Themes in neuronavigation research: A machine learning topic analysis

Objective

To understand trends in neuronavigation we employed machine learning methods to perform a broad literature review which would be impractical by manual inspection.

Methods

PubMed was queried for articles with "Neuronavigation" in any field from inception-2020. Articles were designated neuronavigation-focused (NF) if "Neuronavigation" was a major MeSH. The latent dirichlet allocation topic modeling technique was used to identify themes of NF research.

Results

There were 3896 articles of which 1727 (44%) were designated as NF. Between 1999-2009 and 2010-2020, the number of NF publications experienced 80% growth. Between 2009-2014 and 2015-2020, there was a 0.3% decline. Eleven themes covered 1367 (86%) NF articles. "Resection of Eloquent Lesions" comprised the highest number of articles (243), followed by "Accuracy and Registration" (242), "Patient Outcomes" (156), "Stimulation and Mapping" (126), "Planning and Visualization" (123), "Intraoperative Tools" (104), "Placement of Ventricular Catheters" (86), "Spine Surgery" (85), "New Systems" (80), "Guided Biopsies" (61), and "Surgical Approach" (61). All topics except for "Planning and Visualization", "Intraoperative Tools", and "New Systems" exhibited a monotonic positive trend. When analyzing subcategories, there were a greater number of clinical assessments or usage of existing neuronavigation systems (77%) rather than modification or development of new apparatuses (18%).

Conclusion

NF research appears to focus on the clinical assessment of neuronavigation and to a lesser extent on the development of new systems. Although neuronavigation has made significant strides, NF research output appears to have plateaued in the last decade.

Translational research in health technologies: A scoping review

Introduction

The current debate on the process of technological innovation points out as a challenge for universities consolidation of competencies that allow the generation and transfer of knowledge to society. The Translational Research (TR) approach has as one of its main objectives the acceleration of the innovation process, based on the transposition from basic science to applied science and innovation, which comprises the different stages of research, development and innovation. The literature points out that the dynamics of translation, which results in new technologies, are complex, transdisciplinary, inter-institutional, systemic, and non-linear. The main objective of this review is to contribute to the adoption of institutional strategies and the formulation of public policies aimed at solving today’s social and economic challenges, ensuring access to technologies and sustainability for the health system. The specific objectives were: (i) to systematize studies that characterized translational research in medical devices; (ii) map the challenges for the implementation of translational health research; (iii) contribute to the design of institutional strategies; and (iv) support the formulation of public policies.

Methods

This study used the scoping review technique, according to PRISMA-ScR and the Joanna Briggs Institute guidelines. Concerning the extraction of relevant articles, the journals indexed in Bireme, Pubmed, Scopus, Web of Science, and Google Scholar were consulted for selecting relevant articles. The search was carried out on November 28, 2021, updated on April 29, 2022, and there were no restrictions as to the year of publication, language or type of analysis. Studies that did not answer the research question were excluded, as they dealt exclusively with the pharmaceutical segment, the translation of knowledge into clinical practice, or addressed the process of translational research applied to specific diseases or technologies.

Results

Thirty-three articles were included indicating that the approach of translation of research is multidisciplinary and transdisciplinary and encompasses knowledge and aspects that go beyond basic and applied research and incorporates final steps concerning regulatory aspects, clinical research, market analysis, technology transfer, production and incorporation of technologies into the health system.

A body-mounted device for MRI-guided spinal therapy

BACKGROUND

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with no cure and limited treatment options. Recent studies have shown that delivering cellular therapeutics to the ventral horn of the spinal cord can effectively halt neurodegeneration associated with ALS in small animal models.

METHODS

We developed a robotic system that assists with MRI-guided percutaneous injections to the spinal cord. The needle positioning robot consists of two linear axes with motorised translational sleds for two-degree-of-freedom (2-DOF) needle translation and a radial template for 2-DOF discrete rotation.

RESULTS

The robot's targeting capability, evaluated using phantom models and swine cadavers, showed mean targeting errors of 0.48 and 2.84 mm, respectively. The duration of the targeting procedure is approximately 60 min, with an extra 10 min for each additional injection.

CONCLUSIONS

The presented robot does not affect imaging quality during MRI-guided procedures, and it enables a simplified workflow for MRI-guided spinal therapy.

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.