@article {Tokuda2012, title = {Preclinical evaluation of an MRI-compatible pneumatic robot for angulated needle placement in transperineal prostate interventions}, journal = {International Journal of Computer Assisted Radiology and Surgery (IJCARS)}, year = {2012}, abstract = {

Purpose. To support transperineal prostate biopsies in a closed-bore magnetic resonance imaging (MRI) scanner, we developed a small profile MRI-compatible pneumatic needle placement robot that can angulate a needle insertion path into a large accessible target volume. We performed a preclinical evaluation of the robot{\textquoteright}s targeting accuracy with angulated needle insertion in a 3 Tesla clinical MRI. Methods. Angulation of the needle insertion path is achieved by a four degrees-of-freedom (4-DOF) mechanism with two parallel triangular structures. The robot is integrated with navigation software that allows an operator to plan angulated needle insertion by selecting a target and an entry point. The targeting error was evaluated while the angle between the needle insertion path and the static magnetic field was between -5.7{\textdegree} and 5.7{\textdegree} horizontally and between -5.7{\textdegree} and 4.3{\textdegree} vertically in the MRI scanner after sterilizing and draping the device. Results. The needle placement robot successfully positioned the needle with angulated insertion as specified on the navigation software. The overall targeting error was 0.8 {\textpm} 0.5 mm along the horizontal axis and 0.8 {\textpm} 0.8 mm along the vertical axis. The two-dimensional root-mean-square targeting error on the axial slices as containing the targets was 1.4 mm. Conclusions. Our preclinical evaluation demonstrated that the MRI-compatible pneumatic needle placement robot with the 4-DOF parallel kinematic structure with the capability to angulate the needle insertion path provides sufficient targeting accuracy for clinical MRI-guided prostate interventions.

}, keywords = {Biopsy, Brachytherapy, medical robotics, MRI-guided therapy, prostate cancer}, doi = {10.1007/s11548-012-0750-1}, url = {http://www.springerlink.com/content/tl77lrh211608j70/}, author = {Junichi Tokuda and Sam Sang-Eun Song and Gregory Fischer and Iulian Iordachita and Reza Seifabadi and Nathan Bongjoon Cho and Kemal Tuncali and Gabor Fichtinger and Clare M Tempany and Nobuhiko Hata} } @conference {Avni2010, title = {Design of a predictive targeting error simulator for MRI-guided prostate biopsy}, booktitle = {Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling}, year = {2010}, month = {2010}, pages = {76251A-1 - 76251A-8}, publisher = {SPIE}, organization = {SPIE}, address = {San Diego, California, USA}, abstract = {

Multi-parametric MRI is a new imaging modality superior in quality to Ultrasound (US) which is currently used in standard prostate biopsy procedures. Surface-based registration of the pre-operative and intra-operative prostate volumes is a simple alternative to side-step the challenges involved with deformable registration. However, segmentation errors inevitably introduced during prostate contouring spoil the registration and biopsy targeting accuracies. For the crucial purpose of validating this procedure, we introduce a fully interactive and customizable simulator which determines the resulting targeting errors of simulated registrations between prostate volumes given user-provided parameters for organ deformation, segmentation, and targeting. We present the workflow executed by the simulator in detail and discuss the parameters involved. We also present a segmentation error introduction algorithm, based on polar curves and natural cubic spline interpolation, which introduces statistically realistic contouring errors. One simulation, including all I/O and preparation for rendering, takes approximately 1 minute and 40 seconds to complete on a system with 3 GB of RAM and four Intel Core 2 Quad CPUs each with a speed of 2.40 GHz. Preliminary results of our simulation suggest the maximum tolerable segmentation error given the presence of a 5.0 mm wide small tumor is between 4-5 mm. We intend to validate these results via clinical trials as part of our ongoing work.

