1,487 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
Medical image computing and computer-aided medical interventions applied to soft tissues. Work in progress in urology
Until recently, Computer-Aided Medical Interventions (CAMI) and Medical
Robotics have focused on rigid and non deformable anatomical structures.
Nowadays, special attention is paid to soft tissues, raising complex issues due
to their mobility and deformation. Mini-invasive digestive surgery was probably
one of the first fields where soft tissues were handled through the development
of simulators, tracking of anatomical structures and specific assistance
robots. However, other clinical domains, for instance urology, are concerned.
Indeed, laparoscopic surgery, new tumour destruction techniques (e.g. HIFU,
radiofrequency, or cryoablation), increasingly early detection of cancer, and
use of interventional and diagnostic imaging modalities, recently opened new
challenges to the urologist and scientists involved in CAMI. This resulted in
the last five years in a very significant increase of research and developments
of computer-aided urology systems. In this paper, we propose a description of
the main problems related to computer-aided diagnostic and therapy of soft
tissues and give a survey of the different types of assistance offered to the
urologist: robotization, image fusion, surgical navigation. Both research
projects and operational industrial systems are discussed
Origami lesion-targeting device for CT-guided interventions
The objective of this study is to preliminarily evaluate a lesion-targeting device for CT-guided interventions. The device is created by laser cutting the structure from a sheet of medical grade paperboard, 3D printing two radiocontrast agent grids onto the surface and folding the structure into a rectangular prism with a viewing window. An abdominal imaging phantom was used to evaluate the device through CT imaging and the targeting of lesions for needle insertion. The lesion-targeting trials resulted in a mean targeting error of 2.53 mm (SD 0.59 mm, n = 30). The device is rigid enough to adequately support standard biopsy needles, and it attaches to the patient, reducing the risk of tissue laceration by needles held rigidly in place by an external manipulator. Additional advantages include adequate support for the insertion of multiple surgical tools at once for procedures such as composite ablation and the potential to guide off-axial needle insertion. The low-cost and disposability of the device make it well-suited for the minimally invasive image-guided therapy environment
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
Stereotactic Image-Guidance for Ablation of Malignant Liver Tumors
Stereotactic percutaneous ablation is a rapidly advancing modality for treatment of tumors in soft solid organs such as the liver. Each year, there are about 850,000 cases of primary liver cancer worldwide. Although surgical resection still is the gold standard for most cases, only 20–30% of patients are candidates for it, due to the advanced stage of the disease. Surgery can also be a huge burden to the patient and his/her quality of life might be temporarily severely reduced due to long hospital stays, complications, and slow recovery. To overcome these disadvantages, thermo-ablation of tumors of up to 3 cm has become a more viable alternative especially in the last decade, offering a potentially equally effective but minimally invasive and tissue sparing treatment alternative. In conjunction with improved CT imaging, stereotactic image-guidance techniques and image fusion technology were introduced to increase safety, efficacy, and accuracy of this treatment. Stereotactic image-guidance leads to a simple, fast, and accurate placement of the ablation probe into the liver tumor, which is a prerequisite for a complete destruction of the tumor by ablation. More and more physicians, including surgeons, consider ablation a viable alternative to resection whenever feasible. Patients undergoing such a minimally invasive treatment benefit from a shorter hospital stays, reduced complication rates, and faster recovery
Role of robotic arm assistance in computed tomography guided bone biopsy
Background: Use of robotic assistance technique has significant benefits over conventional techniques. The present study looks at the recent technological developments in image guidance for bone biopsy procedures.Methods: Patients who were referred to the department of radiodiagnosis, Bharti Hospital and Dot3d scanning center, Sangli, Maharashtra, India from July 2017 till December 2018 with suspected bone lesions were included in the study. These patients underwent robotic arm CT guided bone biopsy of their lesions.Results: In the present study, 47 patients were included. Authors observed that 93.6% had a positive diagnosis based on CT guided bone biopsy. Metastatic lesions were diagnosed in 8 cases. Inflammatory lesions and tuberculosis were other commonly observed diagnosis.Conclusions: Further growth and development of medical imaging devices have allowed more interventional procedures to be performed and more patients to benefit from them. Radiologists needs to develop a thorough understanding of the anatomical structure involved and need to acquire both solid grounding in technology and the practical skills to visualize a nerve structure
Developing and testing a robotic MRI/CT fusion biopsy technique using a purpose-built interventional phantom.
