@article {Marker2017, title = {1.5 Tesla augmented reality navigated interventional magnetic resonance imaging: paravertebral sympathetic plexus injections}, journal = {Diagnostic and Interventional Radiology}, year = {In Press}, month = {01/2017}, author = {David R. Marker and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Gabor Fichtinger and Iulian Iordachita and John A Carrino and Jan Fritz} } @article {Marker2016, title = {MR-guided perineural injection of the ganglion impar: technical considerations and feasibility}, journal = {Skeletal Radiology}, year = {2016}, month = {01/2016}, abstract = {

Objective

Perineural ganglion impar injections are used in the management of pelvic pain syndromes; however, there is no consensus regarding the optimal image guidance. Magnetic resonance imaging (MRI) provides high soft tissue contrast and the potential to directly visualize and target the ganglion. The purpose of this study was to assess the feasibility of MR-guided percutaneous perineural ganglion impar injections.

Materials and methods

Six MR-guided ganglion impar injections were performed in six human cadavers. Procedures were performed with a clinical 1.5-Tesla MRI system through a far lateral transgluteus approach. Ganglion impar visibility, distance from the sacrococcygeal joint, number of intermittent MRI control steps required to place the needle, target error between the intended and final needle tip location, inadvertent punctures of non-targeted vulnerable structures, injectant distribution, and procedure time were determined.

Results

The ganglion impar was seen on MRI in 4/6 (66\ \%) of cases and located 0.8\ mm cephalad to 16.3\ mm caudad (average 1.2\ mm caudad) to the midpoint of the sacrococcygeal joint. Needle placement required an average of three MRI control steps (range, 2{\textendash}6). The average target error was 2.2 {\textpm} 2.1\ mm. In 6/6 cases (100\ \%), there was appropriate periganglionic distribution and filling of the presacrococcygeal space. No punctures of non-targeted structures occurred. The median procedure time was 20\ min (range, 12{\textendash}29\ min).

Conclusion

Interventional MRI can visualize and directly target the ganglion impar for accurate needle placement and successful periganglionic injection with the additional benefit of no ionizing radiation exposure to patient and staff. Our results support clinical evaluation.

}, url = {http://dx.doi.org/10.1007/s00256-016-2333-7}, author = {David R. Marker and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Gabor Fichtinger and Iulian Iordachita and John A Carrino and Jan Fritz} } @article {Seifabadi2015, title = {Toward teleoperated needle steering under continuous MRI guidance for prostate percutaneous interventions}, journal = {The International Journal of Medical Robotics and Computer Assisted Surgery}, year = {2015}, author = {Reza Seifabadi and Fereshteh Aalamifar and Iulian Iordachita and Gabor Fichtinger} } @article {Fritz2014, title = {MR-Guided Vertebroplasty With Augmented Reality Image Overlay Navigation}, journal = {Cardiovasc Intervent Radiol}, year = {2014}, month = {04/2014}, doi = {10.1007/s00270-014-0885-2}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Sudhir Kathuria and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {Fritz2013a, title = {Augmented reality visualisation using an image overlay system for MR-guided interventions: technical performance of spine injection procedures in human cadavers at 1.5 Tesla}, journal = {European Radiology}, volume = {23}, year = {2013}, month = {01/2013}, pages = {235-245}, issn = {0938-7994}, doi = {10.1007/s00330-012-2569-0}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22797956}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {Fritz2013b, title = {Augmented Reality Visualization Using Image Overlay Technology for MR-Guided Interventions: Cadaveric Bone Biopsy at 1.5 T}, journal = {Investigative Radiology}, volume = {48}, number = {6}, year = {2013}, month = {06/2013}, keywords = {augmented reality, image overlay, interventional MR imaging, MR-guided, MRI guidance, MRI-guided bone biopsy, navigation, osscous biopsy}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23328911}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and McCarthy, EF. and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @conference {Monfaredi2013a, title = {Design of a Decoupled MRI-compatible Force Sensor using Fiber Bragg Grating Sensors for Robot-assisted Prostate Interventions}, booktitle = {SPIE}, volume = {8671}, year = {2013}, month = {03/2013}, address = {Orlando, Floirda}, abstract = {

{During prostate needle insertion, the gland rotates and displaces resulting in needle placement inaccuracy. To compensate for this error, we proposed master-slave needle steering under real-time MRI in a previous study. For MRI-compatibility and accurate motion control, the master (and the slave) robot uses piezo actuators. These actuators however, are non-backdrivable. To cope with this issue, force sensor is required. Force sensor is also required at the slave side to reflect the insertion force to clinician{\textquoteright}s hand through the master robot. Currently, there is no MRI-compatible force sensor commercially available. In order to generate a combination of linear and rotary motions for needle steering, this study is seeking to develop a MRI-compatible 2 Degrees of Freedom (DOF) force/torque sensor. Fiber Brag Grating (FBG) strain measuring sensors which are proven to be MRI-compatible are used. The active element is made of phosphor-bronze and other parts are made of brass. The force and torque measurements are designed to be entirely decoupled. The sensor measures -20 to 20 N axial force with 0.1 N resolution, and -200 to 200 Nmm axial torque with 1 Nmm resolution. Analytical and Finite Element (FE) analyses are performed to ensure the strains are within the measurable range of the FBG sensors. The sensor is designed to be compact (diameter =15 mm

