Adaptive Percutaneous Prostate Interventions using Sensorized Needle

项目总结/摘要 不准确的针放置阻碍了靶向前列腺活检和局灶性前列腺增生的临床结局 尽管最近在图像引导技术方面取得了进展， MRI引导和MR-TRUS融合。特别地，针偏离预期的插入路径 由于针和周围组织之间的相互作用是导致针不准确的主要原因 安置我们的长期目标是开发和验证闭环自适应针头插入控制， 在针插入过程中补偿针偏差，以进行靶向活检和局部治疗， 前列腺该提案的具体贡献是开发和验证基于光纤的形状传感 可检测体内针偏离并反馈给医生的针（传感器化针） 实时的。我们的假设是，来自传感针的实时反馈，使用光纤布拉格光栅 (FBG)光纤将允许医生补偿针的偏差，并因此最小化 瞄准错误。该技术可以与任何类型的成像模式相结合，包括TRUS和 核磁共振我们将追求以下四个具体目标来检验我们的假设：（1）开发和验证一个 具有嵌入式FBG应变传感器的优化的传感器化针，（2）开发并验证自适应针 引导装置，以及（3）在体内使用传感针验证闭环自适应针放置 在MR指导下。这项研究将使我们能够收集必要的试点数据，以验证新的， 前列腺癌的治疗方法在未来的临床研究。这项研究是创新的，因为它 将通过对个体患者进行机械建模来解决针偏离的问题，而不对其进行预测， 并潜在地减少活检中的假阴性或病灶治疗中的次优消融。新 技术可以部署在现有的临床设置中，而不管所使用的引导类型（即， 孔内MR引导或MR-TRUS融合引导）。

Project Summary / Abstract Inaccurate needle placement hampers the clinical outcomes of targeted prostate biopsy and focal ablations of prostate cancer despite the recent advancement in image-guidance techniques including in-bore MRI guidance and MR-TRUS fusion. In particular, the deviation of the needle from the intended insertion path due to the interaction between the needle and the surrounding tissue is a major cause of inaccurate needle placement. Our long-term goal is to develop and validate closed-loop adaptive needle insertion control to compensate for the needle deviation during needle insertion for targeted biopsy and focal treatment in the prostate. The specific contribution of this proposal is to develop and validate optical fiber-based shape-sensing needle (sensorized needle) that can detect the deviation of the needle in vivo and feed it back to the physician in real-time. Our hypothesis is that real-time feedback from the sensorized needle, using fiber Bragg gratings (FBG) optical fibers, will allow the physician to compensate for the deviation of the needle, and hence minimize the targeting errors. The technique can be combined with any type of imaging modalities, including TRUS and MRI. We will pursue the following four specific aims to test our hypothesis: (1) Develop and validate an optimized sensorized needle with embedded FBG strain sensors, (2) Develop and validate an adaptive needle guide device, and (3) validate closed-loop adaptive needle placement using the sensorized needle in vivo under MR guidance. The study will allow us to collect pilot data necessary to validate new, less invasive methods of prostate cancer treatment in a future clinical study. The proposed research is innovative because it will address the issue of needle deviation without predicting it by mechanically modeling individual patients, and potentially reduce false negatives in biopsies or suboptimal ablations in focal treatments. The new technology can be deployed in the existing clinical setup regardless of the type of guidance used (i.e. whether in-bore MR-guidance or MR-TRUS fusion guidance).