Cooperative Brachytherapy for Prostate Cancer Under MRI Guidance

IEEE Trans. Med. Robot. Bionics

Sanz-Lopez

et al. 2022

Self Cite

In this paper, a novel concept for a phantom of the prostate is introduced. To study and improve automated, robotized medical interventions, reliable phantoms are essential. During brachytherapy and biopsy, the prostate will undergo displacements and changes in orientation due to the needle insertion. Therefore, there is a shift in the target regions for radioactive seed deposition or biopsy acquisition. These shifts need to be taken into account for precise dosimetry. Furthermore, the organ can undergo deformations due to edemas with the same shifting result. Therefore, in this paper we propose a bioinspired phantom (BIP) for the prostate that is equipped with sensors and coupled with a numerical simulation for estimating deformations due to external forces. We have also put in place a cavity inside the phantom where pressure can be applied to enable the emulation of prostate growth due to inflammation. The phantom is conceived in such a way that it will be MRIsafe. It can thus be deployed for the in-bore study of automated brachytherapy and biopsy. In our evaluation, we verify that the changes in pose of the phantom can be correctly estimated and that these motions are plausible from a clinical point of view.

Section: A Phantomsmentioning

confidence: 99%

A Bio-Inspired Active Prostate Phantom for Adaptive Interventions

Navarro

IEEE Trans. Med. Robot. Bionics

Sanz-Lopez

et al. 2022

Self Cite

“…TP access is more convenient with the LT position. LT position can be achieved with the commercial existing MR-Safe Uni-Lift 5 specifically developed to stabilize the patient for MRI prostate intervention shown in [31]. Lastly, LT has an advantage with more workspace to target the TP area within the MRI.…”

Section: ) Mr Based Prostate Interventionsmentioning

confidence: 99%

Review of Clinical and Technological Consideration for MRI-Guided Robotic Prostate Brachytherapy

IEEE Trans. Med. Robot. Bionics

Chettibi

Wilby

et al. 2021

Self Cite

Low Dose Rate Brachytherapy (LDR-BT) is a technique for treating localized prostate cancer by implanting radioactive seeds. In conventional practice, the delivery of seeds is performed using transrectal ultrasonography (TRUS) imaging for implant guidance and checked using computed-tomography for post-implant dosimetry. In the case of TRUS, accuracy can be compromised due to sub-optimal imaging. Magnetic Resonance Imaging (MRI), however, is known to provide better soft-tissue contrast, therefore, increasing the ability to detect small lesions; for that reason, the integration of intraoperative MRI in BT workflows has been investigated over the last two decades. The fusion of preoperative MR-images during TRUS-brachytherapy is possible. However, the image registration process introduces a source of uncertainty. Manual, real-time intra-operative LDR-BT is challenging under MRI due to confined space and procedural workflows. This motivates the development of MRI-compatible robots for prostate BT, with potential advantages of improved source placement accuracy and final dosimetry. In this paper, the state-of-art of technological components in MRI compatible robots, especially for LDR-BT, has been presented. This systematic review helps us to position an ongoing Cooperative Brachytherapy project, developing a real-time MRI-guided robot for adaptive LDR-BT. The design approach includes integrating separate modules: imaging, dose planning, needles, and robot.

“…The robot-guide must be capable of operating in-bore within workspace beneath the legs supported by Uni-Lift with lithotomy patient position [10]. The concept should be compatible with 3T wide in-bore scanners, with 70 cm of diameter, able to include the Uni-Lift leg holder Fig.…”

Section: A Design Requirementsmentioning

confidence: 99%

“…The clinically recommended and preferred position is lithotomy Fig. 3 with TP access [10], which helps in accommodating robot and needle module within pyramidal workspace maintaining in-bore patient stability. Workspace constraints illustrated in Fig.…”

Section: B Workpace Constraintsmentioning

confidence: 99%

CoBra: Towards Adaptive Robotized Prostate Brachytherapy under MRI Guidance

2021 Sixth International Conference on Advances in Biomedical Engineering (ICABME)

Belarouci

Sanz-Lopez

et al. 2021

Self Cite

This paper presents a novel concept for robotized adaptive prostate Brachytherapy (BT) under Magnetic Resonance Imaging (MRI). The Cooperative Brachytherapy (CoBra) concept with compact modular design robot-guide is capable of serving mount of Low Dose Rate (LDR-BT), High Dose Rate (HDR-BT), and Biopsy modules and operate in-bore 3 Tesla MRI. CoBra integrates the multi-components -radiotherapy, imaging, needle, robot-guide as one global system. CoBra MR-robot is a 5 degrees-of-freedom, actuated using non-magnetic piezoultrasonic motors. CoBra Robot intends to place BT seeds to the patient positioned in-bore in lithotomy under MRI-feedback control for the purpose of adaptive brachytherapy. The robot is capable of posing biopsy and BT needle modules for both straight and oblique orientation. It is controlled with an absolute sensor for position sensing. The paper presents recent advances in designing a robotic system for adaptive tumor-targeting in-bore intraoperatively under real-time MRI.