}, keywords = {Biopsy, cancer, error, modeling, MRI, Prostate, segmentation, validation}, isbn = {0277-786X}, doi = {http://dx.doi.org/10.1117/12.844476}, author = {Shachar Avni and Siddharth Vikal and Gabor Fichtinger} } @conference {Tadayyon2010a, title = {MRI-Guided prostate motion tracking by means of multislice-to-volume registration}, booktitle = {SPIE Medical Imaging}, year = {2010}, month = {02/2010}, keywords = {Biopsy, motion tracking, MRI, slice-to-volume registation}, doi = {10.1117/12.844454}, author = {Hadi Tadayyon and Gabor Fichtinger and Andras Lasso and Siddharth Vikal and Sean Gill} } @article {Krieger2007a, title = {Design and preliminary accuracy studies of an MRI-guided transrectal prostate intervention system}, journal = {Medical image computing and computer-assisted intervention (MICCAI)}, volume = {10}, number = {Pt 2}, year = {2007}, pages = {59{\textendash}67}, publisher = {Department of Mechanical Engineering, Johns Hopkins University, Baltimore, USA}, abstract = {

This paper reports a novel system for magnetic resonance imaging (MRI) guided transrectal prostate interventions, such as needle biopsy, fiducial marker placement, and therapy delivery The system utilizes a hybrid tracking method, comprised of passive fiducial tracking for initial registration, subsequent incremental motion measurement along the degrees of freedom using fiber-optical encoders, mechanical scales Targeting accuracy of the system is evaluated in prostate phantom experiments Achieved targeting accuracy, procedure times were found to compare favorably with existing systems using passive, active tracking methods Moreover, the portable design of the system using only standard MRI image sequences, minimal custom scanner interfacing allows the system to be easily used on different MRI scanners

}, keywords = {Algorithms, Artificial Intelligence, Automated, Biopsy, Computer-Assisted, Equipment Design, Equipment Failure Analysis, Humans, Image Enhancement, Image Interpretation, Imaging, instrumentation/methods, Interventional, Magnetic Resonance Imaging, Male, methods, Needle, pathology/surgery, Pattern Recognition, Pilot Projects, Prostatectomy, Prostatic Neoplasms, Rectum, Reproducibility of Results, Robotics, Sensitivity, Specificity, Three-Dimensional, User-Computer Interface}, author = {Axel Krieger and Csaba Csoma and Iulian Iordachita and Peter Guion and Anurag K. Singh and Gabor Fichtinger and Whitcomb, Louis L.} } @article {Singh2007a, title = {Patient selection determines the prostate cancer yield of dynamic contrast-enhanced magnetic resonance imaging-guided transrectal biopsies in a closed 3-Tesla scanner}, journal = {British Journal of Urology international}, volume = {101}, number = {2}, year = {2007}, month = {Jan}, pages = {181{\textendash}185}, publisher = {Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1642, USA Anurag Singh@RoswellPark org}, abstract = {

OBJECTIVE: To evaluate the cancer yield of transrectal prostate biopsies in a 3-T magnetic resonance imaging (MRI) scanner in patients with elevated prostate specific antigen (PSA) levels, recent negative transrectal ultrasonography (TRUS)-guided prostate biopsies PATIENTS AND METHODS: Between July 2004, November 2005, patients with at least one previous negative prostate biopsy within the previous 12 months had MRI-guided biopsy of the prostate in a 3-T MRI scanner Patients with previous positive biopsies for cancer were excluded Target selection was based on T2-weighted imaging, dynamic contrast-enhanced (DCE) imaging studies RESULTS: Thirteen patients were eligible; their median (range) age was 61 (47-74) years, PSA value 4 90 (1 3-12 3) ng/mL Most patients had one previous negative biopsy (range 1-4) Four patients had a family history of prostate cancer There were 37 distinct targets based on T2-weighted imaging Fifteen of 16 distinct DCE abnormalities were co-localized with a target based on T2-weighted imaging Despite this correlation, only one of 13 patients had a directed biopsy positive for cancer Including systematic biopsies, two of 13 patients had a biopsy positive for prostate cancer One patient had prostate intraepithelial neoplasia, one had atypical glands in the specimen CONCLUSION: The prostate-cancer yield of transrectal biopsies in a 3-T MRI scanner, among patients with recent negative TRUS-guided prostate biopsies, is similar to repeat systematic TRUS-guided biopsy DCE correlates with T2-imaging but does not appear to improve prostate cancer yield in this population

