MR-guided HDR prostate brachytherapy with teleoperated steerable needles

Vries, M. de; Wijntjes, Maarten; Sikorski, J.; Moreira, Pedro; Berg, Nick J. van de; Dobbelsteen, John J. van den; Misra, Sarthak

doi:10.1007/s11701-023-01676-x

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…EM navigation systems, such as incorporated in TheraVision and many other tools for prostate interventions, can be used to place applicators and temperature probes in pre-planned trajectories. This planning tool could be combined with robotic devices [63] , similar to those being developed for brachytherapy [64] , [65] , [66] and ablation [67] , [68] for more precise positioning of interstitial applicators within the prostate. In addition, MR thermometry [69] , [70] or possibly MST-CBE [71] , acoustic radiation force impulse imaging (ARFI), or contrast enhanced ultrasound imaging methods [72] for intra-procedure monitoring can offer the additional advantage of real-time visualization and quantification of temperature changes within the tissue.…”

Section: Discussionmentioning

confidence: 99%

Treatment Planning Strategies for Interstitial Ultrasound Ablation of Prostate Cancer

Gupta,

Heffter,

Zubair

et al. 2024

IEEE Open J. Eng. Med. Biol.

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To develop patient-specific 3D models using Finite-Difference Time-Domain (FDTD) simulations and pre-treatment planning tools for the selective thermal ablation of prostate cancer with interstitial ultrasound. This involves the integration with a FDA 510(k) cleared catheter-based ultrasound interstitial applicators and delivery system. Methods: A 3D generalized "prostate" model was developed to generate temperature and thermal dose profiles for different applicator operating parameters and anticipated perfusion ranges. A priori planning, based upon these pre-calculated lethal thermal dose and iso-temperature clouds, was devised for iterative device selection and positioning. Full 3D patient-specific anatomic modeling of actual placement of single or multiple applicators to conformally ablate target regions can be applied, with optional integrated pilot-point temperature-based feedback control and urethral/rectum cooling. These numerical models were verified against previously reported ex-vivo experimental results obtained in soft tissues. Results: For generic prostate tissue, 360 treatment schemes were simulated based on the number of transducers (1-4), applied power (8-20 W/cm 2 ), heating time (5, 7.5, 10 min), and blood perfusion (0, 2.5, 5 kg/m 3 /s) using forward treatment modelling. Selectable ablation zones ranged from 0.8-3.0 cm and 0.8-5.3 cm in radial and axial directions, respectively. 3D patientspecific thermal treatment modeling for 12 Cases of T2/T3 prostate disease demonstrate applicability of workflow and technique for focal, quadrant and hemi-gland ablation. A temperature threshold (e.g., Tthres = 52 °C) at the treatment margin, emulating placement of invasive temperature sensing, can be applied for pilot-point feedback control to improve conformality of thermal ablation. Also, binary power control (e.g., Treg = 45 °C) can be applied which will regulate the applied power level to maintain the surrounding temperature to a safe limit or maximum threshold until the set heating time. Conclusions: Prostate-specific simulations of interstitial ultrasound applicators were used to generate a library of thermal-dose distributions to visually optimize and set applicator positioning and directivity during a priori treatment planning pre-procedure. Anatomic 3D forward treatment planning in patient-specific models, along with optional temperature-based feedback control, demonstrated single and multi-applicator

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Section: Discussionmentioning

confidence: 99%

Treatment Planning Strategies for Interstitial Ultrasound Ablation of Prostate Cancer

Gupta,

Heffter,

Zubair

et al. 2024

IEEE Open J. Eng. Med. Biol.

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Path planning for flexible needle based on both insertion mechanism kinematics and needle bending model

Zhao,

Zhang,

et al. 2024

Phys. Med. Biol.

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Objective. Due to the limited operating space in the magnetic resonance (MR) environment, there is coupled motion in the insertion mechanism, which not only reduces the flexibility of the robot but also challenges the insertion path planning. Meanwhile, the path planning is also restricted by the bending rule of the flexible needle, thus the bending model of the needle is also essentially built. Approach. This paper proposes a path planner for the flexible needle based on both the coupled motion kinematics of the insertion robot and the bending model of the flexible needle. A kinematic analysis for the coupled motion of insertion robot is performed. And the bending model of flexible needle is established based on the needle-tissue interactions. The position and posture of the needle insertion at the entry point are obtained by the calculation of the target position and the analysis of the bending model. And the rotation or translation coordinates of each robot joint are calculated by the inverse kinematics of the insertion robot. Then the path planning based on the coupled kinematics and the bending model is realized. Main results. The insertion experiments were performed for each target of G1 and G2. The root mean square errors were 0.83 mm and 0.74 mm, and the maximum errors were 1.1 mm and 0.9 mm for G1 and G2, respectively. The experimental results show that the effectiveness and accuracy of the path planning can meet the requirements for a general minimally invasive surgery, so the proposed path planning algorithm is feasible. Significance. This study provides a new solution for the path planning of insertion robots for the minimally invasive surgery. This method can meet the insertion mechanism working within the limited operating space in the MR environment and has a high application value in future clinical medicine.

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A Dual-Arm Robotics Teleoperation System for Needle Steering in Prostate Brachytherapy

Li,

Yang,

Tzemanaki

et al. 2024

2024 IEEE International Conference on Industrial Technology (ICIT)

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MR-guided HDR prostate brachytherapy with teleoperated steerable needles

Cited by 3 publications

References 42 publications

Treatment Planning Strategies for Interstitial Ultrasound Ablation of Prostate Cancer

Treatment Planning Strategies for Interstitial Ultrasound Ablation of Prostate Cancer

Path planning for flexible needle based on both insertion mechanism kinematics and needle bending model

A Dual-Arm Robotics Teleoperation System for Needle Steering in Prostate Brachytherapy

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