MR-compatible Robot Research Articles

An augmented hybrid multibaseline and referenceless MR thermometry motion compensation algorithm for MRgHIFU hyperthermia.

A hybrid principal component analysis and projection onto dipole fields (PCA-PDF) MR thermometry motion compensation algorithm was optimized with atlas image augmentation and validated. Experiments were conducted on a 3T Philips MRI and Profound V1 Sonalleve high intensity focused ultrasound (high intensity focused ultrasound system. An MR-compatible robot was configured to induce motion on custom gelatin phantoms. Trials with periodic and sporadic motion were introduced on phantoms while hyperthermia was administered. The PCA-PDF algorithm was augmented with a predictive atlas to better compensate for larger sporadic motion. During periodic motion, the temperature SD in the thermometry was improved from to C with both the original and augmented PCA-PDF application. For large sporadic motion, the augmented atlas improved the motion compensation from the original PCA-PDF correction from to C. The PCA-PDF algorithm improved temperature accuracy to <1°C during periodic motion, but was not able to adequately address sporadic motion. By augmenting the PCA-PDF algorithm, temperature SD during large sporadic motion was also reduced to <1°C, greatly improving the original PCA-PDF algorithm.

Preliminary Study of a Modular MR-Compatible Robot for Image-Guided Insertion of Multiple Needles.

Percutaneous needle-based interventions such as transperineal prostate brachytherapy require the accurate placement of multiple needles to treat cancerous lesions within the target organ. To guide needle placement, magnetic resonance imaging (MRI) offers excellent visualization of the target lesion without the need for ionizing radiation. To date, multi-needle insertion relies on a grid template, which limits the ability to steer individual needles. This work describes an MR-compatible robot designed for the sequential insertion of multiple non-parallel needles under MR guidance. The 6-DOF system is designed with an articulated arm to extend the reach of the robot. This strategy presents a novel approach enabling the robot to maneuver around existing needles while minimizing the footprint of the robot. Forward kinematics as well as optimization-based inverse kinematics are presented. The impact of the robot on image quality was tested for four sequences (T1w-TSE, T2w-TSE, THRIVE and EPI) on a 3T Philips Achieva system. Quantification of the signal-to-noise ratio showed a 46% signal loss in a gelatin phantom when the system was powered on but no further adverse effects when the robot was moving. Joint level testing showed a maximum error of 2.10 ± 0.72°s for revolute joints and 0.31 ± 0.60 mm for prismatic joints. The theoretical workspace spans the proposed clinical target surface of 10 x 10 cm. Lastly, the feasibility of multi-needle insertion was demonstrated with four needles inserted under real-time MR-guidance with no visible loss in image quality.

Neural Correlates of Multisensory Integration for Feedback Stabilization of the Wrist.

Robust control of action relies on the ability to perceive, integrate, and act on information from multiple sensory modalities including vision and proprioception. How does the brain combine sensory information to regulate ongoing mechanical interactions between the body and its physical environment? Some behavioral studies suggest that the rules governing multisensory integration for action may differ from the maximum likelihood estimation rules that appear to govern multisensory integration for many perceptual tasks. We used functional magnetic resonance (MR) imaging techniques, a MR-compatible robot, and a multisensory feedback control task to test that hypothesis by investigating how neural mechanisms involved in regulating hand position against mechanical perturbation respond to the presence and fidelity of visual and proprioceptive information. Healthy human subjects rested supine in a MR scanner and stabilized their wrist against constant or pseudo-random torque perturbations imposed by the robot. These two stabilization tasks were performed under three visual feedback conditions: “No-vision”: Subjects had to rely solely on proprioceptive feedback; “true-vision”: visual cursor and hand motions were congruent; and “random-vision”: cursor and hand motions were uncorrelated in time. Behaviorally, performance errors accumulated more quickly during trials wherein visual feedback was absent or incongruous. We analyzed blood-oxygenation level-dependent (BOLD) signal fluctuations to compare task-related activations in a cerebello-thalamo-cortical neural circuit previously linked with feedback stabilization of the hand. Activation in this network varied systematically depending on the presence and fidelity of visual feedback of task performance. Addition of task related visual information caused activations in the cerebello-thalamo-cortical network to expand into neighboring brain regions. Specific loci and intensity of expanded activity depended on the fidelity of visual feedback. Remarkably, BOLD signal fluctuations within these regions correlated strongly with the time series of proprioceptive errors—but not visual errors—when the fidelity of visual feedback was poor, even though visual and hand motions had similar variability characteristics. These results provide insight into the neural control of the body’s physical interactions with its environment, rejecting the standard Gaussian cue combination model of multisensory integration in favor of models that account for causal structure in the sensory feedback.

