330 research outputs found
UV Exposed Optical Fibers with Frequency Domain Reflectometry for Device Tracking in Intra-Arterial Procedures
Shape tracking of medical devices using strain sensing properties in optical
fibers has seen increased attention in recent years. In this paper, we propose
a novel guidance system for intra-arterial procedures using a distributed
strain sensing device based on optical frequency domain reflectometry (OFDR) to
track the shape of a catheter. Tracking enhancement is provided by exposing a
fiber triplet to a focused ultraviolet beam, producing high scattering
properties. Contrary to typical quasi-distributed strain sensors, we propose a
truly distributed strain sensing approach, which allows to reconstruct a fiber
triplet in real-time. A 3D roadmap of the hepatic anatomy integrated with a 4D
MR imaging sequence allows to navigate the catheter within the
pre-interventional anatomy, and map the blood flow velocities in the arterial
tree. We employed Riemannian anisotropic heat kernels to map the sensed data to
the pre-interventional model. Experiments in synthetic phantoms and an in vivo
model are presented. Results show that the tracking accuracy is suitable for
interventional tracking applications, with a mean 3D shape reconstruction
errors of 1.6 +/- 0.3 mm. This study demonstrates the promising potential of
MR-compatible UV-exposed OFDR optical fibers for non-ionizing device guidance
in intra-arterial procedures
Organ Shape Sensing using Pneumatically Attachable Flexible Rails in Robotic-Assisted Laparoscopic Surgery
In robotic-assisted partial nephrectomy, surgeons remove a part of a kidney
often due to the presence of a mass. A drop-in ultrasound probe paired to a
surgical robot is deployed to execute multiple swipes over the kidney surface
to localise the mass and define the margins of resection. This sub-task is
challenging and must be performed by a highly skilled surgeon. Automating this
sub-task may reduce cognitive load for the surgeon and improve patient
outcomes. The overall goal of this work is to autonomously move the ultrasound
probe on the surface of the kidney taking advantage of the use of the
Pneumatically Attachable Flexible (PAF) rail system, a soft robotic device used
for organ scanning and repositioning. First, we integrate a shape-sensing
optical fibre into the PAF rail system to evaluate the curvature of target
organs in robotic-assisted laparoscopic surgery. Then, we investigate the
impact of the stiffness of the material of the PAF rail on the curvature
sensing accuracy, considering that soft targets are present in the surgical
field. Finally, we use shape sensing to plan the trajectory of the da Vinci
surgical robot paired with a drop-in ultrasound probe and autonomously generate
an Ultrasound scan of a kidney phantom.Comment: 9 pages, 11 figure
Axially rigid steerable needle with compliant active tip control
Steerable instruments allow for precise access to deeply-seated targets while sparing sensitive tissues and avoiding anatomical structures. In this study we present a novel omnidirectional steerable instrument for prostate high-dose-rate (HDR) brachytherapy (BT). The instrument utilizes a needle with internal compliant mechanism, which enables distal tip steering through proximal instrument bending while retaining high axial and flexural rigidity. Finite element analysis evaluated the design and the prototype was validated in experiments involving tissue simulants and ex-vivo bovine tissue. Ultrasound (US) images were used to provide visualization and shape-reconstruction of the instrument during the insertions. In the experiments lateral tip steering up to 20 mm was found. Manually controlled active needle tip steering in inhomogeneous tissue simulants and ex-vivo tissue resulted in mean targeting errors of 1.4 mm and 2 mm in 3D position, respectively. The experiments show that steering response of the instrument is history-independent. The results indicate that the endpoint accuracy of the steerable instrument is similar to that of the conventional rigid HDR BT needle while adding the ability to steer along curved paths. Due to the design of the steerable needle sufficient axial and flexural rigidity is preserved to enable puncturing and path control within various heterogeneous tissues. The developed instrument has the potential to overcome problems currently unavoidable with conventional instruments, such as pubic arch interference in HDR BT, without major changes to the clinical workflow
Medical robots for MRI guided diagnosis and therapy
Magnetic Resonance Imaging (MRI) provides the capability of imaging tissue with fine resolution and
superior soft tissue contrast, when compared with conventional ultrasound and CT imaging, which
makes it an important tool for clinicians to perform more accurate diagnosis and image guided therapy.
Medical robotic devices combining the high resolution anatomical images with real-time navigation, are
ideal for precise and repeatable interventions. Despite these advantages, the MR environment imposes
constraints on mechatronic devices operating within it. This thesis presents a study on the design and
development of robotic systems for particular MR interventions, in which the issue of testing the MR
compatibility of mechatronic components, actuation control, kinematics and workspace analysis, and
mechanical and electrical design of the robot have been investigated. Two types of robotic systems
have therefore been developed and evaluated along the above aspects.
(i) A device for MR guided transrectal prostate biopsy: The system was designed from components
which are proven to be MR compatible, actuated by pneumatic motors and ultrasonic motors, and
tracked by optical position sensors and ducial markers. Clinical trials have been performed with the
device on three patients, and the results reported have demonstrated its capability to perform needle
positioning under MR guidance, with a procedure time of around 40mins and with no compromised
image quality, which achieved our system speci cations.
(ii) Limb positioning devices to facilitate the magic angle effect for diagnosis of tendinous injuries:
Two systems were designed particularly for lower and upper limb positioning, which are actuated and
tracked by the similar methods as the first device. A group of volunteers were recruited to conduct
tests to verify the functionality of the systems. The results demonstrate the clear enhancement of the
image quality with an increase in signal intensity up to 24 times in the tendon tissue caused by the
magic angle effect, showing the feasibility of the proposed devices to be applied in clinical diagnosis
Enabling technologies for MRI guided interventional procedures
This dissertation addresses topics related to developing interventional assistant devices
for Magnetic Resonance Imaging (MRI). MRI can provide high-quality 3D visualization
of target anatomy and surrounding tissue, but the benefits can not be readily harnessed for
interventional procedures due to difficulties associated with the use of high-field (1.5T or
greater) MRI. Discussed are potential solutions to the inability to use conventional mecha-
tronics and the confined physical space in the scanner bore.
This work describes the development of two apparently dissimilar systems that repre-
sent different approaches to the same surgical problem - coupling information and action
to perform percutaneous (through the skin) needle placement with MR imaging. The first
system addressed takes MR images and projects them along with a surgical plan directly
on the interventional site, thus providing in-situ imaging. With anatomical images and a
corresponding plan visible in the appropriate pose, the clinician can use this information to
perform the surgical action.
My primary research effort has focused on a robotic assistant system that overcomes
the difficulties inherent to MR-guided procedures, and promises safe and reliable intra-prostatic needle placement inside closed high-field MRI scanners. The robot is a servo
pneumatically operated automatic needle guide, and effectively guides needles under real-
time MR imaging. This thesis describes development of the robotic system including
requirements, workspace analysis, mechanism design and optimization, and evaluation of
MR compatibility. Further, a generally applicable MR-compatible robot controller is de-
veloped, the pneumatic control system is implemented and evaluated, and the system is
deployed in pre-clinical trials. The dissertation concludes with future work and lessons
learned from this endeavor
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