@article {Tokuda2008, title = {Software strategy for robotic transperineal prostate therapy in closed-bore MRI}, journal = {Medical image computing and computer-assisted intervention (MICCAI)}, volume = {11}, number = {Pt 2}, year = {2008}, pages = {701{\textendash}709}, publisher = {Department of Radiology, Brigham, Women{\textquoteright}s Hospital, Harvard Medical School, 75 Francis St , Boston, MA 02115, USA tokuda@bwh harvard edu}, abstract = {

A software strategy to provide intuitive navigation for MRI-guided robotic transperineal prostate therapy is presented In the system, the robot control unit, the MRI scanner, and open-source navigation software are connected to one another via Ethernet to exchange commands, coordinates, and images Six states of the system called "workphases" are defined based on the clinical scenario to synchronize behaviors of all components The wizard-style user interface allows easy following of the clinical workflow On top of this framework, the software provides features for intuitive needle guidance: interactive target planning; 3D image visualization with current needle position; treatment monitoring through real-time MRI These features are supported by calibration of robot, image coordinates by the fiducial-based registration The performance test shows that the registration error of the system was 2 6 mm in the prostate area, and it displayed real-time 2D image 1 7 s after the completion of image acquisition

}, keywords = {Brachytherapy, Computer-Assisted, Humans, Image Interpretation, Interventional, Magnetic Resonance Imaging, Male, methods, Needles, pathology/radiotherapy, Prostatic Neoplasms, Radiotherapy, Robotics, Software, Software Design}, author = {Junichi Tokuda and Gregory Fischer and Csaba Csoma and Simon DiMaio and David Gobbi and Gabor Fichtinger and Clare M Tempany and Nobuhiko Hata} } @article {Fischer2007, title = {MRI image overlay: application to arthrography needle insertion}, journal = {Journal of Computer Aided Surgery}, volume = {12}, number = {1}, year = {2007}, month = {Jan}, pages = {2{\textendash}14}, publisher = {Engineering Research Center, Johns Hopkins University, Baltimore, Maryland, USA gfisch@jhu edu}, abstract = {

Magnetic Resonance Imaging (MRI) offers great potential for planning, guiding, monitoring, controlling interventions MR arthrography (MRAr) is the imaging gold standard for assessing small ligament, fibrocartilage injury in joints In contemporary practice, MRAr consists of two consecutive sessions: (1) an interventional session where a needle is driven to the joint space, MR contrast is injected under fluoroscopy or CT guidance;, (2) a diagnostic MRI imaging session to visualize the distribution of contrast inside the joint space, evaluate the condition of the joint Our approach to MRAr is to eliminate the separate radiologically guided needle insertion, contrast injection procedure by performing those tasks on conventional high-field closed MRI scanners We propose a 2D augmented reality image overlay device to guide needle insertion procedures This approach makes diagnostic high-field magnets available for interventions without a complex, expensive engineering entourage In preclinical trials, needle insertions have been performed in the joints of porcine, human cadavers using MR image overlay guidance; in all cases, insertions successfully reached the joint space on the first attempt

}, keywords = {Arthrography, Cartilage, Contrast Media, diagnosis, Humans, injuries, instrumentation, Joint Diseases, Ligaments, Magnetic Resonance Imaging, Needles}, doi = {10 1080/10929080601169930}, url = {http://dx doi org/10 1080/10929080601169930}, author = {Gregory Fischer and Anton Degeut and Csaba Csoma and Russell H. Taylor and Laura Fayad and John A Carrino and James Zinreich and Gabor Fichtinger} } @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 {Fischer2007a, title = {Validation system of MR image overlay and other needle insertion techniques}, journal = {Studies in health technology and informatics}, volume = {125}, year = {2007}, pages = {130{\textendash}135}, publisher = {Engineering Research Center, Johns Hopkins University, Baltimore, MD, USA}, abstract = {

In order to develop accurate, effective augmented reality (AR) systems used in MR, CT guided needle placement procedures, a comparative validation environment is necessary Clinical equipment is prohibitively expensive, often inadequate for precise measurement Therefore, we have developed a laboratory validation system for measuring operator performance using different assistance techniques Electromagnetically tracked needles are registered with the preoperative plan to measure placement accuracy, the insertion path The validation system provides an independent measure of accuracy that can be applied to varying methods of assistance ranging from augmented reality guidance methods to tracked navigation systems, autonomous robots In preliminary studies, this validation system is used to evaluate the performance of the image overlay, bi-plane laser guide, and traditional freehand techniques

