106 research outputs found
An Open-Source 7-Axis, Robotic Platform to Enable Dexterous Procedures within CT Scanners
This paper describes the design, manufacture, and performance of a highly
dexterous, low-profile, 7 Degree-of-Freedom (DOF) robotic arm for CT-guided
percutaneous needle biopsy. Direct CT guidance allows physicians to localize
tumours quickly; however, needle insertion is still performed by hand. This
system is mounted to a fully active gantry superior to the patient's head and
teleoperated by a radiologist. Unlike other similar robots, this robot's fully
serial-link approach uses a unique combination of belt and cable drives for
high-transparency and minimal-backlash, allowing for an expansive working area
and numerous approach angles to targets all while maintaining a small in-bore
cross-section of less than . Simulations verified the system's
expansive collision free work-space and ability to hit targets across the
entire chest, as required for lung cancer biopsy. Targeting error is on average
on a teleoperated accuracy task, illustrating the system's sufficient
accuracy to perform biopsy procedures. The system is designed for lung biopsies
due to the large working volume that is required for reaching peripheral lung
lesions, though, with its large working volume and small in-bore
cross-sectional area, the robotic system is effectively a general-purpose
CT-compatible manipulation device for percutaneous procedures. Finally, with
the considerable development time undertaken in designing a precise and
flexible-use system and with the desire to reduce the burden of other
researchers in developing algorithms for image-guided surgery, this system
provides open-access, and to the best of our knowledge, is the first
open-hardware image-guided biopsy robot of its kind.Comment: 8 pages, 9 figures, final submission to IROS 201
CRANE: A Redundant, Multi-Degree-of-Freedom Computed Tomography Robot for Heightened Needle Dexterity within a Medical Imaging Bore
Computed Tomography (CT) image guidance enables accurate and safe minimally
invasive treatment of diseases, including cancer and chronic pain, with
needle-like tools via a percutaneous approach. The physician incrementally
inserts and adjusts the needle with intermediate images due to the accuracy
limitation of free-hand adjustment and patient physiological motion. Scanning
frequency is limited to minimize ionizing radiation exposure for the patient
and physician. Robots can provide high positional accuracy and compensate for
physiological motion with fewer scans. To accomplish this, the robots must
operate within the confined imaging bore while retaining sufficient dexterity
to insert and manipulate the needle. This paper presents CRANE: CT Robotic Arm
and Needle Emplacer, a CT-compatible robot with a design focused on system
dexterity that enables physicians to manipulate and insert needles within the
scanner bore as naturally as they would be able to by hand. We define abstract
and measurable clinically motivated metrics for in-bore dexterity applicable to
general-purpose intra-bore image-guided needle placement robots, develop an
automatic robot planning and control method for intra-bore needle manipulation
and device setup, and demonstrate the redundant linkage design provides
dexterity across various human morphology and meets the clinical requirements
for target accuracy during an in-situ evaluation.Comment: 20 pages, 13 figures, Transactions on Robotic
Zerobot®: A Remote-controlled Robot for Needle Insertion in CT-guided Interventional Radiology Developed at Okayama University
Since 2012, we have been developing a remote-controlled robotic system (Zerobot®) for needle insertion during computed tomography (CT)-guided interventional procedures, such as ablation, biopsy, and drainage. The system was designed via a collaboration between the medical and engineering departments at Okayama University, including various risk control features. It consists of a robot with 6 degrees of freedom that is manipulated using an operation interface to perform needle insertions under CT-guidance. The procedure includes robot positioning, needle targeting, and needle insertion. Phantom experiments have indicated that robotic insertion is equivalent in accuracy to manual insertion, without physician radiation exposure. Animal experiments have revealed that robotic insertion of biopsy introducer needles and various ablation needles is safe and accurate in vivo. The first in vivo human trial, therefore, began in April 2018. After its completion, a larger clinical study will be conducted for commercialization of the robot. This robotic procedure has many potential advantages over a manual procedure: 1) decreased physician fatigue; 2) stable and accurate needle posture without tremor; 3) procedure automation; 4) less experience required for proficiency in needle insertion skills; 5) decreased variance in technical skills among physicians; and 6) increased likelihood of performing the procedure at remote hospitals (i.e., telemedicine)
New Mechatronic Systems for the Diagnosis and Treatment of Cancer
Both two dimensional (2D) and three dimensional (3D) imaging modalities are useful tools for viewing the internal anatomy. Three dimensional imaging techniques are required for accurate targeting of needles. This improves the efficiency and control over the intervention as the high temporal resolution of medical images can be used to validate the location of needle and target in real time. Relying on imaging alone, however, means the intervention is still operator dependent because of the difficulty of controlling the location of the needle within the image. The objective of this thesis is to improve the accuracy and repeatability of needle-based interventions over conventional techniques: both manual and automated techniques. This includes increasing the accuracy and repeatability of these procedures in order to minimize the invasiveness of the procedure.
