Innovation Corps Administrative Supplement for Magnetic Bronchoscope for Improved Pulmonary Access

每16名美国人中就有一人在有生之年被诊断出患有肺癌。每年在美国 有近250,000例新诊断和150,000例死亡，估计生产力损失超过 200亿美元。由于最近CT成像的进步，检测到较小的可疑肺结节 在肺的远端区域内现在是可能的。结果，死亡率下降了近20%， 更早地启动治疗方案。能够安全地获得可行的活检样本是至关重要的。 然而，尽管可以获得更好的CT成像，但在扩大负担得起方面进展甚微 可以安全地进入肺部远端区域以诊断和分期可疑结节的工具。 经皮针刺活检仍然是获取结节组织样本的标准护理方法，尽管 手术与气胸并发症的发生率超过20%有关。相比之下，支气管镜检查 用于获取活组织检查的安全性是10倍。然而，支气管镜有两个主要限制 导致许多肺癌不能被成功诊断。首先，相对较大的尺寸阻止了它们 无法接触到肺的大部分。其次，因为支气管镜的尖端是从 使用复杂的基于拉线的机构，在近一米之外提供了对尖端的有限控制， 在很大程度上将活检限制在呼吸道内的结节。为了改进人工支气管镜检查，机器人解决方案 已经开发出来了；然而，这些技术很难学习，不会大大改善远端通达 或小费控制，对于大多数医院来说，费用高得令人望而却步(约50万美元)。因此，采用机器人技术 支气管镜检查进展缓慢。UNandUP发明了一种新型的机器人支气管镜检查平台，它提供了 使用比以前可能的更小的范围直径精确控制支气管镜的尖端，这使得 安全进入否则无法进入的肺区，以及更好地对不直接位于肺内的结节进行活检的能力 气道口。通过克服传统机器人方法的复杂性，所提出的技术可以 定价仅为竞争对手机器人解决方案的一小部分。这将使先进的肺活检能力 提供给几乎所有的医院，而不是只在特定的机构提供。重要的是，这项技术 还承诺成为新兴癌症疗法的探索平台，其中包括基因， 光动力疗法和消融疗法。该项目的目标包括1)建造机器人工作站，2)建造 可操纵的支气管镜，以及3)评估基于CT的支气管镜的性能。

One of every 16 Americans will be diagnosed with lung cancer in their lifetime. Each year in the United States there are nearly 250,000 new diagnoses and 150,000 deaths with an estimated productivity loss in excess of $20 billion. Thanks to recent advancements in CT imaging, detection of smaller suspicious pulmonary nodules within distal regions of the lung is now possible. As a result, mortality rates have decreased by nearly 20% due to earlier initiation of treatment protocols. The ability to safely obtain a viable biopsy sample is critical. However, despite the availability of better CT imaging, little progress has been made in expanding affordable tools which can safely access distal regions of the lung to diagnose and stage suspicious nodules. Percutaneous needle biopsy remains the standard of care used to obtain nodule tissue samples, although the procedure is associated with pneumothorax complication rates greater than 20%. In contrast, bronchoscopes are 10X safer when used to acquire biopsies. However, bronchoscopes possess two main limitations which result in many lung cancers not being successfully diagnosed. First, the relatively large size prevents them from being able to access most of the lung. Second, because the bronchoscope’s tip is manipulated from nearly a meter away using complex pull-wire based mechanisms, limited control of the tip is provided which largely restricts biopsy to nodules within the airway. To improve upon manual bronchoscopes, robotic solutions have been developed; however, these technologies are difficult to learn, do not greatly improve distal access or tip control, and are prohibitively expensive (~$500k) for most hospitals. As a result, adoption of robotics for bronchoscopy has been slow. UNandUP has invented a novel robotic bronchoscopy platform that provides precise control of the bronchoscope’s tip using a smaller scope diameter than previously possible that enables safe access into otherwise inaccessible lung regions and the ability to better biopsy nodules not directly in the airway. By overcoming the complexities of traditional robotic approaches, the proposed technology can be priced at a fraction of the cost of competing robotic solutions. This will allow advanced lung biopsy capabilities to be offered to nearly all hospital versus only being available at select institutions. Importantly, the technology also promises to serve as an exploratory platform for emerging cancer therapies which include gene, photodynamic, and ablation therapies. The project’s aims include 1) building the robotic workstation, 2) building a steerable bronchoscope, and 3) assessing performance in CT-based bronchial phantoms.