technical-approach-for-infrared-tracking-for-soft-tissue-navigation

Technical Approach for Infrared Tracking for Soft Tissue Navigation with a Holographic Head-Mounted Display and Preclinical Validation

Augmented Reality (AR) has the potential to enhance surgical guidance by superimposing three-dimensional (3D) anatomical information directly onto the ...

University of Twente

Suspicious lesions in the breast that are only visible on magnetic resonance imaging (MRI) need to be biopsied under MR guidance with high accuracy and efficiency for accurate diagnosis. The aim of this study is to present a novel robotic system, the Stormram 4, and to perform preclinical tests in an MRI environment. Excluding racks and needle, its dimensions are 72 × 51 × 40 mm. The Stormram 4 is driven by two linear and two curved pneumatic stepper motors. The linear motor is capable of exerting 63 N of force at a pressure of 0.65 MPa. In an MRI environment the maximum observed stepping frequency is 30 Hz (unloaded), or 8 Hz when full force is needed. The Stormram 4's mean positioning error is 0.73 ± 0.47 mm in free air, and 1.29 ± 0.59 mm when targeting breast phantoms in MRI. Excluding the off-the-shelf needle, the robot is inherently MR safe. The robot is able to accurately target lesions under MRI guidance, reducing tissue damage and risk of false negatives. These results are promising for clinical experiments, improving the quality of healthcare in the field of MRI-guided breast biopsies.

Stormram 4: An MR Safe Robotic System for Breast Biopsy.

Patient-specific biomedical modeling of the breast is of interest for medical applications such as image registration, image guided procedures and the alignment for biopsy or surgery purposes. The computation of elastic properties is essential to simulate deformations in a realistic way. This study presents an innovative analytical method to compute the elastic modulus and evaluate the elasticity of a breast using magnetic resonance (MRI) images of breast phantoms.

Analytical derivation of elasticity in breast phantoms for deformation tracking.

The modeling of breast deformations is of interest in medical applications such as image-guided biopsy, or image registration for diagnostic purposes. In order to have such information, it is needed to extract the mechanical properties of the tissues. In this work, we propose an iterative technique based on finite element analysis that estimates the elastic modulus of realistic breast phantoms, starting from MRI images acquired in different positions (prone and supine), when deformed only by the gravity force. We validated the method using both a single-modality evaluation in which we simulated the effect of the gravity force to generate four different configurations (prone, supine, lateral, and vertical) and a multi-modality evaluation in which we simulated a series of changes in orientation (prone to supine). Validation is performed, respectively, on surface points and lesions using as ground-truth data from MRI images, and on target lesions inside the breast phantom compared with the actual target segmented from the US image. The use of pre-operative images is limited at the moment to diagnostic purposes. By using our method we can compute patient-specific mechanical properties that allow compensating deformations. Graphical Abstract Workflow of the proposed method and comparative results of the prone-to-supine simulation (red volumes) validated using MRI data (blue volumes).

Iterative simulations to estimate the elastic properties from a series of MRI images followed by MRI-US validation.

The biopsy procedure is an important phase in breast cancer diagnosis. Accurate breast imaging and precise needle placement are crucial in lesion targeting. This paper presents an end-effector (EE) for robotic 3D ultrasound (US) breast acquisitions and US-guided breast biopsies. The EE mechanically guides the needle to a specified target within the US plane. The needle is controlled in all degrees of freedom (DOFs) except for the direction of insertion, which is controlled by the radiologist. It determines the correct needle depth and stops the needle accordingly.

Design of an end-effector for robot-assisted ultrasound-guided breast biopsies.

Among available breast biopsy techniques, ultrasound (US)-guided biopsy is preferable because it is relatively inexpensive and provides live imaging feedback. The availability of magnetic resonance imaging (MRI)-3D US image fusion would facilitate US-guided biopsy even for US occult lesions to reduce the need for expensive and time-consuming MRI-guided biopsy. In this paper, we propose a novel Automated Cone-based Breast Ultrasound Scanning and Biopsy System (ACBUS-BS) to scan and biopsy breasts of women in prone position. It is based on a previously developed system, called ACBUS, that facilitates MRI-3D US image fusion imaging of the breast employing a conical container filled with coupling medium.