In this thesis, I propose that by combining the remote center of motion concept using spherical linkage components into a passive or semi-automated device, the physician will have a useful tracking and guidance system at their disposal in a package, which is less threatening than a robot to both the patient and physician. This design concept offers both the manipulative transparency of a freehand system, and tremor reduction through scaling currently offered in automated systems. In addressing each objective of this thesis, a number of novel mechanical designs incorporating an remote center of motion architecture with varying degrees of freedom have been presented. Each of these designs can be deployed in a variety of imaging modalities and clinical applications, ranging from preclinical to human interventions, with an accuracy of control in the millimeter to sub-millimeter range
Needle and Biopsy Robots: a Review
Purpose of the review Robotics is a rapidly advancing field, and its introduction in healthcare can have a multitude of benefits for clinical practice. Especially, applications depending on the radiologist\u2019s accuracy and precision, such as percutaneous interventions, may profit. This paper provides an overview of recent robot-assisted percutaneous solutions. Recent findings Percutaneous interventions are relatively simple and the quality of the procedure increases a lot by introducing robotics due to the improved accuracy and precision. The success of the procedure is heavily dependent on the ability to merge pre- and intraoperative images, as an accurate estimation of the current target location allows to exploit the robot\u2019s capabilities. Summary Despite much research, the application of robotics in some branches of healthcare is not commonplace yet. Recent advances in percutaneous robotic solutions and imaging are highlighted, as they will pave the way to more widespread implementation of robotics in clinical practic
Ultrasound-Guided Mechatronic System for Targeted Delivery of Cell-Based Cancer Vaccine Immunotherapy in Preclinical Models
Injection of dendritic cell (DC) vaccines into lymph nodes (LN) is a promising strategy for eliciting immune responses against cancer, but these injections in mouse cancer models are challenging due to the small target scale (~ 1 mm × 2 mm). Direct manual intranodal injection is difficult and can cause architectural damage to the LN, potentially disrupting crucial interactions between DC and T cells. Therefore, a second-generation ultrasound-guided mechatronic device has been developed to perform this intervention. A targeting accuracy of \u3c 500 μm will enable targeted delivery of the DCs specifically to a LN subcapsular space. The device was redesigned from its original CT-guided edition, which used a remote centre of motion architecture, to be easily integrated onto a commercially available VisualSonics imaging rail system. Subtle modifications were made to ensure simple workflow that allows for live-animal interventions that fall within the knockout periods stated in study protocols. Several calibration and registration techniques were developed in order to achieve an overall targeting accuracy appropriate for the intended application. A variety of methods to quantify the positioning accuracy of the device were investigated. The method chosen involved validating a guided injection into a tissue-mimicking phantom using ultrasound imaging post-operatively to localize the end-point position of the needle tip in the track left behind by the needle. Ultrasound-guided injections into a tissue-mimicking phantom revealed a targeting accuracy of 285 ± 94 μm for the developed robot compared to 508 ± 166 μm for a commercial-available manually-actuated injection device from VisuailSonics. The utility of the robot was also demonstrated by performing in vivo injections into the lymph nodes of mice
Ultrasound Guided Robot for Human Liver Biopsy using High Intensity Focused Ultrasound for Hemostasis
Percutaneous liver biopsy is the gold standard among clinician\u27s tool to diagnose and guide subsequent therapy for liver disease. Ultrasound image guidance is being increasingly used to reduce associated procedural risks but post–biopsy complications still persist. The major and most common complication is hemorrhage, which is highly unpredictable and may sometimes lead to death. Though the risk of mortality is low, it is too high for a diagnostic procedure. Post-biopsy care and additional surgical intervention to arrest hemorrhage make liver biopsy a costly procedure for health care delivery systems. Non-invasive methods to stop bleeding exist like electro–cautery, microwave, lasers, radio frequency, argon–beam, and High Intensity Focused Ultrasound (HIFU). All the methods except HIFU require direct exposure of the needle puncture site for hemostasis. HIFU is an ultrasound modality and uses mechanical sound waves for focused energy delivery. Ultrasound waves are minimally affected by tissue attenuation and focus internal targets without direct exposure. Human error in focusing HIFU renders it unusable for a medical procedure especially when noninvasive.
