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价用于儿科介入手术中针引导的患者安装MRI兼容肩关节造影机器人。这种安装在身体上的机器人将为儿科关节造影提供一种新颖的简化工作流程，消除对荧光透视的需要，同时在MRI环境中提供准确的针引导。 关节造影术是用于评价关节状况的常用手术，包括肩关节、髋关节、膝关节和踝关节等部位。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的程序，包括活检，引流和消融。该提案是我们为儿科患者提供MRI引导的无辐射手术的长期目标的第一步。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MRI引导的干预。我们的具体目标是：1.设计、构建和评估患者安装的MRI兼容机器人，用于肩关节造影。该机器人将被绑在MRI扫描仪中的儿童身上，并将根据图像精确地定位针引导器以进行造影剂注射。医生将通过针导手动放置针，并在验证针位置后注射造影剂。然后进行诊断性MRI检查，观察造影剂扩散情况并评价关节状况。2.开发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针插入前的轨迹验证。3.将机器人与规划工作站集成，并使用拟人模型在MRI环境中评估系统。根据需要修改系统，并使用邓迪大学（英国）的MRI研究机构完成对Thiel防腐尸体的最终测试。4.获得所需的批准，然后在10名儿科受试者中完成首次人体临床试验，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.