstrates the potential of HAF in creating robust and reliable governing equations for magnetic actuation in medical robotics, with significant implications for enhancing the precision and safety of PCI procedures.

Dexterous helical magnetic robot for improved endovascular access

Treating vascular diseases in the brain requires access to the affected region inside the body. This is usually accomplished through a minimally invasive technique that involves the use of long, thin devices, such as wires and tubes, that are manually maneuvered by a clinician within the bloodstream. By pushing, pulling, and twisting, these devices are navigated through the tortuous pathways of the blood vessels. The outcome of the procedure heavily relies on the clinician's skill and the device's ability to navigate to the affected target region in the bloodstream, which is often inhibited by tortuous blood vessels. Sharp turns require high flexibility, but this flexibility inhibits translation of proximal insertion to distal tip advancement. We present a highly dexterous, magnetically steered continuum robot that overcomes pushability limitations through rotation. A helical protrusion on the device's surface engages with the vessel wall and translates rotation to forward motion at every point of contact. An articulating magnetic tip allows for active steerability, enabling navigation from the aortic arch to millimeter-sized arteries of the brain. The effectiveness of the magnetic continuum robot has been demonstrated through successful navigation in models of the human vasculature and in blood vessels of a live pig.

Magnetic Continuum Robot with Intraoperative Magnetic Moment Programming

Magnetic continuum robots (MCRs), which are free of complicated structural designs for transmission, can be miniaturized and are therefore widely used in the medical field. However, the deformation shapes of different segments, including deflection directions and curvatures, are difficult to control simultaneously under an external programmable magnetic field. This is because the latest MCRs have designs with an invariable magnetic moment combination or profile of one or more actuating units. Therefore, the limited dexterity of the deformation shape causes the existing MCRs to collide readily with their surroundings or makes them unable to approach difficult-to-reach regions. These prolonged collisions are unnecessary or even hazardous, especially for catheters or similar medical devices. In this study, a novel magnetic moment intraoperatively programmable continuum robot (MMPCR) is introduced. By applying the proposed magnetic moment programming method, the MMPCR can deform under three modalities, that is, J, C, and S shapes. Additionally, the deflection directions and curvatures of different segments in the MMPCR can be modulated as desired. Furthermore, the magnetic moment programming and MMPCR kinematics are modeled, numerically simulated, and experimentally validated. The experimental results exhibit a mean deflection angle error of 3.3° and correspond well with simulation results. Comparisons between navigation capacities of the MMPCR and MCR demonstrate that the MMPCR has a higher capacity for dexterous deformation.

Actuation technologies for magnetically guided catheters

Due to their wide range of clinical application possibilities, magnetic actuation technologies have grabbed the attention of researchers worldwide. The design, execution, and analysis of magnetic catheter systems have advanced significantly during the last decade. The review focuses on magnetic actuation for catheter steering and control of the device, which will be explored in detail in the following sections. There is a discussion of future work and the challenges of the review systems, and the conclusions are finally addressed.