A robotic magnetic resonance-guided high-intensity focused ultrasound platform for neonatal neurosurgery: Assessment of targeting accuracy and precision in a brain phantom.

Intraventricular hemorrhage (IVH) is one of the most serious neurovascular complications resulting from premature birth. It can result in clotting of blood within the ventricles, which causes a buildup of cerebrospinal fluid that can lead to posthemorrhagic ventricular dilation and posthemorrhagic hydrocephalus. Currently, there are no direct treatments for these blood clots as the standard of care is invasive surgery to insert a shunt. Magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) has been investigated as a noninvasive treatment to lyse blood clots. However, current MRgHIFU systems are not suitable in the context of treating IVH in neonates. We have developed a robotic MRgHIFU neurosurgical platform designed to treat the neonatal brain. This platform facilitates ergonomic patient positioning and directs treatment through their open anterior fontanelle while providing a larger treatment volume. The platform is based on an MR-compatible robot developed by our group. Further development of the platform has warranted investigation of its targeting ability to assess its feasibility in the neonatal brain. This study aimed to quantify the platform's targeting accuracy, precision, and repeatability using a brain phantom and clinical MRI system. A thermosensitive brain-mimicking phantom was developed to test the platform's targeting accuracy. Rectangular grid patterns were created with HIFU thermal energy "lesions" in the phantoms by targeting specific coordinate points. The intended target locations were demarcated by inserting carbon fiber rods through a targeting assessment template. Coordinates for the intended and actual targets were derived from T2-weighted MRI scans, and the centroid distance between them was measured. Subsequently, the platform's targeting accuracy was quantified according to equations derived from ISO Standard 9283:1998. HIFU ablation resulted in distinct thermal lesions within the thermosensitive phantoms, which appeared as discrete hypointense regions in T2-weighted MR scans. A total of 127 target points were included in the data analysis, which yielded a targeting accuracy of 0.6mm and targeting precision of 1.2mm. The robotic MRgHIFU platform was shown to have a high degree of accuracy, precision, and repeatability. The results demonstrate the platform's functionality when targeting through simulated brain matter. These results serve as an initial verification of the platform targeting ability and showed promise toward the final application in a neonatal brain.

Self-Scanned HIFU Ablation of Moving Tissue Using Real-Time Hybrid US-MR Imaging.

High intensity focused ultrasound (HIFU) treatment in the abdominal cavity is challenging due to the respiratory motion. In the self-scanning HIFU ablation method, the focal spot is kept static and the heating pattern is obtained through natural tissue motion. This paper describes a novel approach for modulating the HIFU power during self-scanning in order to compensate for the effect of tissue motion on thermal buildup. The therapy, using hybrid ultrasound (US)/magnetic resonance (MR) imaging, consists of detecting and tracking speckle on US images in order to predict the next tissue position, and modulating the HIFU power according to the tissue speed in order to obtain a rectilinear pattern of uniform temperature elevation. Experiments were conducted on ex vivo tissue subjected to a breathing-like motion generated by an MR-compatible robot and sonicated by a phased array HIFU transducer. US and MR data were free from interferences. For both periodic and non-periodic motion, MR temperature maps showed a substantial improvement in the uniformity of the temperature elevation by using acoustic power modulation. The presented method does not require a learning stage and enables a duty cycle close to 100%, higher average acoustic intensity and avoidance of side lobe effects versus performing HIFU beam steering to compensate tissue motion. To our knowledge, the proposed method provides the first experimental validation of the self-scanning HIFU ablation paradigm via a real-time hybrid MRI/US imaging, opening the path toward self-scanning in vivo therapies.

