Adaptive Percutaneous Prostate Interventions using Sensorized Needle

项目摘要/摘要 针头放置不准确阻碍了前列腺靶向活检和病灶定位的临床结果 尽管包括内窥镜在内的影像引导技术的最新进展，前列腺癌的消融术 MRI引导和MR-TRUS融合。具体地说，针偏离预期的插入路径 由于针与周围组织的相互作用是造成针刺不准确的主要原因 放置。我们的长期目标是开发和验证闭环自适应插针控制，以 在靶向活检和局部治疗中，补偿针头插入过程中的针偏。 前列腺。这项提议的具体贡献是开发和验证基于光纤的形状传感 能在体内检测到针的偏差并反馈给医生的针(感应针) 实时的。我们的假设是，使用光纤布拉格光栅，来自传感针的实时反馈 (FBG)光纤，将允许医生补偿针的偏差，从而最大限度地减少 目标定位错误。该技术可以与任何类型的成像方式相结合，包括TRUS和 核磁共振检查。我们将追求以下四个具体目标来验证我们的假设：(1)开发和验证 (2)研制并验证了一种自适应针头 引导装置，以及(3)使用感应针在体内验证闭环自适应置针 在MR的指导下。这项研究将使我们能够收集必要的试点数据，以验证新的、侵入性较小的 前列腺癌的治疗方法在未来的临床研究中。这项拟议的研究具有创新性，因为它 将通过对单个患者进行机械建模来解决针头偏差问题而不进行预测， 并有可能减少活检中的假阴性或局部治疗中的次佳消融。新的 技术可以部署在现有的临床设置中，而不考虑使用的指导类型(即 内膛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).