}, keywords = {FBG, force sensor, MRI -compatible}, doi = {0.1117/12.2008160}, author = {Monfaredi, R and Reza Seifabadi and Gabor Fichtinger and Iulian Iordachita} } @article {U-Thainual2013a, title = {MR Image Overlay Adjustable Plane System for Musculoskeletal Interventions}, year = {2013}, address = {Toronto, Ontario, Canada, February 4-5, 2013}, keywords = {adjustable plane overlay system, augmented reality system, image overlay, MRI-guided}, author = {Paweena U-Thainual and Jan Fritz and Tamas Ungi and John A Carrino and Gabor Fichtinger and Iulian Iordachita} } @article {U-Thainual2013b, title = {MR image overlay guidance: system evaluation for preclinical use}, journal = {International Journal of Computer Assisted Radiology and Surgery}, volume = {8}, year = {2013}, month = {05/2013}, pages = {365-378}, issn = {1861-6410}, doi = {10.1007/s11548-012-0788-0}, author = {Paweena U-Thainual and Jan Fritz and Choladawan Moonjaita and Tamas Ungi and Aaron J Flammang and John A Carrino and Gabor Fichtinger and Iulian Iordachita} } @article {Seifabadi2013a, title = {Real-Time 3D Needle Shape Tracking Using Fiber Bragg Grating Sensors for Prostate Percutaneous Interventions}, year = {2013}, address = {Crystal City, VA, USA}, abstract = {

During prostate needle insertion, the gland and therefore targets move resulting in targeting inaccuracy. To compensate for this error, in a previous study we proposed robotic bevel-tip needle steering under live MRI. One important drawback is that tracking a flexible (20G) needle under real-time MRI is inaccurate due to the needle artifact and the image update frequency is relatively slow (\>200 ms). As an alternative solution, we embedded some FBG strain sensors along the needle shaft at certain locations and reconstruct the needle shape from this information. Compared to the previous study on this topic by others, the following development have been done: 1) this study is extended to needle of higher gauge (thinner), 2) we guarantee below 0.5 mm accuracy at the needle tip for all insertion depth, 3) we extended it to bevel-tip needles (through modelling and mathematical formulation), 4) we visualized the 3D shape of the needle in 3D Slicer which is a commonly used planning and navigation software for prostate interventions, 5) our needle tracking is real-time.

}, keywords = {3D Slicer, MRI, needle tracking, real-time}, author = {Reza Seifabadi and Esteban Escobar Gomez and Fereshteh Aalamifar and Gabor Fichtinger and Iulian Iordachita} } @article {Siefabadi2012a, title = {Acuracy Study of a MRI-guided Robotic System for Prostate Needle Placement}, journal = {The International Journal of Medical Robotics and Computer Assisted Surgery (IJMRCAS)}, year = {2012}, abstract = {

Background: Accurate needle placement is the first concern in percutaneous MRI-guided prostate interventions. In this phantom study, different sources contributing to the overall needle placement error of a MRI-guided robot for prostate biopsy have been identified, quantified, and minimized to the possible extent. Methods and Materials: The overall needle placement error of the system was evaluated in a prostate phantom. This error was broken into two parts: the error associated with the robotic system (called before-insertion error) and the error associated with needle-tissue interaction (called due-to-insertion error). The before-insertion error was measured directly in a soft phantom and different sources contributing into this part were identified and quantified. A calibration methodology was developed to minimize the 4-DOF manipulator{\textquoteright}s error. The due-toinsertion error was indirectly approximated by comparing the overall error and the beforeinsertion error. The effect of sterilization on the manipulator{\textquoteright}s accuracy and repeatability was also studied. Results: The average overall system error in phantom study was 2.5 mm (STD=1.1mm). The average robotic system error in super soft phantom was 1.3 mm (STD=0.7 mm). Assuming orthogonal error components, the needle-tissue interaction error was approximated to be 2.13 mm thus having larger contribution to the overall error. The average susceptibility artifact shift was 0.2 mm. The manipulator{\textquoteright}s targeting accuracy was 0.71 mm (STD=0.21mm) after robot calibration. The robot{\textquoteright}s repeatability was 0.13 mm. Sterilization had no noticeable influence on the robot{\textquoteright}s accuracy and repeatability. Conclusions: The experimental methodology presented in this paper may help researchers to identify, quantify, and minimize different sources contributing into the overall needle placement error of an MRI-guided robotic system for prostate needle placement. In the robotic system analyzed here, the overall error of the studied system remained within the acceptable range.

}, doi = {10.1002/rcs.1440}, url = {http://onlinelibrary.wiley.com/doi/10.1002/rcs.1440/abstract}, author = {Reza Seifabadi and Nathan Bongjoon Cho and Sam Sang-Eun Song and Junichi Tokuda and Nobuhiko Hata and Clare M Tempany and Gabor Fichtinger and Iulian Iordachita} } @article {Fritz2012c, title = {Augmented Reality Visualization Using Image-Overlay for MR-guided Interventions: Performance Assessment of Paravertebral Sympathetic Perineural Injections in Cadavers at 1.5 Tesla}, year = {2012}, month = {06/2012}, pages = {S509-S511}, address = {Pisa, Italy, June 27-30}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {Fritz2012a, title = {Augmented Reality Visualization Using Image-Overlay for MR-Guided Interventions: Accuracy for Lumbar Spinal Procedures with a 1.5-Tesla MRI scanner.}, journal = {American Journal of Roentgenology}, volume = {198}, year = {2012}, month = {03/2012}, pages = {W266-73}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Nathan Bongjoon Cho and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {Fritz2012b, title = {Augmented Reality Visualization with Use of Image Overlay Technology for MR Imaging{\textendash}guided Interventions: Assessment of Performance in Cadaveric Shoulder and Hip Arthrography at 1.5 T}, journal = {Radiology}, volume = {265}, number = {1}, year = {2012}, month = {10/2012}, pages = {254-259}, doi = {10.1148/radiol.12112640}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @conference {Siefabadi2012b, title = {Design of a Teleoperated Needle Steering System for MRI-guided Prostate Interventions}, booktitle = {IEEE International Conference on Biomedical Robotics and Biomechatronics (BioRob 2012)}, year = {2012}, publisher = {IEEE}, organization = {IEEE}, address = {Rome, Italy}, abstract = {