}, keywords = {Aged, Biopsy, blood, Cohort Studies, Contrast Media, diagnosis, Digital Rectal Examination, Humans, Interventional, Magnetic Resonance Imaging, Male, methods, Middle Aged, Needle, pathology, Patient Selection, Predictive Value of Tests, Prostate, Prostate-Specific Antigen, Prostatic Neoplasms, Sensitivity, Specificity, standards, Ultrasonography}, doi = {10 1111/j 1464-410X 2007 07219 x}, url = {http://dx doi org/10 1111/j 1464-410X 2007 07219 x}, author = {Anurag K. Singh and Axel Krieger and Jean-Baptiste Lattouf and Peter Guion and R.L. Grubb III and Paul Albert and Greg Metzger and Karen Ullman and Sharon Smith and Gabor Fichtinger and Iclal Ocak and Peter Choyke and Cynthia Menard and Jonathan Coleman} } @article {DiMaio2007a, title = {Robot-assisted needle placement in open MRI: system architecture, integration and validation}, journal = {Journal of Computer Aided Surgery}, volume = {12}, number = {1}, year = {2007}, month = {Jan}, pages = {15{\textendash}24}, publisher = {Brigham, Women{\textquoteright}s Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA simond@bwh harvard edu}, abstract = {

In prostate cancer treatment, there is a move toward targeted interventions for biopsy, therapy, which has precipitated the need for precise image-guided methods for needle placement This paper describes an integrated system for planning, performing percutaneous procedures with robotic assistance under MRI guidance A graphical planning interface allows the physician to specify the set of desired needle trajectories, based on anatomical structures, lesions observed in the patient{\textquoteright}s registered pre-operative, pre-procedural MR images, immediately prior to the intervention in an open-bore MRI scanner All image-space coordinates are automatically computed, and are used to position a needle guide by means of an MRI-compatible robotic manipulator, thus avoiding the limitations of the traditional fixed needle template Automatic alignment of real-time intra-operative images aids visualization of the needle as it is manually inserted through the guide Results from in-scanner phantom experiments are provided

}, keywords = {Biopsy, diagnosis, Humans, instrumentation/methods, Magnetic Resonance Imaging, Male, Needle, Neuronavigation, Prostatic Neoplasms, Robotics}, doi = {10 1080/10929080601168254}, url = {http://dx doi org/10 1080/10929080601168254}, author = {Simon DiMaio and Steve Pieper and Kiyoyuki Chinzei and Nobuhiko Hata and Steven Haker and Daniel Kacher and Gabor Fichtinger and Clare M Tempany and Ron Kikinis} } @article {Singh2007b, title = {Simultaneous integrated boost of biopsy proven and MRI defined dominant intra-prostatic lesions to 95 Gray with IMRT: early results of a phase I NCI study}, journal = {Radiation Oncology}, volume = {2}, year = {2007}, pages = {36}, publisher = {Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, USA singhanu@yahoo com}, abstract = {

BACKGROUND: To assess the feasibility, early toxicity of selective, IMRT-based dose escalation (simultaneous integrated boost) to biopsy proven dominant intra-prostatic lesions visible on MRI METHODS: Patients with localized prostate cancer, an abnormality within the prostate on endorectal coil MRI were eligible All patients underwent a MRI-guided transrectal biopsy at the location of the MRI abnormality Gold fiducial markers were also placed Several days later patients underwent another MRI scan for fusion with the treatment planning CT scan This fused MRI scan was used to delineate the region of the biopsy proven intra-prostatic lesion A 3 mm expansion was performed on the intra-prostatic lesions, defined as a separate volume within the prostate The lesion + 3 mm, the remainder of the prostate + 7 mm received 94 5/75 6 Gray (Gy) respectively in 42 fractions Daily seed position was verified to be within 3 mm RESULTS: Three patients were treated Follow-up was 18, 6, and 3 months respectively Two patients had a single intra-prostatic lesion One patient had 2 intra-prostatic lesions All four intra-prostatic lesions, with margin, were successfully targeted, treated to 94 5 Gy Two patients experienced acute RTOG grade 2 genitourinary (GU) toxicity One had grade 1 gastrointestinal (GI) toxicity All symptoms completely resolved by 3 months One patient had no acute toxicity CONCLUSION: These early results demonstrate the feasibility of using IMRT for simultaneous integrated boost to biopsy proven dominant intra-prostatic lesions visible on MRI The treatment was well tolerated

