Toward Certifiable Motion Planning for Medical Steerable Needles

Toward certifiable optimal motion planning for medical steerable needles

Medical steerable needles can follow 3D curvilinear trajectories to avoid anatomical obstacles and reach clinically significant targets inside the human body. Automating steerable needle procedures can enable physicians and patients to harness the full potential of steerable needles by maximally leveraging their steerability to safely and accurately reach targets for medical procedures such as biopsies. For the automation of medical procedures to be clinically accepted, it is critical from a patient care, safety, and regulatory perspective to certify the correctness and effectiveness of the planning algorithms involved in procedure automation. In this paper, we take an important step toward creating a certifiable optimal planner for steerable needles. We present an efficient, resolution-complete motion planner for steerable needles based on a novel adaptation of multi-resolution planning. This is the first motion planner for steerable needles that guarantees to compute in finite time an obstacle-avoiding plan (or notify the user that no such plan exists), under clinically appropriate assumptions. Based on this planner, we then develop the first resolution-optimal motion planner for steerable needles that further provides theoretical guarantees on the quality of the computed motion plan, that is, global optimality, in finite time. Compared to state-of-the-art steerable needle motion planners, we demonstrate with clinically realistic simulations that our planners not only provide theoretical guarantees but also have higher success rates, have lower computation times, and result in higher quality plans.

Planning of Medical Flexible Needle Motion in Effective Area of Clinical Puncture

Lung cancer is the leading cause of cancer deaths worldwide. Although several lung cancer diagnostic methods are available for lung nodule biopsy, there are limitations in terms of accuracy, safety, and invasiveness. Transbronchial needle aspiration (TBNA) is a common method for diagnosing and treating lung cancer that involves a robot-assisted medical flexible needle moving along a curved three-dimensional trajectory, avoiding anatomical barriers to achieve clinically meaningful goals in humans. Inspired by the puncture angle between the needle tip and the vessel in venipuncture, we suggest that different orientations of the medical flexible needle puncture path affect the cost of the puncture trajectory and propose an effective puncture region based on the optimal puncture direction, which is a strategy based on imposing geometric constraints on the search space of the puncture direction, and based on this, we focused on the improved implementation of RCS*. Planning within the TBNA-based lung environment was performed using the rapidly exploring random tree (RRT), resolution-complete search (RCS), and RCS* (a resolution-optimal version of RCS) within an effective puncture region. The experimental results show that the optimal puncture direction corresponding to the lowest cost puncture trajectory is consistent among the three algorithms and RCS* is more efficient for planning. The experiments verified the feasibility and practicality of our proposed minimum puncture angle and puncture effective region and facilitated the study of the puncture direction of flexible needle puncture.

A Metric for Finding Robust Start Positions for Medical Steerable Needle Automation

Steerable needles are medical devices with the ability to follow curvilinear paths to reach targets while circumventing obstacles. In the deployment process, a human operator typically places the steerable needle at its start position on a tissue surface and then hands off control to the automation that steers the needle to the target. Due to uncertainty in the placement of the needle by the human operator, choosing a start position that is robust to deviations is crucial since some start positions may make it impossible for the steerable needle to safely reach the target. We introduce a method to efficiently evaluate steerable needle motion plans such that they are safe to variation in the start position. This method can be applied to many steerable needle planners and requires that the needle's orientation angle at insertion can be robotically controlled. Specifically, we introduce a method that builds a funnel around a given plan to determine a safe insertion surface corresponding to insertion points from which it is guaranteed that a collision-free motion plan to the goal can be computed. We use this technique to evaluate multiple feasible plans and select the one that maximizes the size of the safe insertion surface. We evaluate our method through simulation in a lung biopsy scenario and show that the method is able to quickly find needle plans with a large safe insertion surface.

A hybrid inductive learning-based and deductive reasoning-based 3-D path planning method in complex environments

Traditional path planning methods, such as sampling-based and iterative approaches, allow for optimal path’s computation in complex environments. Nonetheless, environment exploration is subject to rules which can be obtained by domain experts and could be used for improving the search. The present work aims at integrating inductive techniques that generate path candidates with deductive techniques that choose the preferred ones. In particular, an inductive learning model is trained with expert demonstrations and with rules translated into a reward function, while logic programming is used to choose the starting point according to some domain expert’s suggestions. We discuss, as use case, 3-D path planning for neurosurgical steerable needles. Results show that the proposed method computes optimal paths in terms of obstacle clearance and kinematic constraints compliance, and is able to outperform state-of-the-art approaches in terms of safety distance-from-obstacles respect, smoothness, and computational time.

Resolution-Optimal Motion Planning for Steerable Needles

Medical steerable needles can follow 3D curvilinear trajectories inside body tissue, enabling them to move around critical anatomical structures and precisely reach clinically significant targets in a minimally invasive way. Automating needle steering, with motion planning as a key component, has the potential to maximize the accuracy, precision, speed, and safety of steerable needle procedures. In this paper, we introduce the first resolution-optimal motion planner for steerable needles that offers excellent practical performance in terms of runtime while simultaneously providing strong theoretical guarantees on completeness and the global optimality of the motion plan in finite time. Compared to state-of-the-art steerable needle motion planners, simulation experiments on realistic scenarios of lung biopsy demonstrate that our proposed planner is faster in generating higher-quality plans while incorporating clinically relevant cost functions. This indicates that the theoretical guarantees of the proposed planner have a practical impact on the motion plan quality, which is valuable for computing motion plans that minimize patient trauma.

Adaptively Informed Trees (AIT*) and Effort Informed Trees (EIT*): Asymmetric bidirectional sampling-based path planning

Optimal path planning is the problem of finding a valid sequence of states between a start and goal that optimizes an objective. Informed path planning algorithms order their search with problem-specific knowledge expressed as heuristics and can be orders of magnitude more efficient than uninformed algorithms. Heuristics are most effective when they are both accurate and computationally inexpensive to evaluate, but these are often conflicting characteristics. This makes the selection of appropriate heuristics difficult for many problems. This paper presents two almost-surely asymptotically optimal sampling-based path planning algorithms to address this challenge, Adaptively Informed Trees (AIT*) and Effort Informed Trees (EIT*). These algorithms use an asymmetric bidirectional search in which both searches continuously inform each other. This allows AIT* and EIT* to improve planning performance by simultaneously calculating and exploiting increasingly accurate, problem-specific heuristics. The benefits of AIT* and EIT* relative to other sampling-based algorithms are demonstrated on 12 problems in abstract, robotic, and biomedical domains optimizing path length and obstacle clearance. The experiments show that AIT* and EIT* outperform other algorithms on problems optimizing obstacle clearance, where a priori cost heuristics are often ineffective, and still perform well on problems minimizing path length, where such heuristics are often effective.