Reaching inaccessible anatomy percutaneously via multi-lumen steerable needles

通过多腔可操纵针经皮到达难以接近的解剖结构

• 批准号: 7874963
• 负责人: Ron Alterovitz
• 金额: $ 23.31万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7874963
• 关键词: Accounting; Air; Algorithms; Anatomy; Animal Experiments; Animals; Area; Biological Models; Biomechanics; Biopsy; Blood Vessels; Body cavities; Brachytherapy; Brain; Cadaver; Clinical; Computer software; Deep Brain Stimulation; Devices; Dose; Elements; Engineering; Exploratory/Developmental Grant; Feedback; Fluoroscopy; Foundations; Future; Human; Human body; Image; Image Analysis; Injection of therapeutic agent; Intervention; Kidney; Life; Liquid substance; Liver; Location; Lung; Magnetism; Malignant neoplasm of lung; Mechanics; Medical Imaging; Methods; Mission; Modeling; Motion; Needles; Nerve; Oncologist; Operative Surgical Procedures; Pharmaceutical Preparations; Physicians; Planning Techniques; Positioning Attribute; Procedures; Prostate; Public Health; Radiation; Research; Robotics; Shapes; Simulate; Site; Structure; Surgeon; System; Tars; Tissues; Tube; Ultrasonography; Uncertainty; Urologic Surgeon; Urology; Work; abstracting; base; body cavity; cancer therapy; clinical application; clinical research site; computer science; design; flexibility; high risk; improved; interest; kinematics; minimally invasive; model design; multidisciplinary; pre-clinical; prototype; public health relevance; research study; simulation; simulation software; soft tissue; tool

DESCRIPTION (provided by applicant): The objective of this proposal is to develop multi-lumen steerable needles capable of controllable curved paths through both soft tissues and open or liquid-filled cavities. The pre-curved lumens, or tubes, are nested within each other in a telescoping fashion, enabling control of the needle's shaft shape and curvature in open cavities. Our needles will also harness tip forces for steering, dynamically modifying their forward cutting trajectory through soft tissues. The broad, long-term objective of this work is to create a needle that is (1) more accurate than existing needles, and (2) more dexterous than existing needles. Accuracy is essential, because efficacy in nearly all needle-based interventions (biopsy, therapy delivery, etc.) is strongly correlated to the accuracy with which the needle tip is placed at the desired target. Enhanced dexterity allows the needle to reach previously inaccessible locations, which will enable entirely new minimally invasive percutaneous treatments. Specifically we foresee compelling applications in lung cancer treatment, deep brain stimulation, and prostate brachytherapy - areas where there are anatomical obstacles that require the needle to maneuver through curved trajectories. This research directly aligns with NIH's mission to improve public health; our new multi-lumen steerable needles will enable minimally invasive, percutaneous access to previously unreachable clinical targets for biopsy, local drug injection, radiation dose delivery, surgical interventions, and other procedures. The specific aims of this research are to (1) Design and model multi-lumen steerable needles, (2) Develop simulation and planning software, (3) Construct an integrated pre-clinical testbed capable of robotically control- ling multi-lumen steerable needles. The methods used to achieve these aims will include kinematic and beam mechanics models for the tip and shaft trajectories of flexible needles in soft tissues, optimization-based motion planning techniques, and finite element simulation. We will evaluate the new devices and methods we develop in phantom and ex vivo tissues to establish the feasibility of the approach. Working with clinical collaborators in urology and cardiothoracic surgery we will develop a system that accounts for relevant clinical constraints and objectives, paving the way for future animal, cadaver, and human studies. In summary, we propose a multidisciplinary effort combining mechanical engineering, computer science, and biomechanical modeling to design and develop hardware and software that will dramatically increase minimally invasive access to many sites of clinical importance within the human body. PUBLIC HEALTH RELEVANCE: We will develop multi-lumen steerable needles capable of controllable curved trajectories in the human body. These needles will enhance needle tip placement accuracy under image guidance, thereby increasing the efficacy of a wide variety of needle-based interventions. They will also enable entirely new percutaneous procedures by endowing surgical tools with the ability to maneuver around obstacles to reach previously inaccessible clinical targets.

描述（由申请人提供）：本提案的目的是开发能够通过软组织和开放或液体填充腔的可控弯曲路径的多腔可控针。预弯曲的管腔或管以伸缩方式彼此嵌套，使得能够控制开放腔中的针的轴形状和曲率。我们的针还将利用尖端力进行转向，动态修改其通过软组织的向前切割轨迹。 这项工作的广泛的长期目标是创造一种（1）比现有的针更精确，（2）比现有的针更灵巧的针。准确性至关重要，因为几乎所有基于针的干预（活检、治疗输送等）的有效性与针尖放置在期望目标处的精度密切相关。增强的灵活性使针头能够到达以前无法到达的位置，这将使全新的微创经皮治疗成为可能。具体来说，我们预见在肺癌治疗、脑深部电刺激和前列腺近距离放射治疗中的引人注目的应用-这些领域存在解剖障碍，需要针通过弯曲的轨迹进行操纵。这项研究直接符合NIH的使命，以改善公众健康;我们的新的多腔可控针将使微创，经皮进入以前无法达到的临床目标活检，局部药物注射，辐射剂量输送，外科手术干预和其他程序。 本研究的具体目的是（1）设计和建模多腔可操纵针，（2）开发模拟和规划软件，（3）构建能够机器人控制多腔可操纵针的集成临床前试验台。用于实现这些目标的方法将包括软组织中柔性针的尖端和轴轨迹的运动学和梁力学模型、基于优化的运动规划技术和有限元模拟。我们将评估我们在体模和离体组织中开发的新器械和方法，以确定该方法的可行性。与泌尿外科和心胸外科的临床合作者合作，我们将开发一个系统，说明相关的临床约束和目标，为未来的动物，尸体和人体研究铺平道路。总之，我们提出了一个多学科的努力，结合机械工程，计算机科学和生物力学建模，设计和开发硬件和软件，将大大增加微创进入人体内的许多临床重要性的网站。 公共卫生相关性：我们将开发能够在人体内实现可控弯曲轨迹的多腔可控针。这些针将在图像引导下提高针尖放置的准确性，从而提高各种基于针的干预的有效性。它们还将使全新的经皮手术成为可能，赋予手术工具绕过障碍物的能力，以达到以前无法达到的临床目标。