MRI Robot for Prostate Focal Laser Ablation: An Ex Vivo Study in Human Prostate

Purpose: A novel grid-template-mimicking MR-compatible robot was developed for in-gantry MRI-guided focal laser ablation of prostate cancer. Method: A substantially compact robot was designed and prototyped to meet in-gantry lithotomy ergonomics and allow for accommodation in the perineum. The controller software was reconfigured and integrated with the custom-designed navigation and multi-focal ablation software. Three experiments were conducted: (1) free space accuracy test; (2) phantom study under computed tomography (CT) guidance for image-guided accuracy test and overall workflow; and (3) magnetic resonance imaging (MRI)-guided focal laser ablation of an ex vivo prostate. The free space accuracy study included five targets that were selected across the workspace. The robot was then commanded five times to each target. The phantom study used a gel phantom made with color changing thermos-chromic ink, and four spherical metal fiducials were deployed with the robot. Then, laser ablation was applied, and the phantom was sliced for gross observation. For an MR-guided ex vivo test, a prostate from a donor who died of prostate cancer was obtained and multi-focally ablated using the system within the MRI gantry. The tissue was sliced after ablation for validation. Results: free-space accuracy was 0.38 ± 0.27 mm. The overall system targeting accuracy under CT guidance (including robot, registration, and insertion error) was 2.17 ± 0.47 mm. The planned ablation zone was successfully covered in both acrylamide gel phantom and in human prostate tissue. Conclusions: The new robot can accurately facilitate fiber targeting for MR-guided focal laser ablation of targetable prostate cancer.

Kinesthetic Feedback During 2DOF Wrist Movements via a Novel MR-Compatible Robot

We demonstrate the interaction control capabilities of the MR-SoftWrist, a novel MR-compatible robot capable of applying accurate kinesthetic feedback to wrist pointing movements executed during fMRI. The MR-SoftWrist, based on a novel design that combines parallel piezoelectric actuation with compliant force feedback, is capable of delivering 1.5 N [Formula: see text] of torque to the wrist of an interacting subject about the flexion/extension and radial/ulnar deviation axes. The robot workspace, defined by admissible wrist rotation angles, fully includes a circle with a 20 deg radius. Via dynamic characterization, we demonstrate capability for transparent operation with low (10% of maximum torque output) backdrivability torques at nominal speeds. Moreover, we demonstrate a 5.5 Hz stiffness control bandwidth for a 14 dB range of virtual stiffness values, corresponding to 25%-125% of the device's physical reflected stiffness in the nominal configuration. We finally validate the possibility of operation during fMRI via a case study involving one healthy subject. Our validation experiment demonstrates the capability of the device to apply kinesthetic feedback to elicit distinguishable kinetic and neural responses without significant degradation of image quality or task-induced head movements. With this study, we demonstrate the feasibility of MR-compatible devices like the MR-SoftWrist to be used in support of motor control experiments investigating wrist pointing under robot-applied force fields. Such future studies may elucidate fundamental neural mechanisms enabling robot-assisted motor skill learning, which is crucial for robot-aided neurorehabilitation.

Adaptive planning strategy for high dose rate prostate brachytherapy—a simulation study on needle positioning errors

The development of magnetic resonance (MR) guided high dose rate (HDR) brachytherapy for prostate cancer has gained increasing interest for delivering a high tumor dose safely in a single fraction. To support needle placement in the limited workspace inside the closed-bore MRI, a single-needle MR-compatible robot is currently under development at the University Medical Center Utrecht (UMCU). This robotic device taps the needle in a divergent way from a single rotation point into the prostate. With this setup, it is warranted to deliver the irradiation dose by successive insertions of the needle. Although robot-assisted needle placement is expected to be more accurate than manual template-guided insertion, needle positioning errors may occur and are likely to modify the pre-planned dose distribution.In this paper, we propose a dose plan adaptation strategy for HDR prostate brachytherapy with feedback on the needle position: a dose plan is made at the beginning of the interventional procedure and updated after each needle insertion in order to compensate for possible needle positioning errors. The introduced procedure can be used with the single needle MR-compatible robot developed at the UMCU. The proposed feedback strategy was tested by simulating complete HDR procedures with and without feedback on eight patients with different numbers of needle insertions (varying from 4 to 12). In of the cases tested, the number of clinically acceptable plans obtained at the end of the procedure was larger with feedback compared to the situation without feedback. Furthermore, the computation time of the feedback between each insertion was below 100 s which makes it eligible for intra-operative use.

Accurate error compensation for a MR-compatible surgical robot based on a novel kinematic calibration method

Kinematic calibration is an effective and economical way to improve the accuracy of surgical robot, and in most cases, it is a necessary procedure before the robot is put into operation. This study investigates a novel kinematic calibration method where the effect of controller error is taken into account when formulating the model based on screw theory, which is applied to the kinematic control of magnetic resonance compatible surgical robot. Based on screw theory, the kinematic error model is established for the relationship between error of controller and the deviation of the measured pose of the end-effector. Therefore, the error of controller can be figured out and parameters of controller can be adjusted accordingly. Control strategy based on the kinematic calibration framework is proposed. According to artificial neural network, the deviation of end-effector in arbitrary configuration can be effectively obtained. Comparative experiments are carried out to show the validity and effectiveness of the proposed framework with the help of commercial visual system and joint encoders.