Accurate needle placement plays a key role in success of prostate biopsy and brachytherapy. During percutaneous interventions, the prostate gland rotates and deforms which may cause significant target displacement. In these cases straight needle trajectory is not sufficient for precise targeting. Although needle spinning and fast insertion may be helpful, they do not entirely resolve the issue. We propose robot-assisted bevel-tip needle steering under MRI guidance as a potential solution to compensate for the target displacement. MRI is chosen for its superior soft tissue contrast in prostate imaging. Due to the confined workspace of the MRI scanner and the requirement for the clinician to be present inside the MRI room during the procedure, we designed a MRI-compatible 2-DOF haptic device to command the needle steering slave robot which operates inside the scanner. The needle steering slave robot was designed to be integrated with a previously developed pneumatically actuated transperineal robot for MRI-guided prostate needle placement. We describe design challenges and present the conceptual design of the master and slave robots and the associated controller.

}, keywords = {MRI-compatible, Needle Steering, Real-time MRI, Teleoperation}, author = {Reza Seifabadi and Iulian Iordachita and Gabor Fichtinger} } @article {Tokuda2012, title = {In-bore Setup and Software for 3T MRI-guided Transperineal Prostate Biopsy}, journal = {Physics in Medicine and Biology}, year = {2012}, month = {09/2012}, author = {Junichi Tokuda and Kemal Tuncali and Iulian Iordachita and Sam Sang-Eun Song and Andriy Fedorov and Sota Oguro and Andras Lasso and Fiona M. Fennessy and Clare M Tempany and Nobuhiko Hata} } @article {U-Thainual2012a, title = {MR Image Overlay Guidance: System Evaluation for Clinical Use}, year = {2012}, month = {06/2012}, pages = {S179-S180}, address = {Pisa, Italy, June 27-30}, keywords = {augmented reality, image overlay, needle guidance, percutaneous interventions}, author = {Paweena U-Thainual and Jan Fritz and Choladawan Moonjaita and Tamas Ungi and Aaron J Flammang and John A Carrino and Gabor Fichtinger and Iulian Iordachita} } @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} } @article {Tokuda2012a, title = {Preclinical evaluation of MRI-compatible pneumatic robot for angulated needle placement in prostate interventions}, year = {2012}, month = {2012}, address = {Pisa, Italy}, keywords = {angulation, MRI compatiber robot, transprineal}, author = {Junichi Tokuda and Sam Sang-Eun Song and Gregory Fischer and Iulian Iordachita and Reza Seifabadi and Nathan Bongjoon Cho and Gabor Fichtinger and Clare M Tempany and Nobuhiko Hata} } @article {Escobar2012a, title = {Real-time needle tip tracking using Fiber Brag Grating sensors for MRI-guided prostate interventions: Design considerations}, year = {2012}, address = {Boston, USA, September}, author = {Esteban Escobar Gomez and Reza Seifabadi and Gabor Fichtinger and Iulian Iordachita} } @article {Siefabadi2012c, title = {Towards teleoperated needle steering in MRI-guided prostate interventions}, year = {2012}, address = {Boston, USA, September}, author = {Reza Seifabadi and Iulian Iordachita and Gabor Fichtinger} } @article {Tuncali2011, title = {3T MRI-guided Transperineal Targeted Prostate Biopsy: Clinical Feasibility, Safety, and Early Results}, volume = {19}, year = {2011}, pages = {53}, author = {Kemal Tuncali and Junichi Tokuda and Iulian Iordachita and Sam Sang-Eun Song and Andriy Fedorov and Sota Oguro and Andras Lasso and Fiona M. Fennessy and Yi Tang and Clare M Tempany and Nobuhiko Hata} } @article {Fritz2011, title = {Augmented reality