In this project we designed and developed an ultrasound guided prototype robot for accurate HIFU targeting to induce hemostasis. The robotic system performs percutaneous needle biopsy and a 7.5 cm focal length HIFU is fired at the puncture point when the needle tip retracts to the liver surface after sample collection. The robot has 4 degrees of freedom (DOF) for biopsy needle insertion, HIFU positioning, needle angle alignment and US probe image plane orientation. As the needle puncture point is always in the needle path, mechanically constraining the HIFU to focus on the needle reduced the required functionality significantly. Two mini c-arms are designed for needle angle alignment and US probe image plane orientation. This reduced the contact foot print of the robot over the patient providing a greater dexterity for positioning the robot. The robot is validated for HIFU hemostasis by a series of experiments on chicken breasts.
HIFU initiated hemorrhage control with robotic biopsy ensures arrest of post-biopsy hemorrhage and decreases patient anxiety, hospital stay, morbidity, time of procedure, and cost. This can also be extended to other organs like kidneys, lungs etc. and has widespread implications such as control of hemorrhage in post-biopsies in patients with reduced ability for hemostasis. This research opens a greater scope for research for automation and design making it a physician friendly tool for eventual clinical use
Design, Development, and Evaluation of a Teleoperated Master-Slave Surgical System for Breast Biopsy under Continuous MRI Guidance
The goal of this project is to design and develop a teleoperated master-slave surgical system that can potentially assist the physician in performing breast biopsy with a magnetic resonance imaging (MRI) compatible robotic system. MRI provides superior soft-tissue contrast compared to other imaging modalities such as computed tomography or ultrasound and is used for both diagnostic and therapeutic procedures. The strong magnetic field and the limited space inside the MRI bore, however, restrict direct means of breast biopsy while performing real-time imaging. Therefore, current breast biopsy procedures employ a blind targeting approach based on magnetic resonance (MR) images obtained a priori. Due to possible patient involuntary motion or inaccurate insertion through the registration grid, such approach could lead to tool tip positioning errors thereby affecting diagnostic accuracy and leading to a long and painful process, if repeated procedures are required. Hence, it is desired to develop the aforementioned teleoperation system to take advantages of real-time MR imaging and avoid multiple biopsy needle insertions, improving the procedure accuracy as well as reducing the sampling errors.
The design, implementation, and evaluation of the teleoperation system is presented in this dissertation. A MRI-compatible slave robot is implemented, which consists of a 1 degree of freedom (DOF) needle driver, a 3-DOF parallel mechanism, and a 2-DOF X-Y stage. This slave robot is actuated with pneumatic cylinders through long transmission lines except the 1-DOF needle driver is actuated with a piezo motor. Pneumatic actuation through long transmission lines is then investigated using proportional pressure valves and controllers based on sliding mode control are presented. A dedicated master robot is also developed, and the kinematic map between the master and the slave robot is established. The two robots are integrated into a teleoperation system and a graphical user interface is developed to provide visual feedback to the physician. MRI experiment shows that the slave robot is MRI-compatible, and the ex vivo test shows over 85%success rate in targeting with the MRI-compatible robotic system. The success in performing in vivo animal experiments further confirm the potential of further developing the proposed robotic system for clinical applications
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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