Terabotics - terahertz robotics for surgery and medicine

Terabotics - 用于手术和医学的太赫兹机器人

• 批准号: EP/V047914/1
• 负责人: Emma MacPherson
• 金额: $ 1019.46万
• 依托单位: University of Warwick
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FV047914%2F1
• 关键词: Terabotics; terahertz; robotics; surgery; medicine

There is a pressing need to improve the precision, control and selectivity of surgical procedures addressing several high-incidence cancers. For example in the UK, the incidence of basal cell carcinoma (BCC) has increased by approximately 250% since the 1990s, with 137,000 new cases of BCC each year. Bowel cancer is the 4th most common cancer and is the second most common cause of cancer death. Some 15% of new bowel cancer cases are early stage and amenable to potential endoluminal surgery; this proportion is increasing with national screening programs. Delayed diagnosis and incomplete excision of tumours are key drivers of patient morbidity, and squander limited surgical resources. Streamlining screening and early diagnosis processes is now even more important with more patient backlog caused by Covid-19. The default surgical practice is to remove cancers wherever possible, along with a margin of healthy tissue. Leaving cancer cells behind leads to reoccurrence, but removing too much healthy tissue increases both the risk of complications and the loss of normal function. Trying to optimise this balance is a global challenge. For example, BCCs often spread out beneath the surface of the skin such that their entirety cannot be detected until surgery. Moh's micrographic surgery is the gold standard for treating BCCs: the tumour is removed section by section and examined under the microscope until no further tumour can be seen. This is both time consuming and traumatic for the patient, typically resulting in larger skin grafts than expected. If the extent of the tumour could be accurately determined, using terahertz (THz) imaging prior to surgery, the procedure would be faster, and grafts better planned. Similarly, if a diagnostic THz imaging capability could be added to a flexible endoscope, more colorectal tumours could be identified in situ and resected without waiting for histology results (typically 2 weeks) and a follow-up procedure. In this programme, a highly interdisciplinary team consisting of investigators at Universities of Warwick, Exeter and Leeds in Physics, Engineering and Medicine, and at the University Hospital of Coventry and Warwickshire and the Leeds Teaching Hospitals NHS Trust, join forces to optimise patient diagnosis and treatment. The team is supported by industry partners including TeraView Ltd, Intuitive Surgical, Kuka (world leader of industrial robots), QinetiQ, the National Physical Laboratory and Lubrizol (an international cosmetics company). THz light is non-ionising, uses low power levels such that thermal effects are insignificant and is consequently safe for in vivo imaging of humans. It is very sensitive to intermolecular interactions such as hydrogen bonds, and probes processes that occur on picosecond timescales. Owing to the high sensitivity of THz light to tissue hydration and composition, THz spectroscopic imaging can help locate and diagnose lesions that cannot be seen by other imaging modalities. In Terabotics, we will integrate THz technology into robotic probes to develop improved platforms for cancer detection and surgical removal. We will develop probes that can be used on the skin as well as in the abdominal cavity and, by miniaturising the technology, we will also develop a new flexible probe for robotic colonoscopy. In this way the project will lead to more efficient cancer diagnosis and surgery, saving surgeons' operating time and reducing the number of surgeries needed. This is because accurately determining the extent of cancers prior to surgery will enable better surgical planning and reduce the need for a second surgery. Being able to diagnose cancers in situ will also give a faster diagnosis to treatment time. These factors will reduce trauma, costs, patient backlog and waiting lists, and improve patient outcomes. In short, our breakthrough in developing in situ diagnosis will bring step changes in the detection and treatment of cancer for many years to come.