visualization using image-overlay for MR-guided interventions: assessment of accuracy for lumbar spinal procedures with a 1.5-Tesla MRI scanner}, year = {2011}, month = {09/2011}, address = {Munich, Germany}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Nathan Bongjoon Cho and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @conference {Fritz2011a, title = {Augmented Reality Visualization Using Image-overlay for MR-guided Interventions: Assessment of Performance in Cadaveric Shoulder and Hip Arthrography}, booktitle = {RSNA 97th Scientific Assembly and Annual Meeting}, year = {2011}, month = {07/2012}, address = {Chicago, IL}, doi = {10.1148/radiol.12112640}, url = {http://radiology.rsna.org/content/early/2012/07/24/radiol.12112640.abstract}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Nathan Bongjoon Cho and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {Krieger2011b, title = {Development and Evaluation of an Actuated MRI-Compatible Robotic System for MRI-Guided Prostate Intervention}, journal = {IEEE/ASME Transactions on Mechatronics}, year = {2011}, month = {2011}, pages = {PP}, issn = {1941-014X}, doi = {10.1109/TMECH.2011.2163523}, author = {Axel Krieger and Sam Sang-Eun Song and Nathan Bongjoon Cho and Iulian Iordachita and Peter Guion and Gabor Fichtinger and Whitcomb, Louis L.} } @article {U-Thainual2011, title = {MR Image Overlay Adjustable Plane System for Percutaneous Musculoskeletal Interventions}, volume = {4}, year = {2011}, month = {10/2011}, address = {Arlington VA, October 12-13, 2011}, author = {Paweena U-Thainual and Tamas Ungi and John A Carrino and Gabor Fichtinger and Iulian Iordachita} } @article {Krieger2011, title = {An MRI-Compatible Robotic System with Hybrid Tracking for MRI-Guided Prostate Intervention}, journal = {IEEE Transactions on Biomedical Engineering}, volume = {58 PP}, year = {2011}, month = {04/2011}, doi = {10.1109/TBME.2011.2134096}, author = {Axel Krieger and Iulian Iordachita and Peter Guion and Anurag K. Singh and Aradhana Kaushal and Cynthia Menard and P.A. Pinto and Kevin Camphausen and Gabor Fichtinger and Whitcomb, Louis L.} } @article {Song2011b, title = {Needle Artifact Localization for Intraprocedural Biopsy Position Confirmation in 3T MRI-guided Robotic Transrectal Prostate Intervention}, volume = {4}, year = {2011}, month = {10/2011}, address = {Arlington VA, October 12-13, 2011}, author = {Sam Sang-Eun Song and Nathan Bongjoon Cho and Iulian Iordachita and Peter Guion and Gabor Fichtinger and Whitcomb, Louis L.} } @article {Tokuda2011, title = {Preliminary Accuracy Evaluation of 3T MRI-guided Transperineal Prostate Biopsy with Grid Template}, volume = {19}, year = {2011}, pages = {3761}, author = {Junichi Tokuda and Kemal Tuncali and Iulian Iordachita and Sam Sang-Eun Song and Andriy Fedorov and Sota Oguro and Andras Lasso and Fiona M. Fennessy and Yi Tang and Clare M Tempany and Nobuhiko Hata} } @article {Song2011, title = {Robotic needle guide for prostate brachytherapy: Clinical testing of feasibility and performance}, journal = {Brachytherapy}, volume = {10}, year = {2011}, month = {1/2011}, pages = {57 - 63}, issn = {15384721}, doi = {10.1016/j.brachy.2010.01.003}, author = {Danny Y Song and E. Clif Burdette and Jonathan Fiene and Elwood Armour and Gernot Kronreif and Anton Degeut and Zhe Zhang and Iulian Iordachita and Gabor Fichtinger and Peter Kazanzides} } @article {Seifabadi2011, title = {Robotic System for MRI-guided Prostate Biopsy: Feasibility of Teleoperated Needle Insertion and ex vivo Phantom Study}, journal = {International Journal of Computer Aided Radiology and Surgery (IJCARS)}, year = {2011}, abstract = {

