A Robotically Steerable Guidewire With Forward-Viewing Ultrasound: Development of Technology for Minimally-Invasive Imaging.
A Robotically Steerable Guidewire With Forward-Viewing Ultrasound: Development of Technology for Minimally-Invasive Imaging.
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DOI：
10.1109/tbme.2020.3042115
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Lindsey BD
中科院分区：
文献类型：
--
作者：
Collins GC;Sarma A;Bercu ZL;Desai JP;Lindsey BD
外周慢性完全闭塞的当前护理标准涉及在X线透视下手动引导导丝。尽管近几十年来取得了显著进步，但导航仍然具有临床挑战性，手术失败率和医源性损伤率较高。为了应对这一挑战，我们提出了一种概念验证机器人导丝系统，具有前视超声成像，可以通过复杂的血管系统实现可视化和可操作性。设计、制造并表征了具有匹配层和声学背衬的0.035”导丝专用超声换能器。通过模拟和实验评估了导丝运动对信号去相关的影响，从而推动了合成孔径波束形成方法的发展，以在换能器在机器人导丝上转向时形成图像。系统性能进行了评估，在水中成像线目标。最后，通过对离体动脉成像证明了概念验证。所设计的定制换能器的中心频率为15.7 MHz，45.4%的分数带宽和31 dB SNR。在6 mm深度处对20 μm导丝靶成像时，横向−6 dB靶宽度为0.25 ± 0.03 mm。3D动脉重建允许血管壁结构和管腔可视化。针对具有集成超声换能器和机器人操纵导丝的sub-mm系统，证明了超声换能器头端可操纵导丝的初始概念验证，包括3D图像形成，而无需额外的传感器来确定导丝位置。所开发的前视、机器人操纵的导丝可以使导航通过当前方法无法穿过的闭塞血管区域。
The current standard of care for peripheral chronic total occlusions involves the manual routing of a guidewire under fluoroscopy. Despite significant improvements in recent decades, navigation remains clinically challenging with high rates of procedural failure and iatrogenic injury. To address this challenge, we present a proof-of-concept robotic guidewire system with forward-viewing ultrasound imaging to allow visualization and maneuverability through complex vasculature. A 0.035” guidewire-specific ultrasound transducer with matching layer and acoustic backing was designed, fabricated, and characterized. The effect of guidewire motion on signal decorrelation was assessed with simulations and experimentally, driving the development of a synthetic aperture beamforming approach to form images as the transducer is steered on the robotic guidewire. System performance was evaluated by imaging wire targets in water. Finally, proof-of-concept was demonstrated by imaging an ex vivo artery. The designed custom transducer was fabricated with a center frequency of 15.7 MHz, 45.4% fractional bandwidth, and 31 dB SNR. In imaging 20 μm wire targets at a depth of 6 mm, the lateral −6 dB target width was 0.25 ± 0.03 mm. The 3D artery reconstruction allowed visualization of vessel wall structure and lumen. Initial proof-of-concept for an ultrasound transducer-tipped steerable guidewire including 3D image formation without an additional sensor to determine guidewire position was demonstrated for a sub-mm system with an integrated ultrasound transducer and a robotically-steered guidewire. The developed forward-viewing, robotically-steered guidewire may enable navigation through occluded vascular regions that cannot be crossed with current methods.
影响因子：
2.9
作者：
Light, Edward D.;Lindsey, Brooks D.;Upchurch, Joseph A.;Smith, Stephen W.
通讯作者：
Smith, Stephen W.