迫切需要提高外科手术的精确度、可控性和选择性，以应对几种高发癌症。例如，在英国，自20世纪90年代以来，基底细胞癌(BCC)的发病率增加了约250%，每年新增13.7万例基底细胞癌。肠癌是第四大常见癌症，也是导致癌症死亡的第二大常见原因。大约15%的新的肠癌病例是早期的，可以接受潜在的腔内手术；随着国家筛查计划的实施，这一比例正在增加。延误诊断和不完全切除肿瘤是患者发病率的关键驱动因素，浪费了有限的手术资源。随着新冠肺炎导致更多患者积压，简化筛查和早期诊断流程现在变得更加重要。默认的手术做法是尽可能地切除癌症，同时切除边缘的健康组织。留下癌细胞会导致复发，但切除过多的健康组织会增加并发症的风险和正常功能的丧失。试图优化这种平衡是一项全球性的挑战。例如，基底细胞癌通常散布在皮肤表面之下，因此在手术之前无法检测到它们的整体。MoH的显微外科手术是治疗基底细胞癌的黄金标准：肿瘤被一节一节地切除，并在显微镜下检查，直到看不到进一步的肿瘤。这对患者来说既耗时又痛苦，通常会导致移植的皮肤比预期的更大。如果能在手术前使用太赫兹(THz)成像准确地确定肿瘤的范围，手术会更快，移植物也会得到更好的规划。同样，如果能在柔性内窥镜上增加诊断太赫兹成像的能力，更多的结直肠肿瘤可以被原位识别和切除，而不需要等待组织学结果(通常是2周)和后续程序。在这项计划中，一个由华威大学、埃克塞特大学和利兹大学物理、工程和医学专业的研究人员以及考文垂和沃里克郡大学医院以及利兹教学医院NHS信托基金的研究人员组成的高度跨学科的团队，联手优化患者的诊断和治疗。该团队得到了包括TeraView有限公司、直觉外科公司、库卡(工业机器人的世界领先者)、QinetiQ、国家物理实验室和路博润(国际化妆品公司)在内的行业合作伙伴的支持。太赫兹光是非电离的，使用低功率水平，因此热效应微不足道，因此对人体的活体成像是安全的。它对分子间的相互作用非常敏感，例如氢键，以及发生在皮秒时间尺度上的探测过程。由于太赫兹光对组织水合和成分的高度敏感性，太赫兹光谱成像可以帮助定位和诊断其他成像方式看不到的病变。在Terbotics，我们将把太赫兹技术集成到机器人探测器中，以开发用于癌症检测和手术切除的改进平台。我们将开发可用于皮肤和腹部的探头，通过将技术微型化，我们还将开发一种用于机器人结肠镜检查的新的灵活探头。通过这种方式，该项目将导致更高效的癌症诊断和手术，节省外科医生的手术时间，并减少所需的手术次数。这是因为在手术前准确地确定癌症的范围将使更好的手术计划和减少第二次手术的需要。能够原位诊断癌症也将使治疗时间得到更快的诊断。这些因素将减少创伤、成本、患者积压和等待名单，并改善患者结果。简而言之，我们在发展原位诊断方面的突破将在未来许多年带来癌症检测和治疗的阶段性变化。

项目成果

An introduction to terahertz time-domain spectroscopic ellipsometry

• DOI: 10.1063/5.0094056
• 发表时间: 2022-07-01
• 期刊: APL PHOTONICS
• 影响因子: 5.6
• 作者: Chen, X.;Pickwell-MacPherson, E.
• 通讯作者: Pickwell-MacPherson, E.

Active Stabilization of Interventional Tasks Utilizing a Magnetically Manipulated Endoscope.

• DOI: 10.3389/frobt.2022.854081
• 发表时间: 2022
• 期刊: Frontiers in robotics and AI
• 影响因子: 3.4
• 作者: Barducci L;Scaglioni B;Martin J;Obstein KL;Valdastri P
• 通讯作者: Valdastri P

Terahertz photoconductance dynamics of semiconductors from sub-nanosecond to millisecond timescales

• DOI: 10.1063/5.0130721
• 发表时间: 2023-01
• 期刊: Applied Physics Letters
• 影响因子: 4
• 作者: E. Butler-Caddle;N. Grant;S. Pain;J. Murphy;K. Jayawardena;J. Lloyd‐Hughes

Optimum Optical Designs for Diffraction-Limited Terahertz Spectroscopy and Imaging Systems Using Off-Axis Parabolic Mirrors

使用离轴抛物面镜的衍射限制太赫兹光谱和成像系统的最佳光学设计

• DOI: 10.1007/s10762-023-00949-8
• 发表时间: 2023
• 期刊: Journal of Infrared, Millimeter, and Terahertz Waves
• 作者: Chopra N

Monitoring the Terahertz Response of Skin Beneath Transdermal Drug Delivery Patches Using Sparse Deconvolution

• DOI: 10.1109/tthz.2023.3292546
• 发表时间: 2023-09
• 期刊: IEEE Transactions on Terahertz Science and Technology
• 影响因子: 3.2
• 作者: X. Barker;Gonçalo Costa;R. Stantchev;A. Hernandez-Serrano;Gabit Nurumbetov;D. Haddleton;E. Pickwell‐MacPherson