Robotic Systems in Radiotherapy and Radiosurgery

Gerlach, Stefan; Schlaefer, Alexander

doi:10.1007/s43154-021-00072-3

Cited by 6 publications

(4 citation statements)

References 72 publications

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“…These components are interconnected through a robust and efficient network, ensuring seamless communication and coordination. This integration of state-of-the-art components forms the backbone of our system, enabling it to meet the stringent demands of precision and reliability required in its application [12]. Figure 7 shows the axes numbering and the network connection of the PPS Subsystem Motion Controller and Drives.…”

Section: Design Componentsmentioning

confidence: 99%

Developing Robust Safety Protocols for Radiosurgery within Patient Positioning System Framework

Saadah,

Medlin,

Saud

et al. 2024

Machines

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This paper offers a comprehensive examination of the development and implementation of advanced safety protocols in the Patient Positioning System (PPS) for radiosurgery. In an era where precision and safety are increasingly crucial in medical procedures, particularly radiosurgery, the implementation of sophisticated safety measures in PPS is vital. This research delves into the detailed design of the system, emphasizing the sensor and controller mechanisms employed. A significant focus is placed on comparing single-loop and dual-loop control systems, assessing their impact on the precision, accuracy, and repeatability of the PPS. The study showcases how dual-loop control demonstrates superior performance in these areas, leading to enhanced patient safety and treatment outcomes. Additionally, the paper discusses the integration of these safety protocols within the system’s architecture, underscoring the practical implications of these advanced measures in augmenting patient safety and treatment effectiveness.

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Section: Design Componentsmentioning

confidence: 99%

Developing Robust Safety Protocols for Radiosurgery within Patient Positioning System Framework

Saadah,

Medlin,

Saud

et al. 2024

Machines

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“…While most preclinical FLASH studies have been performed using electrons ( Table 2 ), the results of such experiments are being extrapolated to photons, protons, and other types of radiation (e.g., carbon ions), for which there is emerging preclinical data [ 46 , 68 , 69 ]. The low penetration depth of electron beams is adequate for preclinical studies and the treatment of superficial tumors/surfaces in the clinic (e.g., skin metastases, intra-operative treatments), and machines are being developed for these clinical indications, including FLASHKNiFE [ 70 , 71 ], IntraOp Mobetron [ 72 ], and modified NOVAC7 [ 73 ]. Electron FLASH has already been used in the clinic, and trials have been initiated.…”

Section: Towards the Clinicmentioning

confidence: 99%

Radiobiological Aspects of FLASH Radiotherapy

et al. 2022

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Radiotherapy (RT) is one of the primary treatment modalities for cancer patients. The clinical use of RT requires a balance to be struck between tumor effect and the risk of toxicity. Sparing normal tissue is the cornerstone of reducing toxicity. Advances in physical targeting and dose-shaping technology have helped to achieve this. FLASH RT is a promising, novel treatment technique that seeks to exploit a potential normal tissue-sparing effect of ultra-high dose rate irradiation. A significant body of in vitro and in vivo data has highlighted a decrease in acute and late radiation toxicities, while preserving the radiation effect in tumor cells. The underlying biological mechanisms of FLASH RT, however, remain unclear. Three main mechanisms have been hypothesized to account for this differential FLASH RT effect between the tumor and healthy tissue: the oxygen depletion, the DNA damage, and the immune-mediated hypothesis. These hypotheses and molecular mechanisms have been evaluated both in vitro and in vivo. Furthermore, the effect of ultra-high dose rate radiation with extremely short delivery times on the dynamic tumor microenvironment involving circulating blood cells and immune cells in humans is essentially unknown. Therefore, while there is great interest in FLASH RT as a means of targeting tumors with the promise of an increased therapeutic ratio, evidence of a generalized FLASH effect in humans and data to show that FLASH in humans is safe and at least effective against tumors as standard photon RT is currently lacking. FLASH RT needs further preclinical investigation and well-designed in-human studies before it can be introduced into clinical practice.

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“…The highly innovative topic of robot assisted (Gerlach and Schläfer 2022) and image guided interventions (Unger et al 2021) includes robot assisted US imaging (Priester et al 2013, von Haxthausen et al 2021 and is focused on developments in a variety of scenarios, including long term motion monitoring (Ipsen et al 2021) to scanning applications (Aalamifar et al 2016, Seitz et al 2020, Abbas et al 2021, Chen et al 2021.…”

Section: Introductionmentioning

confidence: 99%

“…Some additional semi-autonomous positioning strategy were presented by Conti et al (2014), Seitz et al (2020), Ipsen et al (2021), which moves the robot arm above the desired position and uses a game controller for remote control of the final lowering of the probe to patient's skin. Some comparisons can be found in the literaturWestern et al (2015), von Haxthausen et al (2021), Gerlach and Schläfer (2022). These methods may be feasible for experimental setups but are potentially impracticable for clinical use.…”

Section: Introductionmentioning

confidence: 99%

Strategy for automatic ultrasound (US) probe positioning in robot-assisted ultrasound guided radiation therapy

et al. 2023

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Objective: As part of image-guided radiotherapy, ultrasound-guided radiotherapy is currently already in use and under investigation for robot assisted systems. It promises a real-time tumor localization during irradiation (intrafractional) without extra dose. The ultrasound probe is held and guided by a robot. However, there is a lack of basic safety mechanisms and interaction strategies to enable a safe clinical procedure. In this study we investigate potential positioning strategies with safety mechanisms for a safe robot-human-interaction. Approach: A compact setup of ultrasound device, lightweight robot, tracking camera, force sensor and control computer were integrated in a software application to represent a potential USgRT setup. For the realization of a clinical procedure, positioning strategies for the ultrasound head with the help of the robot were developed, implemented, and tested. In addition, basic safety mechanisms for the robot have been implemented, using the integrated force sensor, and have been tested by intentional collisions. Main results: Various positioning methods from manual guidance to completely automated procedures were tested. Robot-guided methods achieved higher positioning accuracy and were faster in execution compared to conventional hand-guided methods. The developed safety mechanisms worked as intended and the detected collision force were below 20 N. Significance: The study demonstrates the feasibility of a new approach for safe robotic ultrasound imaging, with a focus on abdominal usage (liver, prostate, kidney). The safety measures applied here can be extended to other human-robot interactions and present the basic for further studies in medical applications.

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Robotic Systems in Radiotherapy and Radiosurgery

Cited by 6 publications

References 72 publications

Developing Robust Safety Protocols for Radiosurgery within Patient Positioning System Framework

Developing Robust Safety Protocols for Radiosurgery within Patient Positioning System Framework

Radiobiological Aspects of FLASH Radiotherapy

Strategy for automatic ultrasound (US) probe positioning in robot-assisted ultrasound guided radiation therapy

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