"Purpose": Magnetic Resonance Imaging (MRI) combined with robotic assistance has the potential to improve on clinical outcomes of biopsy and local treatment of prostate cancer. "Methods": We report the workspace optimization and phantom evaluation of a five Degree of Freedom (DOF) parallel pneumatically actuated modular robot for MRI-guided prostate biopsy. To shorten procedure time and consequently increase patient comfort and system accuracy, a prototype of a MRI-compatible master-slave needle driver module using piezo motors was also added to the base robot. "Results": Variable size workspace was achieved using appropriate link length, compared to the previous design. The 5-DOF targeting accuracy demonstrated an average error of 2.5 mm (STD=1.37 mm) in a realistic phantom inside a 3T magnet with a bevel-tip 18G needle. The average position tracking error of the master-slave needle driver was always below 0.1 mm. "Conclusion": Phantom experiments showed sufficient accuracy for manual prostate biopsy. Also, the implementation of teleoperated needle insertion was feasible and accurate. These two together suggest feasibility of accurate fully actuated needle placement into prostate while keeping the clinician supervision over the task.

}, keywords = {accuracy evaluation, MRI -compatible, phantom study, Pneumatic Robot, Teleoperation, Transperineal prostate biopsy}, doi = {10.1007/s11548-011-0598-9}, url = {http://www.springerlink.com/content/h53329764x605415/fulltext.pdf}, author = {Reza Seifabadi and Sam Sang-Eun Song and Axel Krieger and Nathan Bongjoon Cho and Junichi Tokuda and Gabor Fichtinger and Iulian Iordachita} } @article {Song2011c, title = {Robotic System for MRI-guided Prostate Intervention: Feasibility Study of Tele-operated Needle Insertion}, year = {2011}, publisher = {Springer}, address = {Berlin, Germany}, keywords = {MRI-compatible, Pneumatic Robot, Prostate Intervention, Teleoperation}, url = {http://www.cars-int.org/}, author = {Sam Sang-Eun Song and Reza Seifabadi and Axel Krieger and Junichi Tokuda and Gabor Fichtinger and Iulian Iordachita} } @article {Song2011d, title = {A study of needle image artifact localization in confirmation imaging of MRI-guided robotic prostate biopsy}, year = {2011}, pages = {4834 - 4839}, publisher = {IEEE}, address = {Shanghai, China}, isbn = {978-1-61284-386-5}, doi = {10.1109/ICRA.2011.5980309}, author = {Sam Sang-Eun Song and Nathan Bongjoon Cho and Iulian Iordachita and Peter Guion and Gabor Fichtinger and Whitcomb, Louis L.} } @conference {Song2010, title = {Development of a Pneumatic Robot for MRI-guided Transperineal Prostate Biopsy and Brachytherapy: New Approaches}, booktitle = {IEEE International Conference on Robotics and Automation, ICRA 2010}, year = {2010}, pages = {2580-2585}, address = {Anchorage, Alaska, USA, 3-7 May 2010}, doi = {http://dx.doi.org/10.1109/ROBOT.2010.5509710}, author = {Sam Sang-Eun Song and Nathan Bongjoon Cho and Gregory Fischer and Nobuhiko Hata and Clare M Tempany and Gabor Fichtinger and Iulian Iordachita} } @article {Song2010b, title = {Development of a Pneumatic Robot for MRI-Guided Transperineal Prostate Intervention}, year = {2010}, address = {Stockholm, Sweden, 1-7 May 2010}, author = {Sam Sang-Eun Song and Nathan Bongjoon Cho and Iulian Iordachita and Gregory Fischer and Junichi Tokuda and Nobuhiko Hata and Gabor Fichtinger and Clare M Tempany} } @article {U-Thainual2010, title = {Evaluation of accuracy and clinical feasibility of the MR-compatible image overlay}, year = {2010}, address = {Leipzig, Germany, September 24-25, 2010}, keywords = {augmented reality, Image overlay system, MRI-guided}, author = {Paweena U-Thainual and Jan Fritz and Nathan Bongjoon Cho and Tamas Ungi and Segundo, AJM and John A Carrino and Gabor Fichtinger and Lewin, JS and Iulian Iordachita} } @article {Song2010c, title = {MRI compatibility study of a pneumatically actuated robotic system for transperineal prostate needle placement}, year = {2010}, address = {Arlington, VA, March 8-9, 2010}, author = {Sam Sang-Eun Song and Nathan Bongjoon Cho and Junichi Tokuda and Nobuhiko Hata and Clare M Tempany and Gabor Fichtinger and Iulian Iordachita} } @article {Song2010, title = {MRI compatibility study of a pneumatically actuated robotic system for transperineal prostate needle placement}, volume = {Int J CARS Vol 5 (Suppl 1)}, year = {2010}, pages = {26-27}, address = {Geneva. Switzerland, June 23-26, 2010}, author = {Sam Sang-Eun Song and Nathan Bongjoon Cho and Junichi Tokuda and Nobuhiko Hata and Clare M Tempany and Gabor Fichtinger and Iulian Iordachita} } @conference {U-Thainual2009a, title = {The Perk Station: Systems design for percutaneous intervention training suite}, booktitle = {Procedings IEEE International Conference on Robotics and Biomimetics ROBIO 2009}, year = {2009}, month = {22{\textendash}25 Feb}, pages = {1693{\textendash}1697}, address = {Bangkok, Thailand}, doi = {10 1109/ROBIO 2009 4913256}, author = {Paweena U-Thainual and Gregory Fischer and Iulian Iordachita and Siddharth Vikal and Gabor Fichtinger} } @article {Vikal2009a, title = {Perk Station-Percutaneous surgery training and performance measurement platform}, journal = {Computerized Medical Imaging and Graphics}, volume = {34}, year = {2009}, month = {05/2009}, pages = {19-32}, abstract = {

MOTIVATION: Image-guided percutaneous (through the skin) needle-based surgery has become part of routine clinical practice in performing procedures such as biopsies, injections, therapeutic implants A novice physician typically performs needle interventions under the supervision of a senior physician; a slow, inherently subjective training process that lacks objective, quantitative assessment of the surgical skill, performance Shortening the learning curve, increasing procedural consistency are important factors in assuring high-quality medical care METHODS: This paper describes a laboratory validation system, called Perk Station, for standardized training, performance measurement under different assistance techniques for needle-based surgical guidance systems The initial goal of the Perk Station is to assess, compare different techniques: 2D image overlay, biplane laser guide, laser protractor, conventional freehand The main focus of this manuscript is the planning, guidance software system developed on the 3D Slicer platform, a free, open source software package designed for visualization, analysis of medical image data RESULTS: The prototype Perk Station has been successfully developed, the associated needle insertion phantoms were built, and the graphical user interface was fully implemented The system was inaugurated in undergraduate teaching, a wide array of outreach activities Initial results, experiences, ongoing activities, future plans are reported

