Smart Needle with Intelligent Robotic Control for Prostate Brachytherapy

项目总结/摘要 近距离放射治疗程序是前列腺癌的最流行的治疗方式之一，其中癌细胞被切除。 由外科医生植入的放射性剂量的种子局部照射和破坏。近距离放射治疗的成功 在很大程度上依赖于将种子安全和精确地放置在癌细胞中或癌细胞附近。该程序要求 非常有经验的外科医生，他们在针插入时有直观的感觉，并且能够将针引导到 在手眼协调和成像设备的辅助下定位所需位置。然而，对于传统的刚性针， 只有一条笔直的路径可以到达目标，因此种子的放置需要多次插入， 最近的一项研究表明，在曲线入路中引导针将减少 所需的针插入次数，并提供其他剂量测定益处。缺乏驱动和控制（在 针头插入患者体内）是使该手术具有挑战性的另一个因素。灵活的3D可操纵 具有多方向致动和可靠的引导控制和引导的“智能”针可以帮助外科医生执行 该任务具有更高的准确性，减少了侵入性，并采用曲线方法。此外，远程操作指导 智能针将赋予机器人仪器智能。另一方面，深入了解 针-组织相互作用机制（具有术中模型参数更新以及形状和力感测）是关键 在开发适当的控制和制导策略以补偿系统的不确定性时考虑到这一因素。这项工作 将首先开发一种主动的“智能”近距离放射治疗针，该针将提供强大的驱动、形状和力感测， 组织中的3D运动。然后，将开发一种具有机器人驱动的智能针的远程操作接口，以执行半 自动近距离放射治疗将开发针-组织相互作用的现实分析和计算模型 使用真实的组织特征。这些模型将在控制系统中作为动态模型使用，以做出适当的 在插入任务期间的决定。我们提出的方法的创新功能依赖于我们最先进的智能针 设计、新的动态模型、形状和力传感以及专门为此应用开发的控制算法。 本研究将开发一种临床上可接受尺寸的“智能”手术针，具有机器人控制界面， 评价其在近距离放射治疗过程中的影响。利用主动和被动柔性针进行诊断和 治疗过程是一个快速发展的领域。这项拟议中的研究很有可能导致一场革命。 医疗保健中的针插入实践也有益于各种基于针的过程如药物输送， 活组织检查和介入治疗，其中需要精确的放置和最小的组织损伤。

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.