Compact registration-free robotic tool guide for image guided percutaneous interventions

项目摘要/摘要 影像指导成为现代医疗干预的关键要素。尤其是核磁共振成像，一直以来 由于其优越的软性，被研究为各种癌症活检和局部治疗的经皮工具指南 组织对比度和多参数图像处理能力，可精确定位目标组织。前列腺 癌症，在美国是一个主要的健康问题，一直是可以受益于核磁共振的开创性领域之一 作为指导，当在局部或区域阶段检测到存活率时，接近100%。核磁共振成像的使用有 提高了癌症的发现率，使早期局部治疗成为可能。然而，尽管结果令人振奋，核磁共振 由于前列腺介入术的技术复杂性，导引前列腺介入术尚未广泛应用于临床。 这样的干预。复杂性造成的主要阻力是冗长的程序时间。磁共振成像引导 前列腺活检需要2~3小时，而常规超声通常只需要0.5小时左右 引导活检。延长程序的主要原因是干预内孔设置和重复图像配准。 通过多年在MRI引导下的前列腺介入治疗的实践经验 试验中，已经意识到包括移动病床的MRI空间已经完全数字化，因此， 可以省去复杂的设备到图像配准过程。同时简化了硬件和 增强了MRI的兼容性，整个手术时间可以显著减少到与超声波相当 引导下的前列腺介入治疗。最终的目标是通过加强早期发现来提高癌症存活率。 并能进行可治愈的局部治疗。这项提案的总体目标是制定和评估一项契约 用于MRI引导的前列腺介入手术的免注册四自由度机器人工具导向器 在典型的核磁共振诊断性设置中需要一个小时。我们实现这一目标的方法是实施一种新的 机械手机构，可以将设备紧凑，为临床提供更多的空间，并消除 通过粘贴和动态跟踪设备来重复设备到图像的配准过程，这可以 极大地简化了程序。合理化的干预和程序可以实现一站式 明确的诊断可能会取代目前前列腺癌几个月来多次就诊的做法。 在这个R15项目中，一个由多学科调查人员和生物启发工程学本科生组成的团队 将设计、开发和测试拟议中的机器人实验室和核磁共振套件之间的干预。促进 桌面开发和现场实验的实践经验将加强生物医学研究 美国最大的以本科生为中心的大学的环境并为学生提供灵感 以及更多获得生物医学研究经验的机会。

PROJECT SUMMARY/ABSTRACT Image guidance became a key element of modern medical interventions. MRI, in particular, has been investigated as percutaneous tool guidance for various cancer biopsy and focal therapies due to its superior soft tissue contrast and multi-parametric image processing capabilities to precisely localize target tissues. Prostate cancer, a major health concern in the US, has been one of the pioneering areas that can benefit from MRI guidance as the survival rate, when detected at local or regional stages, is nearly 100%. The use of MRI has increased cancer detection rate and enabled early focal treatments. Despite promising results, however, MRI guided prostate intervention has not been widely implemented in clinical practice due to technical complexity of such interventions. The major resistance caused by the complexity is lengthy procedure time. MRI guided prostate biopsy takes 2~3 hours whereas only around 0.5 hour is usually required for conventional ultrasound guided biopsy. The prolonged procedure is mainly due to intervention in-bore setup and repeat image registration. Through many years of hands-on experience on MRI guided prostate intervention developments and clinical trials, it has been realized that an MRI space including moving patient table is already fully digitized, hence, complex device-to-image registration processes can be eliminated. Along with simplification of hardware and increased MRI compatibility, overall procedure time can be significantly reduced to be comparable to ultrasound guided prostate interventions. The ultimate goal is to increase cancer survival rate by enhancing early detection and enabling curable focal therapy. The overall objective of this proposal is to develop and evaluate a compact registration-free 4-DOF robotic tool guide for MRI guided prostate intervention that can be performed less than an hour in a typical diagnostic MRI setup. Our approach to achieve the objective is to implement a novel manipulator mechanism that can compact the device providing more space for clinical access, and eliminate repeat device-to-image registration processes by affixing and kinematically tracking the device, which can dramatically simplify the procedure. The rationalized intervention and procedure could enable a one-stop definitive diagnosis that could replace the current prostate cancer practice of multiple hospital visits over months. In this R15 project, a team of multidisciplinary investigators and bio inspired engineering undergraduate students will design, develop, and test the proposed intervention between a robotics laboratory and MRI suite. Facilitating hands-on experience on benchtop developments and onsite experiments will strengthen biomedical research environment of the largest undergraduate centered university in the US and provide students with inspirations and more opportunities to gain biomedical research experience.