}, keywords = {adverse effects/methods, Biopsy, epidemiology, epidemiology/radiotherapy, Follow-Up Studies, Humans, Intensity-Modulated, Magnetic Resonance Imaging, Male, National Cancer Institute (U S ), Patient Selection, Prostatic Neoplasms, Questionnaires, Radiotherapy, Radiotherapy Dosage, United States}, doi = {10 1186/1748-717X-2-36}, url = {http://dx doi org/10 1186/1748-717X-2-36}, author = {Anurag K. Singh and Peter Guion and Nancy Sears-Crouse and Karen Ullman and Sharon Smith and Paul Albert and Gabor Fichtinger and Peter Choyke and Sheng Xu and Jochen Kruecker and Bradford Wood and Axel Krieger and Holly Ning} } @article {Blumenfeld2007, title = {Transperineal prostate biopsy under magnetic resonance image guidance: a needle placement accuracy study}, journal = {Journal of magnetic resonance imaging}, volume = {26}, number = {3}, year = {2007}, month = {Sep}, pages = {688{\textendash}694}, publisher = {Department of Radiology, Brigham, Women{\textquoteright}s Hospital, Harvard Medical School, Boston, Massachusetts, USA}, abstract = {

PURPOSE: To quantify needle placement accuracy of magnetic resonance image (MRI)-guided core needle biopsy of the prostate MATERIALS AND METHODS: A total of 10 biopsies were performed with 18-gauge (G) core biopsy needle via a percutaneous transperineal approach Needle placement error was assessed by comparing the coordinates of preplanned targets with the needle tip measured from the intraprocedural coherent gradient echo images The source of these errors was subsequently investigated by measuring displacement caused by needle deflection, needle susceptibility artifact shift in controlled phantom studies Needle placement error due to misalignment of the needle template guide was also evaluated RESULTS: The mean, standard deviation (SD) of errors in targeted biopsies was 6 5 +/- 3 5 mm Phantom experiments showed significant placement error due to needle deflection with a needle with an asymmetrically beveled tip (3 2-8 7 mm depending on tissue type) but significantly smaller error with a symmetrical bevel (0 6-1 1 mm) Needle susceptibility artifacts observed a shift of 1 6 +/- 0 4 mm from the true needle axis Misalignment of the needle template guide contributed an error of 1 5 +/- 0 3 mm CONCLUSION: Needle placement error was clinically significant in MRI-guided biopsy for diagnosis of prostate cancer Needle placement error due to needle deflection was the most significant cause of error, especially for needles with an asymmetrical bevel

}, keywords = {Aged, Artifacts, Biopsy, Contrast Media, diagnosis/pathology, Humans, Imaging, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Male, methods, Middle Aged, Needle, Needles, Phantoms, pharmacology, Prostatectomy, Prostatic Neoplasms, Reproducibility of Results, Retrospective Studies}, doi = {10 1002/jmri 21067}, url = {http://dx doi org/10 1002/jmri 21067}, author = {Philip Blumenfeld and Nobuhiko Hata and Simon DiMaio and Kelly Zou and Steven Haker and Gabor Fichtinger and Clare M Tempany} } @article {Kazanzides2006, title = {Design, validation of an image-guided robot for small animal research}, journal = {Medical image computing and computer-assisted intervention (MICCAI)}, volume = {9}, number = {Pt 1}, year = {2006}, pages = {50{\textendash}57}, publisher = {Department of Computer Science, Johns Hopkins University, USA pkaz@jhu edu}, abstract = {

We developed an image-guided robot system to achieve highly accurate placement of thin needles, probes into in-vivo rodent tumor tissue in a predefined pattern that is specified on a preoperative image This system can be used for many experimental procedures where the goal is to correlate a set of physical measurements with a corresponding set of image intensities or, more generally, to perform a physical action at a set of anatomic points identified on a preoperative image This paper focuses on the design, validation of the robot system, where the first application is to insert oxygen measurement probes in a three-dimensional (3D) grid pattern defined with respect to a PET scan of a tumor The design is compatible with CT, MRI, which we plan to use to identify targets for biopsy, for the injection of adenoviral sequences for gene therapy The validation is performed using a phantom, includes a new method for estimating the Fiducial Localization Error (FLE) based on the measured Fiducial Distance Error (FDE)

