Magnetic Bronchoscope for Improved Pulmonary Access

用于改善肺部通路的磁力支气管镜

• 批准号: 10152980
• 负责人: WALTER BLUME
• 金额: $ 40.14万
• 依托单位: UNANDUP, LLC
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10152980
• 关键词: 3-Dimensional; 3D Print; Ablation; Accounting; Acrylates; Adoption; American; Angiography; Animals; Biopsy; Biopsy Specimen; Bronchoscopes; Bronchoscopy; Caliber; Cancer Etiology; Cause of Death; Cessation of life; Clinical; Complex; Complication; Data; Data Set; Detection; Device Designs; Devices; Diagnosis; Distal; Early Diagnosis; Fatigue; Forcep; Genes; Goals; Hospitals; Human; In Vitro; Institution; Intervention; Joystick; Learning; Length; Lesion; Lung; Lung nodule; Magnetism; Malignant Neoplasms; Malignant neoplasm of lung; Manuals; Measurement; Measures; Mechanics; Metals; Modality; Needle biopsy procedure; Needles; Nodule; Optics; Outcome; Pathway interactions; Performance; Phase; Pneumothorax; Positioning Attribute; Price; Procedures; Property; Research Personnel; Resolution; Robotics; Roentgen Rays; Safety; Sampling; Shapes; Staging; Statistical Methods; Structure; Surface; System; Technology; Time; Tissue Sample; Treatment Protocols; Underserved Population; United States; Visualization; Width; X-Ray Computed Tomography; arm; base; cancer therapy; cost; cost effective; early screening; flexibility; imaging detection; improved; magnetic field; meetings; meter; mortality; novel; performance tests; pre-clinical; prevent; productivity loss; prototype; robotic system; safety assessment; sensor; standard of care; success; tool; usability

One of every 16 Americans will be diagnosed with lung cancer in their lifetime. Each year in the United States there are nearly 250,000 new diagnoses and 150,000 deaths with an estimated productivity loss in excess of $20 billion. Thanks to recent advancements in CT imaging, detection of smaller suspicious pulmonary nodules within distal regions of the lung is now possible. As a result, mortality rates have decreased by nearly 20% due to earlier initiation of treatment protocols. The ability to safely obtain a viable biopsy sample is critical. However, despite the availability of better CT imaging, little progress has been made in expanding affordable tools which can safely access distal regions of the lung to diagnose and stage suspicious nodules. Percutaneous needle biopsy remains the standard of care used to obtain nodule tissue samples, although the procedure is associated with pneumothorax complication rates greater than 20%. In contrast, bronchoscopes are 10X safer when used to acquire biopsies. However, bronchoscopes possess two main limitations which result in many lung cancers not being successfully diagnosed. First, the relatively large size prevents them from being able to access most of the lung. Second, because the bronchoscope’s tip is manipulated from nearly a meter away using complex pull-wire based mechanisms, limited control of the tip is provided which largely restricts biopsy to nodules within the airway. To improve upon manual bronchoscopes, robotic solutions have been developed; however, these technologies are difficult to learn, do not greatly improve distal access or tip control, and are prohibitively expensive (~$500k) for most hospitals. As a result, adoption of robotics for bronchoscopy has been slow. UNandUP has invented a novel robotic bronchoscopy platform that provides precise control of the bronchoscope’s tip using a smaller scope diameter than previously possible that enables safe access into otherwise inaccessible lung regions and the ability to better biopsy nodules not directly in the airway. By overcoming the complexities of traditional robotic approaches, the proposed technology can be priced at a fraction of the cost of competing robotic solutions. This will allow advanced lung biopsy capabilities to be offered to nearly all hospital versus only being available at select institutions. Importantly, the technology also promises to serve as an exploratory platform for emerging cancer therapies which include gene, photodynamic, and ablation therapies. The project’s aims include 1) building the robotic workstation, 2) building a steerable bronchoscope, and 3) assessing performance in CT-based bronchial phantoms.

每16个美国人中就有一个在一生中被诊断出患有肺癌。美国每年 有近25万人被确诊，15万人死亡，估计生产力损失超过1000万美元。 200亿由于CT成像的最新进展， 在肺的远端区域内的治疗现在是可能的。因此，死亡率下降了近20%， 提前启动治疗方案安全获得活的活检样本的能力至关重要。 然而，尽管有更好的CT成像，但在扩大负担得起的 可以安全进入肺部远端区域以诊断和分期可疑结节的工具。 经皮穿刺活检仍然是用于获得结节组织样本的护理标准，尽管 手术与气胸并发症发生率大于20%相关。相反，支气管镜 在进行活检时要安全十倍。然而，支气管镜具有两个主要局限性， 导致许多肺癌不能被成功诊断。首先，相对较大的尺寸阻止了它们 无法进入大部分肺部第二，因为支气管镜的尖端是从 使用复杂的基于拉线的机构，提供了对尖端的有限控制， 很大程度上限制了对气道内结节的活检。为了改进手动支气管镜，机器人解决方案 但是，这些技术很难学习，不能大大改善远端入路 或尖端控制，并且对于大多数医院来说过于昂贵（约50万美元）。因此，采用机器人技术 支气管镜检查进展缓慢UNandUP发明了一种新型的机器人支气管镜检查平台， 使用比以前可能的更小的镜直径精确控制支气管镜的尖端， 安全进入否则无法到达的肺部区域，并且能够更好地对不直接在肺部的结节进行活检 气道。通过克服传统机器人方法的复杂性，所提出的技术可以 价格仅为竞争机器人解决方案的一小部分。这将实现先进的肺活检功能 几乎所有医院都可以使用，而不是只在选定的机构提供。重要的是， 还有望作为新兴癌症治疗的探索平台， 光动力学和消融疗法。该项目的目标包括1）建立机器人工作站，2）建立 可操纵支气管镜，以及3）评估基于CT的支气管体模的性能。