Increasing the precision of the biopsy with robots: two case studies

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’s accuracy and precision, such as percutaneous interventions, may profit. Percutaneous interventions are relatively simple and the quality of the procedure increases a lot by introducing robotics due to the improved accuracy and precision. This paper provides the description of two robotic systems for percutaneous interventions: breast biopsy and prostate biopsy. The systems presented here are complete prototypes in an advanced state ready to be tested in clinical practice.https://youtu.be/KZxfRtg0afg https://www.youtube.com/watch?v=AB3Qa6LyHP

Position-based modeling of lesion displacement in Ultrasound-guided breast biopsy

International audiencePurpose Although ultrasound (US) images represent the most popular modality for guiding breast biopsy, malignant regions are often missed by sonography, thus preventing accurate lesion localization which is essential for a successful procedure. Biomechanical models can support the localization of suspicious areas identified on a pre-operative image during US scanning since they are able to account for anatomical deformations resulting from US probe pressure. We propose a deformation model which relies on position-based dynamics (PBD) approach to predict the displacement of internal targets induced by probe interaction during US acquisition. Methods The PBD implementation available in NVIDIA FleX is exploited to create an anatomical model capable of deforming online. Simulation parameters are initialized on a calibration phantom under different levels of probe-induced deformations, then they are fine-tuned by minimizing the localization error of a US-visible landmark of a realistic breast phantom. The updated model is used to estimate the displacement of other internal lesions due to probe-tissue interaction. Results The localization error obtained when applying the PBD model remains below 11 mm for all the tumors even for input displacements in the order of 30 mm. This proposed method obtains results aligned with FE models with faster computational performance, suitable for real-time applications. In addition, it outperforms rigid model used to track lesion position in US-guided breast biopsies, at least halving the localization error for all the displacement ranges considered. 2 Eleonora Tagliabue et al. Conclusions Position-based dynamics approach has proved to be successful in modeling breast tissue deformations during US acquisition. Its stability, accuracy and real-time performance make such model suitable for tracking lesions displacement during US-guided breast biopsy

Toward autonomous robotic prostate biopsy: a pilot study

Purpose We present the validation of PROST, a robotic device for prostate biopsy. PROST is designed to minimize human error by introducing some autonomy in the execution of the key steps of the procedure, i.e., target selection, image fusion and needle positioning. The robot allows executing a targeted biopsy through ultrasound (US) guidance and fusion with magnetic resonance (MR) images, where the target was defined. Methods PROST is a parallel robot with 4 degrees of freedom (DOF) to orient the needle and 1 DOF to rotate the US probe. We reached a calibration error of less than 2 mm, computed as the difference between the needle positioning in robot coordinates and in the US image. The autonomy of the robot is given by the image analysis software, which employs deep learning techniques, the integrated image fusion algorithms and automatic computation of the needle trajectory. For safety reasons, the insertion of the needle is assigned to the doctor. Results System performance was evaluated in terms of positioning accuracy. Tests were performed on a 3D printed object with nine 2-mm spherical targets and on an anatomical commercial phantom that simulates human prostate with three lesions and the surrounding structures. The average accuracy reached in the laboratory experiments was 1.30 ± 0.44 mm in the first test and 1.54 ± 0.34 mm in the second test. Conclusions We introduced a first prototype of a prostate biopsy robot that has the potential to increase the detection of clinically significant prostate cancer and, by including some level of autonomy, to simplify the procedure, to reduce human errors and shorten training time. The use of a robot for the biopsy of the prostate will create the possibility to include also a treatment, such as focal ablation, to be delivered through the same system

Correction to: Position-based modeling of lesion displacement in ultrasound-guided breast biopsy

Comparison and metrics for medical simulation

Preclinical Validation of a Semi-Autonomous Robot for Transperineal Prostate Biopsy

Prostate biopsy is a manual procedure carried out mostly under ultrasound (US) guidance to confirm the presence of cancer. The standard biopsy is random and includes at least 12 insertions; targeted biopsy makes use of dedicated hardware and software, but is still performed manually. We present here the pre-clinical validation of PROST, a robot primarily designed to automate targeted transperineal biopsy. The overall validation of the system was performed on cadavers, while some features, such as image segmentation, were tested on human tissue. PROST is designed to minimize human error by introducing some autonomy in the execution of key steps of the procedure, i.e., target selection, image fusion and needle positioning. The protocol was approved by the ethics committee; 10 cadavers were included in the study. We envision that PROST has the potential to increase the detection of clinically significant prostate cancer, to simplify the procedure, to reduce human errors and to shorten training time. The use of a robot for the biopsy of the prostate will create the possibility to include also a treatment, such as focal ablation, to be delivered through the same system