Augmented Reality Real-Time Guidance for MRI-Guided Interventions

项目摘要 该提案的目的是将先前第一阶段项目的结果，即一个契约， 器械引导系统，允许医生看到器械通过MRI容积推进， 使用特殊的针头、特殊的头盔或校准步骤。MRI引导已用于经皮 针注射诊断和治疗神经性疼痛，进行针活检，引流，肿瘤消融， 其他临床适应症。在儿科环境中，MR和超声优于CT和X射线 成像，因为没有电离辐射发射。此外，MR图像更适合MSK软件的可视化 组织和骨病变，临床医生首选，但需要进行实时穿刺的时间 MR引导下的插入，以及孔内插入的不良人体工程学。 儿童骨肿瘤和其他可疑骨病变的准确和快速诊断是至关重要的， 适当的临床管理。儿童骨活检程序需要更高的靶向精度， 由于其较小的尺寸而具有准确性。由于目前的局限性，MRI引导下骨活检并没有被常规使用 工具和技术。“推进和检查”技术，通过该技术引导/监测针轨迹 通过中间扫描已经从CT环境中转换，但是这种技术在CT中工作良好 因为快速的图像采集和短的扫描仪孔，这是非常耗时的， 在MRI环境中就不那么方便了。第二阶段工作的总体目标是调整 在第一阶段开发的技术，以帮助临床医生准确和快速的图像引导仪器 仅使用MRI扫描时的位置。MRI引导介入的拟议导航系统将 通过使用计算机视觉和硬件进步来提高护理标准， 操作者可以使用配套设备，自动执行许多当前需要用户输入的步骤。的 LUMENA系统将引导反馈直接投射到介入部位以及监视器上。这 这种方法允许介入医生将他们的注意力集中在插入部位而不是监视器上， 别当着他们的面说预计的反馈很容易遵循，并且可以很容易地理解，这使得 系统直观，几乎没有学习曲线。通过使MRI引导的活检更快， 器械的另一个优点是，它将允许在MR引导下进行更多的介入手术，减少电离 辐射对病人和医生都是一样的。

Project Summary The objective of this proposal is to move into clinical practice the result of a preceding Phase I project, a compact instrument guidance system that allows physicians to see instruments advancing through an MRI volume without utilizing special needles, special headgear or calibration steps. MRI-guidance has been used for percutaneous needle injections to diagnose and treat neuropathic pain, perform needle biopsy, drainage, tumor ablation, and other clinical indications. In a pediatric setting, there is a preference for MR and ultrasound over CT and X-ray imaging because no ionizing radiation is emitted. Further, MR images are better for visualization of MSK soft tissue and bone lesions and would be preferred by clinicians but for the length of time to perform real-time needle insertions under MR guidance, and the poor ergonomics of in-bore insertions. Accurate and rapid diagnosis of bone tumors and other suspicious bone lesions in children is essential to appropriate clinical management. Bone biopsy procedures in children require higher targeting precision and accuracy due to their smaller sizes. MRI-guided bone biopsy is not routinely used because of current limitations in tools and technology. The “advance and check” technique whereby the needle trajectory is guided/monitored by intermediate scans has been translated from the CT environment, but this technique works well in the CT environment because of quick image acquisitions and short scanner bores. It is much more time consuming and much less convenient in the MRI environment. The overall objective of this Phase II effort is to adapt the technologies developed in the phase I to assist clinicians in accurate and fast image-guided instrument placement when using only MRI scans. The proposed navigation system for MRI-guided interventions will improve the standard of care by using computer vision and hardware advances to become a nearly hands-off companion device to the operator, automatically performing many steps which currently require user input. The LUMENA system projects the guidance feedback directly onto the intervention site as well as on a monitor. This approach allows the interventionalist to keep their focus on the insertion site instead of the monitor which is often not in front of them. The projected feedback is simple to follow and can be easily understood which makes the system intuitive with almost no learning curve. By making MRI-guided biopsies faster, the societal impact of the device is that it will allow more interventional procedures to be performed under MR-guidance, reducing ionizing radiation for patients and physicians alike.