}, doi = {10.1016/j.compmedimag.2009.05.001}, url = {http://dx.doi.org/10.1016/j.compmedimag.2009.05.001}, author = {Siddharth Vikal and Paweena U-Thainual and John A Carrino and Iulian Iordachita and Gregory Fischer and Gabor Fichtinger} } @article {U-Thainual2009, title = {Teaching Aid for Computer-Assisted Surgery}, year = {2009}, author = {Paweena U-Thainual and Iulian Iordachita and Siddharth Vikal and Gabor Fichtinger} } @conference {Kazanzides2008, title = {Clinical Trials of a Robot Assistant for Ultrasound-Guided Prostate Brachytherapy}, booktitle = {Abstract in Minimally Invasive Therapy, 20th International Conference of the Society for Medical Innovation and Technology (SMIT)}, volume = {14}, number = {4}, year = {2008}, pages = {213}, author = {Peter Kazanzides and Danny Y Song and Jonathan Fiene and E. Clif Burdette and Gernot Kronreif and Wolfgang Ptacek and Iulian Iordachita and Gabor Fichtinger} } @conference {Krieger2008a, title = {Design and Preliminary Clinical Studies of an MRI-Guided Transrectal Prostate Intervention System}, booktitle = {7th International Symposium on Interventional MRI}, year = {2008}, pages = {6-10}, author = {Axel Krieger and Iulian Iordachita and Csaba Csoma and Gabor Fichtinger and Whitcomb, Louis L.} } @conference {Krieger2008, title = {Design and Preliminary Clinical Studies of an MRI-Guided Transrectal Prostate Intervention System}, booktitle = {International Society of Magnetic Resonance in Medicine (ISMRM)}, year = {2008}, author = {Axel Krieger and Peter Guion and Csaba Csoma and Iulian Iordachita and Anurag K. Singh and Aradhana Kaushal and Cynthia Menard and Gabor Fichtinger and Whitcomb, Louis L.} } @conference {Jain2008, title = {Dynamic dosimetry and edema detection in prostate brachytherapy: a complete system}, booktitle = {Medical Imaging 2008: Visualization and Image-guided Procedures, and Modeling}, volume = {6918}, number = {1}, year = {2008}, pages = {69181Y}, publisher = {SPIE}, organization = {SPIE}, doi = {10 1117/12 772352}, url = {http://link aip org/link/?PSI/6918/69181Y/1}, author = {Ameet K. Jain and Anton Degeut and Iulian Iordachita and Gouthami Chintalapani and Jack Blevins and Le Yi and Elwood Armour and E. Clif Burdette and Danny Y Song and Gabor Fichtinger} } @conference {U-Thainual2008, title = {MR/CT Percutaneous Intervention Training Suite}, booktitle = {7th International Symposium on Interventional MRI}, year = {2008}, pages = {81-85}, author = {Paweena U-Thainual and Gregory Fischer and John A Carrino and Gabor Fichtinger and Iulian Iordachita} } @article {Fischer2008, title = {MRI Compatibility of Robot Actuation Techniques - A Comparative Study}, journal = {Medical Image Computing and Computer-Assisted Intervention (MICCAI) Proceedings in Lecture Notes in Computer Science}, volume = {5242}, year = {2008}, pages = {509-517}, author = {Gregory Fischer and Axel Krieger and Iulian Iordachita and Whitcomb, Louis L. and Gabor Fichtinger} } @conference {Krieger2008b, title = {MRI Guided Prostate Biopsy and Marker Placements}, booktitle = {Workshop on Clinical Image-Guided Therapy: Opportunities and Needs}, year = {2008}, author = {Axel Krieger and Peter Guion and Csaba Csoma and Iulian Iordachita and Anurag K. Singh and Aradhana Kaushal and Whitcomb, Louis L. and Gabor Fichtinger} } @article {Fischer2008b, title = {MRI-Compatible Pneumatic Robot for Transperineal Prostate Needle Placement}, journal = {IEEE/ASME Transactions on Mechatronics}, volume = {13}, number = {3}, year = {2008}, month = {June}, pages = {295{\textendash}305}, doi = {10 1109/TMECH 2008 924044}, author = {Gregory Fischer and Iulian Iordachita and Csaba Csoma and Junichi Tokuda and Simon DiMaio and Clare M Tempany and Nobuhiko Hata and Gabor Fichtinger} } @conference {U-Thainual2008b, title = {The Perk Station: Design of a percutaneous intervention training suite}, booktitle = {20th International Conference of the Society for Medical Innovation and Technology (SMIT)}, year = {2008}, month = {08/2008}, pages = {148-153}, address = {Vienna, Austria, August 28-31}, isbn = {3-902087-25-0}, author = {Paweena U-Thainual and Iulian Iordachita and Gabor Fichtinger} } @conference {U-Thainual2008a, title = {The Perk Station: Portable training station for percutaneous interventions}, booktitle = {Orthopaedic Care Conference}, year = {2008}, author = {Paweena U-Thainual and Siddharth Vikal and Iulian Iordachita and Gabor Fichtinger} } @conference {Fischer2008a, title = {Pneumatically operated MRI-compatible needle placement robot for prostate interventions}, booktitle = {Procedings IEEE International Conference on Robotics and Automation ICRA 2008}, year = {2008}, month = {19{\textendash}23 May}, pages = {2489{\textendash}2495}, doi = {10 1109/ROBOT 2008 4543587}, author = {Gregory Fischer and Iulian Iordachita and Csaba Csoma and Junichi Tokuda and Philip Mewes and Clare M Tempany and Nobuhiko Hata and Gabor Fichtinger} } @article {Song2008, title = {Registered ultrasound and fluoroscopy for intraoperative dynamic dosimetry in prostate brachytherapy}, journal = {Brachytherapy}, volume = {7}, number = {2}, year = {2008}, pages = {102 - 102}, issn = {1538-4721}, doi = {DOI: 10 1016/j brachy 2008 02 364}, url = {http://www sciencedirect com/science/article/B6X3G-4S86YJ8-1B/2/332751abcc9066ed833bea302ef2f604}, author = {Danny Y Song and Anton Degeut and Iulian Iordachita and Elwood Armour and Ameet K. Jain and E. Clif Burdette and Gabor Fichtinger} } @conference {Song2008b, title = {Registered Ultrasound and Fluoroscopy for Intraoperative Dynamic Dosimetry in Prostate Brachytherapy}, booktitle = {Workshop on Clinical Image-Guided Therapy: Opportunities and Needs}, year = {2008}, author = {Danny Y Song and Anton Degeut and Ameet K. Jain and Elwood Armour and Le Yi and Jack Blevins and Iulian Iordachita and E. Clif Burdette and Gabor Fichtinger} } @conference {Fichtinger2008a, title = {Robotic Assistance for Ultrasound Guided Prostate Brachytherapy}, booktitle = {Workshop on Clinical Image-Guided Therapy: Opportunities and Needs}, year = {2008}, author = {Gabor Fichtinger and Jonathan Fiene and Christopher Kennedy and Iulian Iordachita and Gernot Kronreif and Danny Y Song and E. Clif Burdette and Peter Kazanzides} } @article {Fichtinger2008b, title = {Robotic assistance for ultrasound-guided prostate brachytherapy}, journal = {Medical Image Analysis}, volume = {12}, number = {5}, year = {2008}, month = {06/2008}, pages = {535}, publisher = {Queen{\textquoteright}s University; 25 Union Street;725 Goodwin Hall; Kingston; ON; Canada gabor@cs queensu ca}, abstract = {

