Physician Assistance Technology in Image-guided Robotic Intervention of Prostate

图像引导机器人前列腺介入治疗的医师辅助技术

• 批准号: 10614594
• 负责人: Nobuhiko Hata
• 金额: $ 66.17万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10614594
• 关键词: Address; Adopted; Animals; Antibiotics; Area; Automobiles; Biopsy; Biopsy Specimen; Clinical; Clinical Research; Collection; Compensation; Data; Detection; Devices; Diagnosis; Diagnostic; Dose; Engineering; Ensure; Escherichia coli; Excision; Functional Imaging; Future; Goals; Guidelines; Gynecologic Brachytherapy; Image; Image Guided Biopsy; Infection; Information Systems; Intervention; Interventional Imaging; Knowledge; Learning; Lesion; Literature; Magnetic Resonance Imaging; Malignant Neoplasms; Malignant neoplasm of prostate; Manuals; Measurement; Measures; Medical Device; Methods; Modernization; Molecular; Motion; Needle biopsy procedure; Needles; Pathologic; Patients; Pelvis; Phenotype; Physicians; Precision Medicine Initiative; Precision therapeutics; Procedures; Prostate; Protocols documentation; Public Health; Radiology Specialty; Rectum; Reporting; Research; Research Methodology; Research Personnel; Robot; Robotics; Safety; Sampling; Science; Site; Specific qualifier value; Techniques; Technology; Testing; Time; Tissues; Translating; Transrectal Ultrasound; Treatment Protocols; Ultrasonography; United States National Institutes of Health; Work; anatomic imaging; cancer diagnosis; cancer therapy; clinical practice; clinically significant; design; detection method; editorial; experience; fluoroquinolone resistance; image guided; image guided intervention; improved; individual patient; innovation; instrument; molecular imaging; next generation; novel; pre-clinical; prevent; programs; prostate biopsy; rectal; risk stratification; robot control; robotic device; technology development; technology platform; tool; tumor; ultrasound

Recent advances in the multi-parametric MRI of the prostate have led to a surge in new research methods for the detection and diagnosis of prostate cancer - with the goal of accurate risk- stratification of prostate cancer. Specifically, a traditional Transrectal Ultrasound (TRUS)-guided biopsy tends to fail, as samples are randomly collected from the prostate without aiming at suspicious lesions often visible in MRI. Currently, several new MRI biopsy approaches have come to the forefront. They are being evaluated and adopted in clinical practice, including in-bore MRI- guided biopsy and TRUS-guided MRI-fusion biopsy, collectively called ‘MRI-targeted biopsy.’ While recent literature shows that MRI-targeted biopsies can detect more clinically significant cancer than a conventional TRUS-guided biopsy, there is still a substantial issue with the precision placement of the needle in these procedures particularly in transperineal approach, resulting in clinicians being overly conservative with the amount of tissue removal (Zhang et al., 2019). Need to address needle placement accuracy in transperineal biopsy is further heightened lately as the fluoroquinolone- resistant Escherichia coli is becoming a significant concern in public health, and clinicians are shifting to use transperineal biopsies to avoid post-biopsy infections and overuse of antibiotics. Literature, as well as our preliminary studies, found that needle deflection is a substantial obstacle for precision aiming in transperineal biopsies. Abundant literature on needle deflection analysis, needle steering, and image-guided robots are available in pre-clinical engineering studies. Yet, clinically viable or proven solutions to address the needle deflection is yet to be seen. Therefore, the objective of this application is to develop and test a cooperative robotic intervention with closed-loop error compensation in MRI targeted biopsies and focal therapies, resulting in more precisely targeted instrument placement. Accurately, we will aim to address needle deflection by the synergic use of advanced imaging and robotics. Guided by robust preliminary data, this objective is achieved by pursuing three specific aims: 1) We will develop novel tracking techniques and clinically deploy a cooperatively controlled, hands-on robotic needle placement manipulator to enable fine instrument control at the periphery of the MRI bore. 2) We will test the usefulness of a cooperatively controlled robot to increase the accuracy of needle placement in animal studies mimicking MRI-guided biopsies of the prostate. Our approach is innovative in its application of novel cooperative robotic control, in which the clinician maintains ultimate control with the direction of motion being autonomous to ensure the desired path is followed to the intended target. The proposed study is also clinically significant since the completion of this current engineering study will enable machine- assisted semi-autonomous percutaneous therapy, much discussed in the recent editorial article in Science Robotics (Yang et al., 2018). The impact of the study reaches beyond MRI-targeted prostate intervention; the technology developed can be translated into other forms of MRI-guided or ultrasound-guided intervention.

最近在前列腺多参数MRI的进展导致了新的激增

项目成果

Promoting the use of the PI-QUAL score for prostate MRI quality: results from the ESOR Nicholas Gourtsoyiannis teaching fellowship.

• DOI: 10.1007/s00330-022-08947-5
• 发表时间: 2023-01
• 期刊: European radiology
• 影响因子: 5.9

A Pilot Study of Multidimensional Diffusion MRI for Assessment of Tissue Heterogeneity in Prostate Cancer.

• DOI: 10.1097/rli.0000000000000796
• 发表时间: 2021-12-01
• 期刊: Investigative radiology
• 影响因子: 6.7
• 作者: Langbein BJ;Szczepankiewicz F;Westin CF;Bay C;Maier SE;Kibel AS;Tempany CM;Fennessy FM
• 通讯作者: Fennessy FM

Intracardiac MR imaging (ICMRI) guiding-sheath with amplified expandable-tip imaging and MR-tracking for navigation and arrythmia ablation monitoring: Swine testing at 1.5 and 3T.

心内 MR 成像 (ICMRI) 引导鞘，具有放大的可扩展尖端成像和 MR 跟踪，用于导航和心律失常消融监测：1.5 和 3T 的猪测试。

• DOI: 10.1002/mrm.29168
• 发表时间: 2022-06
• 期刊: Magnetic resonance in medicine
• 影响因子: 3.3
• 作者: Schmidt EJ;Olson G;Tokuda J;Alipour A;Watkins RD;Meyer EM;Elahi H;Stevenson WG;Schweitzer J;Dumoulin CL;Johnson T;Kolandaivelu A;Loew W;Halperin HR
• 通讯作者: Halperin HR

Contemporary patterns of local ablative therapies for prostate cancer at United States cancer centers: results from a national registry.

• DOI: 10.1007/s00345-023-04354-7
• 发表时间: 2023-05
• 期刊: WORLD JOURNAL OF UROLOGY
• 影响因子: 3.4
• 作者: Koelker, Mara;Labban, Muhieddine;Frego, Nicola;Meyer, Christian P.;Salomon, Georg;Lipsitz, Stuart R.;Withington, John;Moore, Caroline M.;Tempany, Clare M.;Tuncali, Kemal;George, Arvin;Kibel, Adam S.;Trinh, Quoc-Dien;Cole, Alexander P.
• 通讯作者: Cole, Alexander P.

PI-RADS 3 score: A retrospective experience of clinically significant prostate cancer detection.

• DOI: 10.1002/bco2.231
• 发表时间: 2023-07
• 期刊: BJUI COMPASS
• 作者: Camacho, Andres;Salah, Fatima;Bay, Camden P.;Waring, Jonathan;Umeton, Renato;Hirsch, Michelle S.;Cole, Alexander P.;Kibel, Adam S.;Loda, Massimo;Tempany, Clare M.;Fennessy, Fiona M.
• 通讯作者: Fennessy, Fiona M.