MRI Compatible Body-Mounted Robot to Streamline Pediatric Shoulder Arthrography

 描述(由申请人提供)：本提案的目标是开发和评估一种患者安装的、与MRI兼容的肩关节造影术机器人，用于儿科介入手术中的针灸指导。安装在身体上的机器人将实现一种新颖的简化的儿科关节造影工作流程，它将消除对透视的需要，同时在核磁共振环境中提供准确的针头引导。关节造影术是评估关节状况的常用方法，包括肩部、髋部、膝盖和脚踝等部位。虽然这项建议的重点是儿科，但开发的技术也适用于成人手术。这里开发的机器人技术也将适用于许多其他基于针头的程序，包括活组织检查、引流和消融。这项提议是我们为儿科患者提供MRI引导的无辐射手术这一长期目标的第一步。MRI扫描是肌肉骨骼成像的标准护理，因此肌肉骨骼损伤非常适合于MRI引导的介入治疗。我们的具体目标是：1.设计、建造和评估患者安装的、与MRI兼容的肩关节造影机器人。机器人将被绑在核磁共振扫描仪中的儿童身上，并根据图像精确定位针头导向器以进行对比注射。医生将通过导针手动放置针头，并在验证针头位置后注射造影剂。然后将获得诊断性磁共振成像，以观察对比剂的扩散并评估关节状况。2.开发了一个路径规划工作站，用于图像到机器人的配准、目标位置的选择和手动插针前的轨迹验证。3.将机器人与规划工作站集成，并在核磁共振环境中使用拟人模型对系统进行评估。根据需要修改系统，并使用邓迪大学(英国)的核磁共振研究设施在经过硫磺防腐处理的身体上完成最终测试。4.获得所需的批准，然后在10名儿科受试者中完成第一次人类临床试验，以评估该技术的安全性和可行性。

 DESCRIPTION (provided by applicant): The goal of this proposal is to develop and evaluate a Patient-Mounted MRI-Compatible Shoulder Arthrography Robot for Needle Guidance in Pediatric Interventional Procedures. The body-mounted robot will enable a novel streamlined workflow for pediatric arthrography that will eliminate the need for fluoroscopy while providing accurate needle guidance in the MRI environment. Arthrography is a commonly performed procedure for evaluation of joint condition, including the shoulder, hip, knee, and ankle, among other sites. While this proposal is focused on pediatrics, the techniques developed are applicable to adult procedures as well. The robotic technology developed here will also be applicable to many other needle-based procedures, including biopsy, drainage, and ablation. This proposal is a first step in our long-term goal of offering MRI-guided radiation free procedures to our pediatric patients. MRI scanning is the standard of care for musculoskeletal imaging and therefore musculoskeletal injuries are well suited to MRI-guided interventions. Our specific aims are to: 1. Design, construct, and evaluate a patient-mounted, MRI-compatible robot for shoulder arthrography. The robot will be strapped on the child in the MRI scanner and will precisely orient a needle guide for contrast injection, based on the images. The physician will place the needle manually through the needle guide and inject the contrast once the needle position is verified. A diagnostic MRI will then be obtained to observe the spread of contrast and evaluate the joint condition. 2. Develop a path planning workstation for image-to-robot registration, selection of the target location, and trajectory verification before manual needle insertion. 3. Integrate the robot with the planning workstation and evaluate the system in the MRI environment using anthropomorphic phantoms. Modify the system as needed and complete final testing on Thiel-embalmed cadavers using the MRI research facility at the University of Dundee (UK). 4. Obtain the required approvals and then complete a first-in-human clinical trial in ten pediatric subjects to evaluate the safety and feasibility of the technique.