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A Cyber-Physical System for Unified Diagnosis and Treatment of Lung Diseases

肺部疾病统一诊疗的网络物理系统

基本信息

批准号：
MR/T023252/1
负责人：
Mohsen Khadem
金额：
$ 138.04万
依托单位：
University of Edinburgh
依托单位国家：
英国
项目类别：
Fellowship
财政年份：
2020
资助国家：
英国
起止时间：
2020 至无数据
项目状态：
未结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FT023252%2F1
关键词：
Cyber Physical System Unified Diagnosis

项目摘要

In this research, I will develop a cyber-physical system (CPS) for the diagnosis and treatment of lung diseases. My project is motivated by three facts: 1) Lung cancer treatment is most successful when it is found at an early stage. Treatment of early-stage cancer offers 73% chance of survival, whereas in late-stage this is reduced to 13%. However, the current methods for early diagnosis of peripheral lung lesions using bronchoscopic biopsy are challenging with varying diagnostic yield. Thus, there is a need to develop new technologies for reliable diagnosis of cancer in the lung periphery.2) At present, surgical resection of malignant nodules (Tumours<3cm diameter) in the lung is the treatment modality of choice. However, most patients are not suitable surgical candidates, thus prompting the need for other therapeutic options. An emerging less invasive treatment option is bronchoscopic ablation of lung cancer via delivering physical therapy to lesions in the lung (cryotherapy/photonic ablation). Bronchoscopic ablation is not widely used to treat lung cancer, primarily due to the limited depth of penetration and small range of motion of the bronchoscope. 3) The overall in-hospital mortality rate for patients in ICU with ventilator associated events approaches 30%. New pulmonary infiltrates are a diagnostic challenge and due to the poor sampling methods available, patients are often initiated on non-targeted therapies. Bronchoscopy and sampling of the distal lung in diffuse diseases is not standardised and lacks repeatability and requires expert operators. The key aim of this research is to democratise ICU bronchoscopy and develop a platform using vision computing, EMT and external registration to enable non-skilled operators to sense, sample and diagnose pathology in vivo in situ.To this end, I propose a CPS that addresses the unique issues of bronchoscopic diagnosis and treatment of lung diseases using novel mechatronic systems, control algorithms, and image guidance. The CPS has the potential to deliver unified diagnosis and treatment platform for early-stage lung cancer and on-site differential diagnosis of diffuse lung diseases by enhancing the current bronchoscopic technology in two specific ways:1) Manipulation augmentation: I will design and develop a mechatronic device comprised of an active mini-bronch and a user interface for steering. The active mini-bronch is made of a flexible robot equipped with an endoscopic camera, fibre-optics for molecular imaging/sensing of tissue. It also provides a working channel that can be used for ablation of cancerous tissue or tissue sampling. The proposed mechatronic device can be used in two scenarios: (1) Autonomous tissue sampling in intensive care units: The mini-bronch uses control algorithms to navigate to lung subsegments and take multiple samples for diagnosis, (2) Semi-autonomous tissue diagnosis/treatment: the operator uses the user interface to navigate the mini-bronch to the periphery of the lung, characterise, sample and detect cancerous tissue, and then ablate . My control algorithms will provide unprecedented capabilities in terms of dexterity, safety, and ease of operation. 2) Visual augmentation: A key goal is to develop algorithms that employ emerging molecular imaging techniques to provide an imaging technology for in-vivo diagnosis of lung diseases. I postulate that the proposed CPS will enable rapid on-site evaluation of lung diseases and successful bronchoscopic detection and therapy.

在本研究中，我将开发一个用于肺部疾病诊断和治疗的信息物理系统（CPS）。我的项目是基于三个事实：1）肺癌治疗最成功的时候是在早期发现。早期癌症的治疗提供了73%的生存机会，而在晚期则降低到13%。然而，目前使用支气管镜活检早期诊断外周肺病变的方法具有不同的诊断率。因此，有必要开发新的技术来可靠地诊断肺周围的癌症。2）目前，手术切除肺部恶性结节（肿瘤直径<3cm）是首选的治疗方式。然而，大多数患者不适合手术，因此需要其他治疗方案。一种新兴的微创治疗选择是通过对肺部病变进行物理治疗（冷冻疗法/光子消融）进行支气管镜肺癌消融。支气管镜消融术未广泛用于治疗肺癌，主要是由于支气管镜的穿透深度有限且活动范围小。3)ICU中呼吸机相关事件患者的总体院内死亡率接近30%。新的肺浸润是一个诊断挑战，由于可用的采样方法差，患者往往开始非靶向治疗。弥漫性疾病中的支气管镜检查和远端肺取样没有标准化，缺乏可重复性，需要专业操作员。本研究的主要目的是民主化ICU支气管镜检查，并开发一个平台，使用视觉计算，EMT和外部注册，使非熟练的操作人员能够感测，采样和诊断病理在体内situ.To为此，我提出了一个CPS，解决了独特的问题，支气管镜诊断和治疗肺部疾病，使用新型机电系统，控制算法和图像引导。CPS有可能通过两种特定方式增强当前支气管镜技术，为早期肺癌和弥漫性肺部疾病的现场鉴别诊断提供统一的诊断和治疗平台：1）操作增强：我将设计和开发一种机电一体化设备，包括一个主动微型支气管和一个用于转向的用户界面。主动微型支气管由配备内窥镜摄像机的柔性机器人制成，光纤用于组织的分子成像/传感。它还提供了一个工作通道，可用于消融癌组织或组织取样。所提出的机电设备可用于两种场景：（1）重症监护室中的自主组织采样：微型支气管使用控制算法导航到肺子段并采集多个样本进行诊断，（2）半自主组织诊断/治疗：操作者使用用户界面来将微型支气管导航到肺的外围、活检、取样和检测癌组织，然后切除。我的控制算法将提供前所未有的灵活性，安全性和操作简便性。2)视觉增强：一个关键目标是开发采用新兴分子成像技术的算法，以提供用于肺部疾病的体内诊断的成像技术。我假设，拟议的CPS将能够快速现场评估肺部疾病和成功的支气管镜检测和治疗。