}, keywords = {Animals, Biopsy, Computer-Assisted, Equipment Design, Equipment Failure Analysis, Imaging, Injections, instrumentation/methods, instrumentation/methods/veterinary, Needle, Phantoms, Positron-Emission Tomography, Research, Robotics, Surgery}, author = {Peter Kazanzides and Jenghwa Chang and Iulian Iordachita and Jack Li and Clifton Ling and Gabor Fichtinger} } @article {DiMaio2006b, title = {Robot-assisted needle placement in open-MRI: system architecture, integration and validation}, journal = {Studies in health technology and informatics}, volume = {119}, year = {2006}, pages = {126{\textendash}131}, publisher = {Brigham, Women{\textquoteright}s Hospital, Harvard Medical School, USA simond@bwh harvard edu}, abstract = {

This work describes an integrated system for planning, performing percutaneous procedures-such as prostate biopsy-with robotic assistance under MRI-guidance The physician interacts with a planning interface in order to specify the set of desired needle trajectories, based on anatomical structures, lesions observed in the patient{\textquoteright}s MR images All image-space coordinates are automatically computed, and used to position a needle guide by means of an MRI-compatible robotic manipulator, thus avoiding the limitations of the traditional fixed needle template Direct control of real-time imaging aids visualization of the needle as it is manually inserted through the guide Results from in-scanner phantom experiments are provided

}, keywords = {Biopsy, Computer Systems, diagnosis, Humans, instrumentation, Magnetic Resonance Imaging, Male, Needle, Prostatic Neoplasms, Robotics}, author = {Simon DiMaio and Steve Pieper and Kiyoyuki Chinzei and Nobuhiko Hata and Emese Balogh and Gabor Fichtinger and Clare M Tempany and Ron Kikinis} } @article {Susil2006, title = {Transrectal prostate biopsy and fiducial marker placement in a standard 1 5T magnetic resonance imaging scanner}, journal = {The Journal of Urology}, volume = {175}, number = {1}, year = {2006}, month = {Jan}, pages = {113{\textendash}120}, publisher = {Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA}, abstract = {

PURPOSE: We investigated the accuracy, feasibility of a system that provides transrectal needle access to the prostate concurrent with 1 5 Tesla MRI which previously has not been possible MATERIALS AND METHODS: In 5 patients with previously diagnosed prostate cancer, MRI guided intraprostatic placement of gold fiducial markers (4 procedures),/or prostate biopsy (3 procedures) was performed using local anesthesia RESULTS: Mean procedure duration was 76 minutes, all patients tolerated the intervention well Procedure related adverse events included self-limited hematuria, hematochezia following 3 of 8 procedures (all resolved in less than 1 week) Mean needle placement accuracy was 1 9 mm for the fiducial marker placement studies, 1 8 mm for the biopsy procedures Mean fiducial marker placement accuracy was 4 8 mm, the mean fiducial marker placement accuracy transverse to the needle direction was 2 6 mm All patients who underwent the procedure were able to complete their course of radiotherapy without delay or complication CONCLUSIONS: While studies of clinical usefulness are warranted, transrectal 1 5 T MRI guided prostate biopsy, fiducial marker placement is feasible using this system, providing new opportunities for image guided diagnostic, therapeutic prostate interventions

}, keywords = {Biopsy, Equipment Design, Feasibility Studies, Humans, instrumentation, instrumentation/methods, Magnetic Resonance Imaging, Male, Needle, pathology, Prostate, Prostatic Neoplasms}, doi = {10 1016/S0022-5347(05)00065-0}, url = {http://dx doi org/10 1016/S0022-5347(05)00065-0}, author = {Robert Susil and Cynthia Menard and Axel Krieger and Jonathan Coleman and Kevin Camphausen and Peter Choyke and Gabor Fichtinger and Whitcomb, Louis L. and Norman Coleman and Ergin Atalar} } @article {Krieger2005a, title = {Design of a novel MRI compatible manipulator for image guided prostate interventions}, journal = {IEEE Transactions on Biomedical Engineering}, volume = {52}, number = {2}, year = {2005}, month = {Feb}, pages = {306{\textendash}313}, abstract = {