Mechanistic force modeling and machinability evaluation on MR-compatible materials

Magnetic resonance imaging (MRI)-guided surgical robots are becoming a hotspot owing to the good quality of MR image and stability of robot. For the MR-compatible robot, machinability influences assembly accuracy and kinematic accuracy directly. At the same time, the cutting force plays a vital role in evaluating machinability and machining process. This paper presents the machinability evaluation on five kinds of MR-compatible materials and an improved mechanistic force model. The model takes shearing and edge forces of flank and bottom edge combined with tool runout into consideration. Experimental results show that the prediction error is within 9 %. The effects that chip shape imposes on the machining stability and surface roughness are analyzed and then involved in the machinability evaluation. Digraph and matrix method are applied to evaluate the material machinability based on cutting force, roughness, and the chip shape. Relative importance between the three components is analyzed and taken into the evaluation. At last, polyformaldehyde is proved to have the best machinability.

1301 FIRST CLINICAL EXPERIENCE WITH ROBOTIC MR-GUIDED FOCAL LASER ABLATION OF PROSTATE CANCER

1301 FIRST CLINICAL EXPERIENCE WITH ROBOTIC MR-GUIDED FOCAL LASER ABLATION OF PROSTATE CANCER

Feasibility of a Pneumatically Actuated MR-compatible Robot for Transrectal Prostate Biopsy Guidance

To assess the feasibility of using a remote-controlled, pneumatically actuated magnetic resonance (MR)-compatible robotic device to aid transrectal biopsy of the prostate performed with real-time 3-T MR imaging guidance. This prospective study was approved by the ethics review board, and written informed consent was obtained from all patients. Twelve consecutive men who were clinically suspected of having prostate cancer and had a history of at least one transrectal ultrasonography (US)-guided prostate biopsy with negative results underwent diagnostic multiparametric MR imaging of the prostate. Two radiologists in consensus identified cancer-suspicious regions (CSRs) in 10 patients. These regions were subsequently targeted with the robot for MR imaging-guided prostate biopsy. To direct the needle guide toward the CSRs, the MR-compatible robotic device was remote controlled at the MR console by means of a controller and a graphical user interface for real-time MR imaging guidance of the needle guide. The ability to reach the CSRs with the robot for biopsy was analyzed. A total of 17 CSRs were detected in 10 patients at the diagnostic MR examinations. These regions were targeted for MR imaging-guided robot-assisted prostate biopsy. Thirteen (76%) of the 17 CSRs could be reached with the robot for biopsy. Biopsy of the remaining four CSRs was performed without use of the robot. It is feasible to perform transrectal prostate biopsy with real-time 3-T MR imaging guidance with the aid of a remote-controlled, pneumatically actuated MR-compatible robotic device.

Advancements in magnetic resonance-guided robotic interventions in the prostate.

Magnetic resonance imaging (MRI) provides more detailed anatomical images of the prostate compared with the transrectal ultrasound imaging. Therefore, for the purpose of intervention in the prostate gland, diagnostic or therapeutic, MRI guidance offers a possibility of more precise targeting that may be crucial to the success of prostate interventions. However, access within the scanner is limited for manual instrument handling and the MR environment is most demanding among all imaging equipment with respect to the instrumentation used. A solution to this problem is the use of MR-compatible robots purposely designed to operate in the space and environmental restrictions inside the MR scanner allowing real-time interventions. Building an MRI-compatible robot is a very challenging engineering task because, in addition to the material restrictions that MRI instruments have, the robot requires actuators and sensors that limit the type of energies that can be used. Several important design problems have to be overcome before a successful MR-compatible robot application can be built. A number of MR-compatible robots, ranging from a simple manipulator to a fully automated system, have been developed, proposing ingenious solutions to the design challenge. Several systems have been already tested clinically for prostate biopsy and brachytherapy. As technology matures, precise image guidance for prostate interventions performed or assisted by specialized MR-compatible robotic devices may provide a uniquely accurate solution for guiding the intervention directly based on MR findings and feedback. Such an instrument would become a valuable clinical tool for biopsies directly targeting imaged tumor foci and delivering tumor-centered focal therapy.