We present a robotically assisted prostate brachytherapy system, test results in training phantoms, Phase-I clinical trials The system consists of a transrectal ultrasound (TRUS), a spatially co-registered robot,fully integrated with an FDA-approved commercial treatment planning system The salient feature of the system is a small parallel robot affixed to the mounting posts of the template The robot replaces the template interchangeably,using the same coordinate system Established clinical hardware,workflow, calibration remain intact In all phantom experiments,we recorded the first insertion attempt without adjustment All clinically relevant locations in the prostate were reached Non-parallel needle trajectories were achieved The pre-insertion transverse, rotational errors (measured with a Polaris optical tracker relative to the template{\textquoteright}s coordinate frame) were 0 25 mm (STD=0 17 mm), 0 75 degrees (STD=0 37 degrees) In phantoms,needle tip placement errors measured in TRUS were 1 04 mm (STD=0 50mm) A Phase-I clinical feasibility, safety trial has been successfully completed with the system We encountered needle tip positioning errors of a magnitude greater than 4mm in only 2 of 179 robotically guided needles,in contrast to manual template guidance where errors of this magnitude are much more common Further clinical trials are necessary to determine whether the apparent benefits of the robotic assistant will lead to improvements in clinical efficacy, outcomes

}, keywords = {Brachytherapy, Computer-Assisted, Equipment Design, Equipment Failure Analysis, Humans, instrumentation, instrumentation/methods, Interventional, Male, Prostatic Neoplasms, Radiotherapy, radiotherapy/ultrasonography, Robotics, Ultrasonography}, doi = {10 1016/j media 2008 06 002}, url = {http://dx doi org/10 1016/j media 2008 06 002}, author = {Gabor Fichtinger and Jonathan Fiene and Christopher Kennedy and Gernot Kronreif and Iulian Iordachita and Danny Y Song and E. Clif Burdette and Peter Kazanzides} } @article {Song2008a, title = {Robotic needle positioner for ultrasound-guided prostate brachytherapy}, journal = {Brachytherapy}, volume = {7}, number = {2}, year = {2008}, pages = {176 - 176}, issn = {1538-4721}, doi = {DOI: 10 1016/j brachy 2008 02 440}, url = {http://www sciencedirect com/science/article/B6X3G-4S86YJ8-9B/2/5e814b7f2bd163b3e6a2aa414211fce0}, author = {Danny Y Song and Gabor Fichtinger and Jonathan Fiene and Christopher Kennedy and Gernot Kronreif and Iulian Iordachita and E. Clif Burdette and Peter Kazanzides} } @conference {Ahmidi2008, title = {A System for Performance Analysis of Surgeon Dexterity in Percutaneous Needle-based Interventions}, booktitle = {7th Imaging Symposium of the Imaging Network of Ontario}, year = {2008}, author = {Narges Ahmidi and Paweena U-Thainual and Siddharth Vikal and Parvin Mousavi and Iulian Iordachita and Gabor Fichtinger} } @conference {Fischer2008c, title = {A Training Suite for Image Overlay and Other Needle Insertion Techniques}, booktitle = {2008 MICCAI Workshop - Augmented Environments for Medical Imaging and Computer-Aided Surgery (AMI-ARCS)}, year = {2008}, author = {Gregory Fischer and Iulian Iordachita and Paweena U-Thainual and John A Carrino and Gabor Fichtinger} } @conference {Jain2007b, title = {C-arm based Intra-operative Dosimetry in Prostate Brachytherapy}, booktitle = {Annual Meeting of the American Association of Physicists in Medicine (AAPM)}, year = {2007}, author = {Ameet K. Jain and Anton Degeut and Iulian Iordachita and Jack Blevins and Le Yi and Elwood Armour and E. Clif Burdette and Danny Y Song and Gabor Fichtinger} } @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 {Kazanzides2007, title = {Development of an image-guided robot for small animal research}, journal = {Journal of Computer Aided Surgery}, volume = {12}, number = {6}, year = {2007}, month = {Nov}, pages = {357{\textendash}365}, publisher = {Department of Computer Science, The Johns Hopkins University, Baltimore, Maryland 21218, USA pkaz@jhu edu}, abstract = {