This paper reports a novel remotely actuated manipulator for access to prostate tissue under magnetic resonance imaging guidance (APT-MRI) device, designed for use in a standard high-field MRI scanner The device provides three-dimensional MRI guided needle placement with millimeter accuracy under physician control Procedures enabled by this device include MRI guided needle biopsy, fiducial marker placements, and therapy delivery Its compact size allows for use in both standard cylindrical, open configuration MRI scanners Preliminary in vivo canine experiments, first clinical trials are reported

}, keywords = {Animals, Biopsy, Computer-Assisted, Dogs, Equipment Design, Equipment Failure Analysis, Feasibility Studies, Imaging, instrumentation/methods, Magnetic Resonance Imaging, Male, Micromanipulation, Needle, pathology/surgery, Prostate, Reproducibility of Results, Robotics, Sensitivity, Specificity, Surgery, Three-Dimensional}, doi = {10 1109/TBME 2004 840497}, url = {http://dx doi org/10 1109/TBME 2004 840497}, author = {Axel Krieger and Robert Susil and Cynthia Menard and Jonathan Coleman and Gabor Fichtinger and Ergin Atalar and Whitcomb, Louis L.} } @article {Fichtinger2005, title = {Image overlay for CT-guided needle insertions}, journal = {Journal of Computer Aided Surgery}, volume = {10}, number = {4}, year = {2005}, month = {Jul}, pages = {241{\textendash}255}, abstract = {

OBJECTIVE: We present a 2D image overlay device to assist needle placement on computed tomography (CT) scanners MATERIALS AND METHODS: The system consists of a flat display, a semitransparent mirror mounted on the gantry When the physician looks at the patient through the mirror, the CT image appears to be floating inside the body with correct size, position as if the physician had 2D {\textquoteright}X-ray vision{\textquoteright} The physician draws the optimal path on the CT image The composite image is rendered on the display, thus reflected in the mirror The reflected image is used to guide the physician in the procedure In this article, we describe the design, various embodiments of the 2D image overlay system, followed by the results of phantom, cadaver experiments in multiple clinical applications RESULTS: Multiple skeletal targets were successfully accessed with one insertion attempt Generally, successful access was recorded on liver targets when a clear path opened, but the number of attempts, accuracy showed variability because of occasional lack of access Soft tissue deformation further reduced the accuracy, consistency in comparison to skeletal targets CONCLUSION: The system demonstrated strong potential for reducing faulty needle insertion attempts, thereby reducing X-ray dose, patient discomfort

}, keywords = {Animals, Biopsy, Cadaver, Calibration, Computer-Assisted, Equipment Design, Humans, Image Processing, Imaging, instrumentation, Interventional, Needle, Phantoms, Radiography, Swine, Tomography, User-Computer Interface, X-Ray Computed}, doi = {10 1080/10929080500230486}, url = {http://dx doi org/10 1080/10929080500230486}, author = {Gabor Fichtinger and Anton Degeut and Gregory Fischer and Iulian Iordachita and Emese Balogh and Ken Masamune and Russell H. Taylor and Laura Fayad and Michelle de Oliveira and James Zinreich} } @article {Cleary2005, title = {Precision placement of instruments for minimally invasive procedures using a "needle driver" robot}, journal = {international journal of medical robotics computer assisted surgery MRCAS}, volume = {1}, number = {2}, year = {2005}, month = {Jan}, pages = {40{\textendash}47}, abstract = {

Medical practice continues to move toward less invasive procedures Many of these procedures require the precision placement of a needle in the anatomy Over the past several years, our research team has been investigating the use of a robotic needle driver to assist the physician in this task This paper summarizes our work in this area The robotic system is briefly described, followed by a description of a clinical trial in spinal nerve blockade The robot was used under joystick control to place a 22 gauge needle in the spines of 10 patients using fluoroscopic imaging The results were equivalent to the current manual procedure We next describe our follow-up clinical application in lung biopsy for lung cancer screening under CT fluoroscopy The system concept is discussed, the results of a phantom study are presented A start-up company named ImageGuide has recently been formed to commercialize the robot Their revised robot design is presented, along with plans to install a ceiling-mounted version of the robot in the CT fluoroscopy suite at Georgetown University