Development of MR Compatible Manipulandum for Finger Movements

Magnetically compatible robots are required as haptic interfaces for neuroscience studies. The purpose of this paper is to develop an MR compatible robot using ultrasonic motor, which is able to work within an MRI/fMRI scanner and to acquire MRI images continuously during finger motions. In addition, the force field control method of ultrasonic motor is discussed. The characteristic of voltage phase and motor torque is investigated experimentally, and these results are used for the force field control of ultrasonic motors. The position dependent force fields and velocity dependent force fields are evaluated with a force sensor. Also, MR compatibility is verified experimentally. Finally, some brain activities are investigated with fMRI during finger movements.

MG312 MRI対応手・腕運動用マニピュランダムの開発(MG31 医療福祉ロボット,あたり前のことを知る)

Magnetically compatible robots are required as haptic interfaces for enhancing neuroscience studies. The purpose of this paper is to develop an MR compatible robot using ultrasonic motors, which is able to work within an MRI/fMRI scanner and to acquire MRI images continuously during fingers and Arm motions. We propose a Manipulandum for the fingers and Arm movements. Our Manipulandum has one feature. Finally, MR compatibility of our Manipulandum is verified experimentally.

Machine vision based fiber optic joint sensor for MR-compatible robot

In the last 10 years, computer-integrated surgery has become a very important area of research in medical technology. Robotics is one of the most increased technologies. The benefits of robotics are, among other things, better accuracy and faster healing process in surgical operations. Imaging technologies have also helped doctors to analyze their patients with greater precision. The accuracy of imaging systems is constantly increasing. When a robot is developed for the MR environment, magnetic properties become very important. Electric equipment produces magnetic fields that can harm the picture quality in the MRI. This paper introduces the basis of a sensor that can replace the normal angle sensor in a robot's joint. Because of the use of fiber optics, the prototype sensor is neither magnetic nor electric for a given distance. By replacing the normal angle sensor with a prototype sensor, it is possible to accomplish robot joints and arms which are MR-compatible and therefore can operate inside different MRIs. The robot joint has to be provided with a sensor because the accurate control of the joint is crucial. This new sensor can be used to improve MR compatibility of the robot at any level of magnetic fields. There are no parts that move or wear in the sensor either.

Mobile intraoperative MRI in neurosurgery at 1.5 T

Introduction: Frameless navigation systems have been plagued by their inability to update preoperative MRI scans. Consequently, intraoperative MRI devices were integrated into several experimental operating rooms. They were of low-field strength, however, and we therefore planned to design and develop a 1.5 T, mobile system. Methods: The resulting design was a ceiling-mounted, mobile device permitting free access to the body. It's gradient coils have a 74 cm internal diameter and provide a maximum strength of 22 mT/m, a rise time of 400 μs for the x and y directions, and 315 μs for z. The cantilevered OR table is constructed of stainless steel, plastic, fiberglass and brass. A hydraulic system allows rotational and vertical movement in six degrees of freedom, and permits conventional patient positioning (including supine, prone and lateral). Three hundred and eighty-eight patients were operated on, and the results prospectively recorded and analysed. Results: A half of the epilepsy patients had residual target tissue when imaged at a time when the surgeon thought the surgical goals had been accomplished. Complete resection was then confirmed in all these cases prior to resection. A similar percentage of pituitary tumor patients benefited from this, as did approximately a quarter of low-grade gliomas. Discussion: Conventional images are being supplemented with MRA techniques, which allow complex vascular procedures to be performed. Carotid endarterectomy research is under way, with intraoperative DWI and perfusion studies evaluating different techniques. An MR-compatible robot has been design to couple with our system to perform guided stereotaxy.

Intraoperative MR at 1.5 Tesla--experience and future directions.

The objective of this report is to present and contrast the development of the different intraoperative MR systems that are currently in use. The manuscript focuses on the design and clinical experience of a 1.5 Tesla MR system, based on a movable magnet. This configuration is similar to the operating microscope and other surgical adjuncts, with MR technology moved to and from the patient as needed. The system has been used to monitor 294 neurosurgical procedures. including CNS neoplasia. epilepsy, cervical spine disorders, arteriovenous malformations, cavernomas and aneurysms. In many cases the surgical procedure was significantly altered by intraoperatively acquired MRI. Future developments include the construction of a 3 Tesla intraoperative MR system and an ambidextrous MR-compatible robot. This seamless integration of robotic technology into an intraoperative MR environment may well revolutionize neurosurgery.