TRD 3 - Enabling Technologies for Intraprocedural Guidance

摘要 个性化医疗的最新进展伴随着越来越多的认识 图像引导的干预。在图像引导之前，必须解决两个关键需求 介入在精准医学中发挥着关键作用-成像作为一种 治疗效果的预测性生物标志物和设备的开发，以识别，采样， 监测靶组织。我们的目标是开发一套术中设备，通过协同 技术和生物医学专业知识的相互作用，并提供原型软件工具/设备 由3D Slicer启用。目的1术中穿刺引导前列腺穿刺活检和消融 我们将 创建、测试和验证图像引导软件，以解决针偏转问题，并提供 最佳插入路径，用于孔内MRI引导的前列腺癌活检和消融。这一目标将 提供一套完整的工具，即带有精细网格图案和引导的经会阴模板 考虑针偏转的软件。目标2.开发一种术中 用于肺部手术的可视化和导航。我们将开发一种增强现实（AR）引导的 用于腹腔镜肺手术的导航系统，其与新型计算机视觉相结合， 机器学习算法来补偿肺部变形。我们还将开发机器- 基于学习的特征描述符，以准确跟踪立体腹腔镜的解剖特征 图像.目标3：集成回收的植入式微型器械的技术开发 机制我们将开发新的植入式微器件（IMD）原型， 对于难以进入的组织（如脑）的可回收性-在局灶性肿瘤内-每个IMD包含 多达20个单独的威尔斯井用于安装药物。我们将使用图像引导来进行最佳放置- 在肿瘤中，允许这些药物的局灶性和受控释放，然后使用图像引导装置 移除（Removal）。一旦图像引导的取回，IMD就与组织的“袖口”或边缘一起被移除， 这将进行病理学分析以发现是否存在足够量的组织， 局部组织/肿瘤反应的分析。合作项目将受益于纳入 在TRD 3中实现的新型临床测试器械和相关软件。

ABSTRACT Recent advances in personalized medicine have been accompanied by increasing recognition of image-guided interventions. Two critical needs have to be addressed before image-guided intervention plays a key role in precision medicine – the successful application of imaging as a predictive biomarker of therapeutic efficacy and the development of devices to identify, sample, and monitor target tissues. The goal is to develop a set of intraoperative devices through synergistic interactions of technical and biomedical expertise and deliver prototypic software tools/devices enabled by 3D Slicer. Aim 1 Intraoperative needle guidance for prostate biopsy and ablation We will create, test, and validate image-guidance software to address needle deflection and provide an optimal insertion path for in-bore MRI-guided biopsy and ablation of prostate cancer. This aim will deliver a complete set of tools namely-a transperineal template with fine grid pattern and guidance software that takes into account needle deflection. Aim 2. Development of an intraoperative visualization and navigation for lung surgery. We will develop an augmented reality (AR)-guided navigation system for laparoscopic lung surgery to be integrated with novel computer vision and machine learning algorithms to compensate for lung deformation. We will also develop machine- learning based feature descriptors to accurately track anatomical features from stereo laparoscopic images. Aim 3: Technical development of an implantable microdevice with integrated retrieval mechanism. We will develop new implantable microdevice (IMD) prototypes that have integrated retrievability for difficult to access tissues such as the brain-within a focal tumor -each IMD contains up to 20 individual wells for installation of drugs. We will use image guidance for optimal placement - in the tumor, to allow focal and controlled release of these drugs and then image guided device retrieval (removal). Once the image guided retrieval the IMD is removed with a “cuff” or rim of tissue, this will undergo pathological analysis to discover if an adequate amount of tissue is present and then analyzes of local tissue/tumor response. Collaborating projects will be benefitted by incorporating novel and clinically tested devices and associated software made possible in the TRD 3.