A brief overview of the current state of the art is given, along with a description of the main opportunities, possibilities and challenges that the future will bring to this exciting and promising field.
Magnetic resonance elastography (MRE) is an emerging technique capable of measuring the shear modulus of tissue. A suspected tumour can be identified by comparing its properties with those of tissues surrounding it; this can be achieved even in deep-lying areas as long as mechanical excitation is possible. This would allow non-invasive methods for cancer-related diagnosis in areas not accessible with conventional palpation. An actuating mechanism is required to generate the necessary tissue displacements directly on the patient in the scanner and three different approaches, in terms of actuator action and position, exist to derive stiffness measurements. However, the magnetic resonance (MR) environment places considerable constraints on the design of such devices, such as the possibility of mutual interference between electrical components, the scanner field, and radio frequency pulses, and the physical space restrictions of the scanner bore. This paper presents a review of the current solutions that have been developed for MRE devices giving particular consideration to the design criteria including the required vibration frequency and amplitude in different applications, the issue of MR compatibility, actuation principles, design complexity, and scanner synchronization issues. The future challenges in this field are also described.
The developments of medical practices and medical technologies have always progressed concurrently. The relatively recent developments in endoscopic technologies have allowed the realization of the “minimally invasive” form of surgeries. The advancements in robotics facilitate precise surgeries that are often integrated with medical image guidance capability. This in turn has driven the further development of technology to compensate for the unique complexities engendered by this new format and to improve the performance and broaden the scope of the procedures that can be performed. Medical robotics has been a central component of this development due to the highly suitable characteristics that a robotic system can purport, including highly optimizable mechanical conformation and the ability to program assistive functions in medical robots for surgeons to perform safe and accurate minimally invasive surgeries. In addition, combining the robot-assisted interventions with touch-sensing and medical imaging technologies can greatly improve the available information and thus help to ensure that minimally invasive surgeries continue to gain popularity and stay at the focus of modern medical technology development. This paper presents a state-of-the-art review of robotic systems for minimally invasive and noninvasive surgeries, precise surgeries, diagnoses, and their corresponding technologies.
Magnetic resonance imaging presents high-resolution preoperative scans of target tissue and allows for the availability of intraoperative real-time images without the exposure of patients to ionizing radiation. This has motivated scientists and engineers to integrate medical robotics with the magnetic resonance imaging modality to allow robot-assisted, image-guided diagnosis and therapy. This article provides a review of the state-of-the-art medical robotic systems available for use in conjunction with intraoperative magnetic resonance imaging. The robot functionalities and mechanical designs for a wide range of magnetic resonance imaging interventions are presented, including their magnetic resonance imaging compatibility, actuation, kinematics and the mechanical and electrical designs of the robots. Classification and comparative study of various intraoperative magnetic resonance image guided robotic systems are provided. The robotic systems reviewed are summarized in a table in detail. Current technologies for magnetic resonance imaging-conditional robotics are reviewed and their potential future directions are sketched.
Medical technologies have undergone significant development to overcome the problems inherent in minimally invasive surgery such as inhibited manual dexterity, reduced visual information, and lack of direct touch feedback to make it easier for surgeons to operate. A minimally invasive tool incorporating haptic feedback is being developed to increase the effectiveness of diagnostic procedures by providing force feedback. Magnetic resonance imaging guidance is possible to allow tool localization; however, this engenders the requirement of magnetic resonance compatibility on the device. This paper describes the work done towards developing a sensing device using piezoelectric sensor elements to locate subsurface inclusions in soft substrates, with its magnetic resonance compatibility tested in a 1.5 T scanner. Results show that the position of a hard inclusion can be determined.
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