A review on the techniques used in prostate brachytherapy

Li, Yanlei; Yang, Chenguang; Bahl, Amit; Persad, Raj; Melhuish, Chris

doi:10.1049/ccs2.12067

Cited by 9 publications

(7 citation statements)

References 105 publications

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“…The deviation of the needle's tip is not taken into account by the robot kinematics since it does not import relative changes of the pivoting joints' angle values. That's why mechanical modelling of the needle behaviour that can estimate the trajectory and deformation of the needle's tip has to be investigated and considered in the control loop for future work to take into consideration the variables stiffness and the cutting forces applied by the human tissues and thus compensate the interactive force change and minimise the needle deflection 30 …”

Section: Discussionmentioning

confidence: 99%

Optimisation and validation of a co‐manipulated robot for brachytherapy procedure

Halima

Bert

Clément

et al. 2022

Robotics Computer Surgery

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Background Low‐dose rate brachytherapy is the referent treatment for early‐stage prostate cancer and consists in manually inserting radioactive seeds within the organ to destroy tumorous cells. This treatment is inaccurate leading to side effects. Researchers developed robots to improve this technique. Despite ameliorating accuracy, they cannot be clinically used because of size and acceptability. Therefore, a 6‐DOF parallel and co‐manipulated robot is proposed to meet these requirements. Methods To fulfil the application requirements, a compact design was modelled. The robot's optimal dimensions were defined by establishing kinematics and implementing genetic algorithm. The robot's relevance was evaluated by measuring workspace and needle placement errors. Results The robot fits into a cube of 300 × 300 × 300 mm3 and provides a free‐singularity workspace of 55 × 55 × 150 mm3 with a possible end‐effector rotation of 15° and a needle placement error <3 mm. Conclusion The results are promising and prove that our robot fulfils the application requirements and presents a beneficial alternative to the manual procedure.

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Section: Discussionmentioning

confidence: 99%

Optimisation and validation of a co‐manipulated robot for brachytherapy procedure

Halima

Bert

Clément

et al. 2022

Robotics Computer Surgery

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“…In high‐dose rate (HDR) prostate brachytherapy (BT), hollow needles are inserted into the target tissue. A radioactive source, usually Ir‐192, is then inserted through the needles usually via an afterloader 1 . To determine the desired positions and dwell times of these sources, an optimization problem is solved in clinical practice 2,3 .…”

Section: Introductionmentioning

confidence: 99%

“…A radioactive source, usually Ir-192, is then inserted through the needles usually via an afterloader. 1 To determine the desired positions and dwell times of these sources, an optimization problem is solved in clinical practice. 2,3 Here, several competing clinical goals have to be considered, including sufficient dose in the clinical target volume (CTV) and sparing of surrounding organs at risk (OARs).…”

Section: Introductionmentioning

confidence: 99%

Robust stochastic optimization of needle configurations for robotic HDR prostate brachytherapy

Gerlach,

Siebert,

Schlaefer

2023

Medical Physics

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BackgroundIdeally, inverse planning for HDR brachytherapy (BT) should include the pose of the needles which define the trajectory of the source. This would be particularly interesting when considering the additional freedom and accuracy in needle pose which robotic needle placement enables. However, needle insertion typically leads to tissue deformation, resulting in uncertainty regarding the actual pose of the needles with respect to the tissue.PurposeTo efficiently address uncertainty during inverse planning for HDR BT in order to robustly optimize the pose of the needles before insertion, that is, to facilitate path planning for robotic needle placement.MethodsWe use a form of stochastic linear programming to model the inverse treatment planning problem. To account for uncertainty, we consider random tissue displacements at the needle tip to simulate tissue deformation. Conventionally for stochastic linear programming, each simulated deformation is reflected by an addition to the linear programming problem which increases problem size and computational complexity substantially and leads to impractical runtime. We propose two efficient approaches for stochastic linear programming. First, we consider averaging dose coefficients to reduce the problem size. Second, we study weighting of the slack variables of an adjusted linear problem to approximate the full stochastic linear program. We compare different approaches to optimize the needle configurations and evaluate their robustness with respect to different amounts of tissue deformation.ResultsOur results illustrate that stochastic planning can improve the robustness of the treatment with respect to deformation. The proposed approaches approximating stochastic linear programming better conform to the tissue deformation compared to conventional linear programming. They show good correlation with the plans computed after deformation while reducing the runtime by two orders of magnitude compared to the complete stochastic linear program. Robust optimization of needle configurations takes on average 59.42 s. Skew needle configurations lead to mean coverage improvements compared to parallel needles from 0.39 to 2.94 percentage points, when 8 mm tissue deformation is considered. Considering tissue deformations from 4 to 10 mm during planning with weighted stochastic optimization and skew needles generally results in improved mean coverage from 1.77 to 4.21 percentage points.ConclusionsWe show that efficient stochastic optimization allows selecting needle configurations which are more robust with respect to potentially negative effects of target deformation and displacement on the achievable prescription dose coverage. The approach facilitates robust path planning for robotic needle placement.

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“…The nonlinearity and heterogeneity of tissues make the deflection of the passive needles unpredictable [3]. Active needles are designed to provide controlled deflection during tissue insertion [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

An experimental study on the mechanics and control of SMA-actuated bioinspired needle

Acharya,

Hutapea

2023

Bioinspir. Biomim.

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Active needles demonstrate improved accuracy and tip deflection compared to their passive needle counterparts, a crucial advantage in percutaneous procedures. However, the ability of these needles to effectively navigate through tissues is governed by needle-tissue interaction, which depends on the tip shape, the cannula surface geometry, and the needle insertion method. In this research, we evaluated the effect of cannula surface modifications and the application of a vibrational insertion technique on the performance of shape memory alloy (SMA)-actuated active needles. These features were inspired by the mosquito proboscis’ unique design and skin-piercing technique that decreased the needle tissue interaction force, thus enhancing tip deflection and steering accuracy. The bioinspired features, i.e., mosquito-inspired cannula design and vibrational insertion method, in an active needle reduced the insertion force by 26.24% and increased the tip deflection by 37.11% in prostate-mimicking (PM) gel. In addition, trajectory tracking error was reduced by 48%, and control effort was reduced by 23.25%, pointing towards improved needle placement accuracy. The research highlights the promising potential of bioinspired SMA-actuated active needles. Better tracking control and increased tip deflection are anticipated, potentially leading to improved patient outcomes and minimized risk of complications during percutaneous procedures.

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A review on the techniques used in prostate brachytherapy

Cited by 9 publications

References 105 publications

Optimisation and validation of a co‐manipulated robot for brachytherapy procedure

Optimisation and validation of a co‐manipulated robot for brachytherapy procedure

Robust stochastic optimization of needle configurations for robotic HDR prostate brachytherapy

An experimental study on the mechanics and control of SMA-actuated bioinspired needle

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