BACKGROUND: Magnetic resonance imaging (MRI) can be used to target tumour components in biopsy procedures, while the ability to precisely correlate histology and MRI signal is crucial for imaging biomarker validation. Robotic MRI/computed tomography (CT) fusion biopsy offers the potential for this without in-gantry biopsy, although requires development. METHODS: Test-retest T1 and T2 relaxation times, attenuation (Hounsfield units, HU), and biopsy core quality were prospectively assessed (January-December 2021) in a range of gelatin, agar, and mixed gelatin/agar solutions of differing concentrations on days 1 and 8 after manufacture. Suitable materials were chosen, and four biopsy phantoms were constructed with twelve spherical 1-3-cm diameter targets visible on MRI, but not on CT. A technical pipeline was developed, and intraoperator and interoperator reliability was tested in four operators performing a total of 96 biopsies. Statistical analysis included T1, T2, and HU repeatability using Bland-Altman analysis, Dice similarity coefficient (DSC), and intraoperator and interoperator reliability. RESULTS: T1, T2, and HU repeatability had 95% limits-of-agreement of 8.3%, 3.4%, and 17.9%, respectively. The phantom was highly reproducible, with DSC of 0.93 versus 0.92 for scanning the same or two different phantoms, respectively. Hit rate was 100% (96/96 targets), and all operators performed robotic biopsies using a single volumetric acquisition. The fastest procedure time was 32 min for all 12 targets. CONCLUSIONS: A reproducible biopsy phantom was developed, validated, and used to test robotic MRI/CT-fusion biopsy. The technique was highly accurate, reliable, and achievable in clinically acceptable timescales meaning it is suitable for clinical application
From Concept to Market: Surgical Robot Development
Surgical robotics and supporting technologies have really become a prime example of modern applied
information technology infiltrating our everyday lives. The development of these systems spans across
four decades, and only the last few years brought the market value and saw the rising customer base
imagined already by the early developers. This chapter guides through the historical development of the
most important systems, and provide references and lessons learnt for current engineers facing similar
challenges. A special emphasis is put on system validation, assessment and clearance, as the most
commonly cited barrier hindering the wider deployment of a system
Body-Mounted Robotic System for MRI-Guided Shoulder Arthrography: Cadaver and Clinical Workflow Studies
This paper presents an intraoperative MRI-guided, patient-mounted robotic system for
shoulder arthrography procedures in pediatric patients. The robot is designed to be
compact and lightweight and is constructed with nonmagnetic materials for MRI safety.
Our goal is to transform the current two-step arthrography procedure (CT/x-ray-guided
needle insertion followed by diagnostic MRI) into a streamlined single-step ionizing
radiation-free procedure under MRI guidance. The MR-conditional robot was evaluated
in a Thiel embalmed cadaver study and healthy volunteer studies. The robot was attached
to the shoulder using straps and ten locations in the shoulder joint space were selected as
targets. For the first target, contrast agent (saline) was injected to complete the clinical
workflow. After each targeting attempt, a confirmation scan was acquired to analyze the
needle placement accuracy. During the volunteer studies, a more comfortable and
ergonomic shoulder brace was used, and the complete clinical workflow was followed
to measure the total procedure time. In the cadaver study, the needle was successfully
placed in the shoulder joint space in all the targeting attempts with translational and
rotational accuracy of 2.07 ± 1.22mm and 1.46 ± 1.06 degrees, respectively. The total
time for the entire procedure was 94 min and the average time for each targeting attempt
was 20 min in the cadaver study, while the average time for the entire workflow for the
volunteer studies was 36 min. No image quality degradation due to the presence of the
robot was detected. This Thiel-embalmed cadaver study along with the clinical workflow
studies on human volunteers demonstrated the feasibility of using an MR-conditional,
patient-mounted robotic system for MRI-guided shoulder arthrography procedure. Future
work will be focused on moving the technology to clinical practice
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