Smart Needle with Intelligent Robotic Control for Prostate Brachytherapy

项目摘要/摘要 近距离放射治疗是前列腺癌最常用的治疗方法之一，前列腺癌的癌细胞 通过外科医生植入的放射性剂量的种子进行局部照射和破坏。近距离放射治疗的成功 这在很大程度上依赖于将种子安全和准确地放置在癌细胞内或其附近。该过程需要一个 非常有经验的外科医生，他对针的插入有一种直观的感觉，并能够将针引导到 具有手眼协调和成像设备辅助的理想位置。然而，使用传统的刚性针， 只能实现朝向目标的直线路径，因此种子放置需要具有高度的多次插入 针头路径上的组织损伤。最近的一项研究表明，以曲线方式引导针头会减少 所需的针头插入次数，并提供其他剂量学好处。缺乏动力和控制(在 针被插入患者体内)是使这一过程具有挑战性的另一个因素。一种灵活的3D操纵器 具有多个方向的驱动和可靠的引导控制和引导的“智能”针可以帮助外科医生完成 这项任务具有更高的准确性，减少了侵入性，并以曲线的方式进行。此外，远程操作指导 智能针将赋予机器人仪器以智能。另一方面，深入了解 针-组织相互作用机制(术中模型参数更新和形状和力感知)是关键 制定适当的控制和制导策略以补偿系统不确定性的因素。这部作品 将首先开发一种主动的“智能”近距离治疗针，它将提供强大的驱动、形状和力传感，以及 组织中的3D运动。然后，将开发一个与机器人驱动的智能针的遥操作接口，以执行半 自动近距离放射治疗。将开发现实的针-组织相互作用的分析和计算模型 使用真实的组织特征。这些模型将在控制系统中用作动态模型，以使适当的 插入任务期间的决策。我们提出的方法的创新功能依赖于我们尖端的智能针 设计，新的动态模型，形状和力传感，以及专门为这一应用开发的控制算法。 目前的研究将开发一种临床上可接受的具有机器人控制界面的“智能”手术针，并 评估其在近距离放射治疗中的影响。主动和被动柔针在诊断和治疗中的应用 治疗程序是一个快速发展的领域。这项拟议的研究很有可能导致一场革命性的 医疗保健中的针插入实践也有利于诸如药物输送的各种基于针的程序， 活组织检查和介入治疗，需要精确的定位和最小的组织损伤。

PROJECT SUMMARY/ABSTRACT Brachytherapy procedure is one of the most popular treatment modalities for prostate cancer where cancerous cells are irradiated and destroyed locally by the radioactive dosage of seeds implanted by the surgeon. The success of brachytherapy heavily relies on safe and precise placement of the seeds in or adjacent to the cancerous cells. The procedure demands a very experienced surgeon who have developed an intuitive feel in needle insertions and is able to guide the needle into a desired location with hand-eye coordination and assistance of an imaging device. However, with conventional rigid needles, only a straight path is achievable towards the target, and thereby seed placements require several insertions with a high tissue damage on the needle’s path. A recent study has shown that guiding the needle in a curvilinear approach will decrease the number of needle insertions required and provide other dosimetric benefits. Lack of actuation and control (after the needle is inserted into the patient’s body) is another factor that make the procedure challenging. A flexible 3D steerable “smart” needle with multi-directional actuation and a reliable guidance control and guidance can aid the surgeon to perform the task with more accuracy, reduced invasiveness, and in a curvilinear approach. Furthermore, teleoperative guidance for the smart needle will endow the robotic instrument with intelligence. On the other hand, in-depth understanding of the needle-tissue interaction mechanism (with intraoperative model parameter updates and shape- and force-sensing) is a key factor in development of an appropriate control and guidance strategies to compensate for system uncertainties. This work will first develop an active “smart” brachytherapy needle that will provide robust actuation, shape- and force-sensing, and 3D motion in tissue. Then a teleoperative interface with robot-driven smart needle will be developed to perform semi- automated brachytherapy. Realistic analytical and computational models of needle-tissue interactions will be developed using realistic tissue characteristics. These models will be used in the control system as dynamic models to make appropriate decisions during an insertion task. The innovative features of our proposed methods rely on our cutting-edge smart needle design, new dynamic models, shape- and force-sensing, and control algorithm specifically developed for this application. The present studies will develop a clinically acceptable size “smart” surgical needle with a robotic control interface and evaluate its impact in brachytherapy procedure. Utilization of active and passive flexible needles for diagnosis and therapeutic procedures is a rapidly advancing filed. This proposed research has a high potential to lead to a revolutionary needle insertion practice in healthcare that is also beneficial to various needle-based procedures such as drug delivery, biopsy, and interventional therapy where an accurate placement is needed with minimal tissue damage.