Ultrasound-guided breast biopsy using an adapted automated cone-based ultrasound scanner: a feasibility study.

Abnormalities in the bladder wall require careful investigation regarding type, spatial position and invasiveness. Construction of a 3-D model of the bladder is helpful to ensure adequate coverage of the scanning procedure, quantitative comparison of bladder wall textures between successive sessions and finding back previously discovered abnormalities.

3-D and 2-D reconstruction of bladders for the assessment of inter-session detection of tissue changes: a proof of concept.

The COVID-19 pandemic resulted in severe shortages of personal protection equipment and non-invasive ventilation devices. As traditional supply chains could not meet up with the demand, makeshift solutions were developed and locally manufactured by rapid prototyping networks. Among the different global initiatives, retrofitting of full-face snorkeling masks for Non-Invasive-Ventilation (NIV) applications seems the most challenging. This article provides a systematic overview of rapid prototyped - 3D printed - designs that enable attachment of medical equipment to snorkeling masks, highlighting potential and challenges in additive manufacturing. The different NIV connector designs are compared on low-cost 3D fabrication time and costs, which allows a rapid assessment of developed connectors for health care workers in urgent need of retrofitting snorkeling masks for NIV purposes. Challenges and safety issues of the rapid prototyping approach for healthcare applications during the pandemic are discussed as well. When critical parameters such as the final product cost, geographical availability of the feedstock and the 3D printers and the medical efficiency of the rapid prototyped products are well considered before deploying decentralized 3D printing as manufacturing method, this rapid prototyping strategy contributed to reduce personal protective equipment and NIV shortages during the first wave of the COVID-19 pandemic. It is also concluded that it is crucial to carefully optimize material and printer parameter settings to realize best fitting and airtight connector-mask connections, which is heavily depending on the chosen feedstock and type of printer.

Use of 3D printed connectors to redesign full face snorkeling masks in the COVID-19 era: A preliminary technical case-study.

As a result of recent advances in the development of small microelectromechanical system mirrors, a novel forward-looking optical coherence tomography (OCT) probe with a uniquely large field of view is being commercially developed. The aim of this study is to prospectively assess the feasibility of this advanced OCT probe in interpreting ex vivo images of colorectal polyp tissue and to identify necessary steps for further development.

Article	Year
Stormram 4: An MR Safe Robotic System for Breast Biopsy. Annals of biomedical engineering\| PubMed ID: 29786775	2018
Analytical derivation of elasticity in breast phantoms for deformation tracking. International journal of computer assisted radiology and surgery\| PubMed ID: 29869320	2018
Iterative simulations to estimate the elastic properties from a series of MRI images followed by MRI-US validation. Medical & biological engineering & computing\| PubMed ID: 30483912	2019
Design of an end-effector for robot-assisted ultrasound-guided breast biopsies. International journal of computer assisted radiology and surgery\| PubMed ID: 32100177	2020
Ultrasound-guided breast biopsy using an adapted automated cone-based ultrasound scanner: a feasibility study. Medical physics\| PubMed ID: 36879348	2023
3-D and 2-D reconstruction of bladders for the assessment of inter-session detection of tissue changes: a proof of concept. International journal of computer assisted radiology and surgery\| PubMed ID: 37085675	2023
Use of 3D printed connectors to redesign full face snorkeling masks in the COVID-19 era: A preliminary technical case-study. Annals of 3D printed medicine\| PubMed ID: 38620734	2021
Evaluation of a novel forward-looking optical coherence tomography probe for endoscopic applications: an ex vivo feasibility study. Surgical endoscopy\| PubMed ID: 39496951	2024

Vincent Groenhuis

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