}, keywords = {Biopsy, Cadaver, Equipment Design, Fluoroscopy, Humans, Imaging, instrumentation, instrumentation/methods, Lung, Lung Neoplasms, methods, Minimally Invasive, Needles, Nerve Block, pathology, pathology/radiography, Phantoms, Randomized Controlled Trials as Topic, Robotics, Spinal Nerves, Surgical Procedures, Tomography, X-Ray Computed}, doi = {10 1002/rcs 40}, url = {http://dx doi org/10 1002/rcs 40}, author = {Kevin Cleary and Vance Watson and David Lindisch and Russell H. Taylor and Gabor Fichtinger and Sheng Xu and Charles White and John Donlon and Michael Taylor and Alexandru Patriciu and Dumitru Mazilu and Dan Stoianovici} } @article {Shen2004a, title = {Optimized prostate biopsy via a statistical atlas of cancer spatial distribution}, journal = {Medical image analysis}, volume = {8}, number = {2}, year = {2004}, month = {Jun}, pages = {139{\textendash}150}, abstract = {

A methodology is presented for constructing a statistical atlas of spatial distribution of prostate cancer from a large patient cohort, and it is used for optimizing needle biopsy An adaptive-focus deformable model is used for the spatial normalization, registration of 100 prostate histological samples, which were provided by the Center for Prostate Disease Research of the US Department of Defense, resulting in a statistical atlas of spatial distribution of prostate cancer Based on this atlas, a statistical predictive model was developed to optimize the needle biopsy sites, by maximizing the probability of detecting cancer Experimental results using cross-validation show that the proposed method can detect cancer with a 99\% success rate using seven needles, in these samples

}, keywords = {Algorithms, Biological, Biopsy, Cohort Studies, Computer Simulation, Computer-Assisted, Forecasting, Humans, Image Processing, Imaging, Male, Models, Needle, pathology, Probability, Prostate, Prostatic Neoplasms, Reproducibility of Results, Statistical, statistics /\&/ numerical data, Three-Dimensional}, doi = {10 1016/j media 2003 11 002}, url = {http://dx doi org/10 1016/j media 2003 11 002}, author = {Dinggang Shen and Zhiqiang Lao and Jianchao Zeng and Wei Zhang and Isabel Sesterhenn and Leon Sun and Judd Moul and Edward Herskovits and Gabor Fichtinger and Christos Davatzikos} } @article {Masamune2001, title = {System for robotically assisted percutaneous procedures with computed tomography guidance}, journal = {Journal of Computer Aided Surgery}, volume = {6}, number = {6}, year = {2001}, pages = {370{\textendash}383}, abstract = {

We present the prototype of an image-guided robotic system for accurate, consistent placement of percutaneous needles in soft-tissue targets under CT guidance inside the gantry of a CT scanner The couch-mounted system consists of a seven-degrees-of-freedom passive mounting arm, a remote center-of-motion robot, and a motorized needle-insertion device Single-image-based coregistration of the robot, image space is achieved by stereotactic localization using a miniature version of the BRW head frame built into the radiolucent needle driver The surgeon plans, controls the intervention in the scanner room on a desktop computer that receives DICOM images from the scanner The system does not need calibration, employs pure image-based registration, and does not utilize any vendor-specific hardware or software features In the open air, where there is no needle-tissue interaction, we systematically achieved an accuracy better than 1 mm in hitting targets at 5-8 cm from the fulcrum point In the phantom, the orientation accuracy was 0 6 degrees, and the distance between the needle tip, the target was 1 04 mm Experiments indicated that this robotic system is suitable for a variety of percutaneous clinical applications

}, keywords = {Biopsy, Computer-Assisted, Humans, Image Processing, Imaging, instrumentation, instrumentation/methods, Needle, Phantoms, Robotics, Surgery, Tomography, User-Computer Interface, X-Ray Computed}, doi = {10 1002/igs 10024}, url = {http://dx doi org/10 1002/igs 10024}, author = {Ken Masamune and Gabor Fichtinger and Alexandru Patriciu and Robert Susil and Russell H. Taylor and Louis Kavoussi and James Anderson and Ichiro Sakuma and Takeyoshi Dohi and Dan Stoianovici} }