}, keywords = {Computer Simulation, Magnetic Resonance Imaging, Needles, Reproducibility of Results, Tomography, United States, X-Ray Computed}, author = {Gregory Fischer and Eva Dyer and Csaba Csoma and Anton Degeut and Gabor Fichtinger} } @article {Fischer2006, title = {MRI image overlay: applications to arthrography needle insertion}, journal = {Studies in health technology and informatics}, volume = {119}, year = {2006}, pages = {150{\textendash}155}, abstract = {

Magnetic Resonance Imaging (MRI) has unmatched potential for planning, guiding, monitoring, controlling interventions MR arthrography (MRA) is the imaging gold standard to assess small ligament, fibrocartilage injury in joints In contemporary practice, MRA consists of two consecutive sessions: 1) an interventional session where a needle is driven to the joint space, gadolinium contrast is injected under fluoroscopy or CT guidance 2) A diagnostic MRI imaging session to visualize the distribution of contrast inside the joint space, evaluate the condition of the joint Our approach to MRA is to eliminate the separate radiologically guided needle insertion, contrast injection procedure by performing those tasks on conventional high-field closed MRI scanners We propose a 2D augmented reality image overlay device to guide needle insertion procedures This approach makes diagnostic high-field magnets available for interventions without a complex, expensive engineering entourage

}, keywords = {Arthrography, Humans, Magnetic Resonance Imaging, Needles, United States, User-Computer Interface}, author = {Gregory Fischer and Anton Degeut and Daniel Schlattman and Russell H. Taylor and Laura Fayad and James Zinreich and Gabor Fichtinger} } @article {DiMaio2006, title = {Needle artifact localization in 3T MR images}, journal = {Studies in health technology and informatics}, volume = {119}, year = {2006}, pages = {120{\textendash}125}, publisher = {Brigham, Women{\textquoteright}s Hospital, Harvard Medical School, Boston 02115, USA simond@bwh harvard edu}, abstract = {

This work explores an image-based approach for localizing needles during MRI-guided interventions, for the purpose of tracking, navigation Susceptibility artifacts for several needles of varying thickness were imaged, in phantoms, using a 3 tesla MRI system, under a variety of conditions The relationship between the true needle positions, the locations of artifacts within the images, determined both by manual, automatic segmentation methods, have been quantified, are presented here

}, keywords = {Artifacts, Magnetic Resonance Imaging, Needles, United States}, author = {Simon DiMaio and Daniel Kacher and Randy Ellis and Gabor Fichtinger and Nobuhiko Hata and Gary Zientara and Lawrence Panych and Ron Kikinis and Ferenc Jolesz} } @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 {Boctor2003b, title = {Virtual remote center of motion control for needle placement robots}, journal = {Journal of Computer Aided Surgery}, volume = {9}, number = {5}, year = {2003}, pages = {175{\textendash}183}, abstract = {

OBJECTIVE: We present an algorithm that enables percutaneous needle-placement procedures to be performed with unencoded, unregistered, minimally calibrated robots while removing the constraint of placing the needle tip on a mechanically enforced Remote Center of Motion (RCM) MATERIALS AND METHODS: The algorithm requires only online tracking of the surgical tool, a five-degree-of-freedom (5-DOF) robot comprising three prismatic DOF, two rotational DOF An incremental adaptive motion control cycle guides the needle to the insertion point, also orients it to align with the target-entry-point line The robot executes RCM motion without having a physically constrained fulcrum point RESULTS: The proof-of-concept prototype system achieved 0 78 mm translation accuracy, 1 4 degrees rotational accuracy (this is within the tracker accuracy) within 17 iterative steps (0 5-1 s) CONCLUSION: This research enables robotic assistant systems for image-guided percutaneous procedures to be prototyped/constructed more quickly, less expensively than has been previously possible Since the clinical utility of such systems is clear, has been demonstrated in the literature, our work may help promote widespread clinical adoption of this technology by lowering system cost, complexity

}, keywords = {Algorithms, Computer-Assisted, Equipment Design, Imaging, instrumentation, Needles, Robotics, Surgery, Three-Dimensional}, doi = {10 1080/10929080500097661}, url = {http://dx doi org/10 1080/10929080500097661}, author = {Emad Boctor and Robert Webster and Herve Mathieu and Allison Okamura and Gabor Fichtinger} }