MR Safe Robot Assisted Needle Access of the Brain: Preclinical Study

Jun, Changhan; Lim, Sunghwan; Wolinsky, Jean-Paul; Garzón-Muvdi, Tomás; Petrisor, Doru; Cleary, Kevin; Stoianovici, Dan

doi:10.1142/s2424905x18500034

Cited by 17 publications

(3 citation statements)

References 29 publications

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“…Some used alternative actuation approaches such as pneumatics, [13] tendondriven transmissions, [14] or piezoelectric motors. [15] For example, Stoianovici et al [16,17] presented a needle positioning robot with custom-made MR-safe pneumatic motors for control over a remote-center-of-motion (RCM) mechanism with three additional manual degrees of freedom (DoFs) that must be locked independently by the surgeon. The robot could be mounted to the patient table or to a Mayfield head frame, although its size would also only accommodate unilateral procedures.…”

Section: Introductionmentioning

confidence: 99%

Interactive Multi‐Stage Robotic Positioner for Intra‐Operative MRI‐Guided Stereotactic Neurosurgery

He,

Dai,

et al. 2023

Advanced Science

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Magnetic resonance imaging (MRI) demonstrates clear advantages over other imaging modalities in neurosurgery with its ability to delineate critical neurovascular structures and cancerous tissue in high‐resolution 3D anatomical roadmaps. However, its application has been limited to interventions performed based on static pre/post‐operative imaging, where errors accrue from stereotactic frame setup, image registration, and brain shift. To leverage the powerful intra‐operative functions of MRI, e.g., instrument tracking, monitoring of physiological changes and tissue temperature in MRI‐guided bilateral stereotactic neurosurgery, a multi‐stage robotic positioner is proposed. The system positions cannula/needle instruments using a lightweight (203 g) and compact (Ø97 × 81 mm) skull‐mounted structure that fits within most standard imaging head coils. With optimized design in soft robotics, the system operates in two stages: i) manual coarse adjustment performed interactively by the surgeon (workspace of ±30°), ii) automatic fine adjustment with precise (<0.2° orientation error), responsive (1.4 Hz bandwidth), and high‐resolution (0.058°) soft robotic positioning. Orientation locking provides sufficient transmission stiffness (4.07 N/mm) for instrument advancement. The system's clinical workflow and accuracy is validated with lab‐based (<0.8 mm) and MRI‐based testing on skull phantoms (<1.7 mm) and a cadaver subject (<2.2 mm). Custom‐made wireless omni‐directional tracking markers facilitated robot registration under MRI.

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Section: Introductionmentioning

confidence: 99%

Interactive Multi‐Stage Robotic Positioner for Intra‐Operative MRI‐Guided Stereotactic Neurosurgery

He,

Dai,

et al. 2023

Advanced Science

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“…Hence, mechanical fixtures, such as the Leksell frame used in stereotactic neurosurgery, are typically used to restrain the patient movement. Table-mounted robotic systems have been investigated for MRIguided procedures of various applications, such as prostate cancer therapy [8][9][10][11][12], stereotactic neurosurgery [13][14][15][16], facet joint treatment [17], breast tissue biopsy [18], and in-room ultrasound fusion [19]. In comparison, a body-mounted robot is mounted directly to a patient using straps or other methods, minimizing the effect of patient movement by moving with him/her.…”

Section: Introductionmentioning

confidence: 99%

MRI-guided lumbar spinal injections with body-mounted robotic system: cadaver studies

Patel

Melzer

et al. 2020

Minimally Invasive Therapy & Allied Technologies

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Introduction: This paper reports the system integration and cadaveric assessment of a body-mounted robotic system for MRI-guided lumbar spine injections. The system is developed to enable MR-guided interventions in close bore magnet and avoid problems due to patient movement during cannula guidance. Material and methods:The robot is comprised by a lightweight and compact structure so that it can be mounted directly onto the lower back of a patient using straps. Therefore, it can minimize the influence of patient movement by moving with the patient. The MR-Conditional robot is integrated with an image-guided surgical planning workstation. A dedicated clinical workflow is created for the robot-assisted procedure to improve the conventional freehand MRI-guided procedure.Results: Cadaver studies were performed with both freehand and robot-assisted approaches to validate the feasibility of the clinical workflow and to assess the positioning accuracy of the robotic system. The experiment results demonstrate that the root mean square (RMS) error of the target position to be 2.57±1.09mm and of the insertion angle to be 2.17±0.89 • . Conclusion:The robot-assisted approach is able to provide more accurate and reproducible cannula placements than the freehand procedure, as well as reduce the number of insertion attempts.

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“…In such cases, mechanical fixtures are usually employed to prevent patient motion, like the Leksell frame in neurosurgery. Table-mounted robots have been developed broadly for MRI-guided percutaneous interventions including prostate cancer therapy [14], [15], [16], [17], [18], [19], stereotactic neurosurgery, [20], [21], [22], [23] and breast tissue biopsy [24], [25]. Body-mounted robots, by contrast, are attached directly to the patient through straps or screws, minimizing any effects of patient motion by moving with the patient.…”

Section: Introductionmentioning

confidence: 99%

Body-mounted robotic assistant for MRI-guided low back pain injection

Patel

Hagemeister

et al. 2019

Int J CARS

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Purpose-This paper presents the development of a body-mounted robotic assistant for magnetic resonance imaging (MRI)-guided low back pain injection. Our goal was to eliminate the radiation exposure of traditional X-ray guided procedures while enabling the exquisite image quality available under MRI. The robot is designed with a compact and lightweight profile that can be mounted directly on the patient's lower back via straps, thus minimizing the effect of patient motion by moving along with the patient. The robot was built with MR-Conditional materials and actuated with piezoelectric motors so it can operate inside the MRI scanner bore during imaging and therefore streamline the clinical workflow by utilizing intraoperative MR images. Methods-The robot is designed with a four degrees-of-freedom (DOF) parallel mechanism, stacking two identical Cartesian stages, to align the needle under intraoperative MRI-guidance. The system targeting accuracy was first evaluated in free space with an optical tracking system, and further assessed with a phantom study under live MRI-guidance. Qualitative imaging quality evaluation was performed on a human volunteer to assess the image quality degradation caused by the robotic assistant. Results-Free space positioning accuracy study demonstrated that the mean error of the tip position to be 0.51 ± 0.27mm and needle angle to be 0.70 ± 0.38°. MRI-guided phantom study indicated the mean errors of the target to be 1.70±0.21mm, entry point to be 1.53 ± 0.19mm, and needle angle to be 0.66 ±0.43°. Qualitative imaging quality evaluation validated that the image degradation caused by the robotic assistant in the lumbar spine anatomy is negligible. Conclusions-The study demonstrates that the proposed body-mounted robotic system is able to perform MRI-guided low back injection in a phantom study with sufficient accuracy and with minimal visible image degradation that should not affect the procedure.

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MR Safe Robot Assisted Needle Access of the Brain: Preclinical Study

Cited by 17 publications

References 29 publications

Interactive Multi‐Stage Robotic Positioner for Intra‐Operative MRI‐Guided Stereotactic Neurosurgery

Interactive Multi‐Stage Robotic Positioner for Intra‐Operative MRI‐Guided Stereotactic Neurosurgery

MRI-guided lumbar spinal injections with body-mounted robotic system: cadaver studies

Body-mounted robotic assistant for MRI-guided low back pain injection

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