We developed a robot system that can be used for image-guided experimental procedures on small animals, where the goal is to perform physical actions at specific positions identified on a preoperative image The animal is first placed in a fixture that is compatible with all imaging systems of interest, including PET, SPECT, CT, MRI After imaging, the fixture is attached, registered to the robot system, where the image-guided intervention is performed This system has been applied to perform pO(2) measurements with physical probes based on tumor hypoxia images obtained in an animal PET scanner This paper focuses on the design, validation of the robot system The validation is performed using a phantom, includes a new method for estimating the Fiducial Localization Error (FLE) that is based on the measured Fiducial Distance Error (FDE) The results indicate that the robot system can position the measurement probe at a defined target with a mean error that is less than 0 4 mm

}, keywords = {Algorithms, analysis, Animals, Imaging, Laboratory, methods, Oxygen, Partial Pressure, Phantoms, Positron-Emission Tomography, Robotics}, doi = {10 1080/10929080701732538}, url = {http://dx doi org/10 1080/10929080701732538}, author = {Peter Kazanzides and Jenghwa Chang and Iulian Iordachita and Jack Li and Clifton Ling and Gabor Fichtinger} } @article {DiMaio2007, title = {Dynamic MRI scan plane control for passive tracking of instruments and devices}, journal = {Medical image computing and computer-assisted intervention (MICCAI)}, volume = {10}, number = {Pt 2}, year = {2007}, pages = {50{\textendash}58}, publisher = {Brigham, Women{\textquoteright}s Hospital, Harvard Medical School, Boston, MA, USA}, abstract = {

This paper describes a novel image-based method for tracking robotic mechanisms, interventional devices during Magnetic Resonance Image (MRI)-guided procedures It takes advantage of the multi-planar imaging capabilities of MRI to optimally image a set of localizing fiducials for passive motion tracking in the image coordinate frame The imaging system is servoed to adaptively position the scan plane based on automatic detection, localization of fiducial artifacts directly from the acquired image stream This closed-loop control system has been implemented using an open-source software framework, currently operates with GE MRI scanners Accuracy, performance were evaluated in experiments, the results of which are presented here

}, keywords = {Algorithms, Anatomy, Artificial Intelligence, Automated, Computer-Assisted, Cross-Sectional, Humans, Image Enhancement, Image Interpretation, Imaging, instrumentation/methods, Magnetic Resonance Imaging, methods, Pattern Recognition, Phantoms, Reproducibility of Results, Robotics, Sensitivity, Specificity, Surgery, Three-Dimensional, User-Computer Interface}, author = {Simon DiMaio and Eigil Samset and Gregory Fischer and Iulian Iordachita and Gabor Fichtinger and Ferenc Jolesz and Clare M Tempany} } @conference {Song2007, title = {Early Results of a Feasibility Study of Registered Fluoroscopy and Ultrasound for Permanent Interstitial Prostate Brachytherapy}, booktitle = {49th Annual Meeting of American Association of Therapeutic Radiology and Oncology}, year = {2007}, author = {Danny Y Song and Anton Degeut and Ameet K. Jain and Elwood Armour and Le Yi and Jack Blevins and Iulian Iordachita and E. Clif Burdette and Gabor Fichtinger} } @conference {Song2007a, title = {Early Results of a Feasibility Study of Registered Fluoroscopy and Ultrasound for Permanent Interstitial Prostate Brachytherapy}, booktitle = {Innovative Minds in Prostate Cancer Today - IMPaCT}, year = {2007}, author = {Danny Y Song and Anton Degeut and Ameet K. Jain and Elwood Armour and Le Yi and Jack Blevins and Iulian Iordachita and E. Clif Burdette and Gabor Fichtinger} } @article {Jain2007, title = {Intra-operative 3D guidance in prostate brachytherapy using a non-isocentric C-arm}, journal = {Medical image computing and computer-assisted intervention (MICCAI)}, volume = {10}, number = {Pt 2}, year = {2007}, pages = {9{\textendash}17}, publisher = {Johns Hopkins University, USA}, abstract = {

Intra-operative guidance in Transrectal Ultrasound (TRUS) guided prostate brachytherapy requires localization of inserted radioactive seeds relative to the prostate Seeds were reconstructed using a typical C-arm, and exported to a commercial brachytherapy system for dosimetry analysis Technical obstacles for 3D reconstruction on a non-isocentric C-arm included pose-dependent C-arm calibration; distortion correction; pose estimation of C-arm images; seed reconstruction;, C-arm to TRUS registration In precision-machined hard phantoms with 40-100 seeds, we correctly reconstructed 99 8\% seeds with a mean 3D accuracy of 0 68 mm In soft tissue phantoms with 45-87 seeds, clinically realistic 15 degrees C-arm motion, we correctly reconstructed 100\% seeds with an accuracy of 1 3 mm The reconstructed 3D seed positions were then registered to the prostate segmented from TRUS In a Phase-1 clinical trial, so far on 4 patients with 66-84 seeds, we achieved intra-operative monitoring of seed distribution, dosimetry We optimized the 100\% prescribed iso-dose contour by inserting an average of 3 75 additional seeds, making intra-operative dosimetry possible on a typical C-arm, at negligible additional cost to the existing clinical installation

}, keywords = {Algorithms, Brachytherapy, Computer-Assisted, Equipment Design, Equipment Failure Analysis, Humans, Imaging, instrumentation/methods, Interventional, Intraoperative Care, Male, methods, Prostatic Neoplasms, Prosthesis Implantation, Radiographic Image Enhancement, Radiographic Image Interpretation, Radiography, radiography/radiotherapy, Radiotherapy, Reproducibility of Results, Sensitivity, Specificity, Three-Dimensional, Tomography, X-Ray Computed}, author = {Ameet K. Jain and Anton Degeut and Iulian Iordachita and Gouthami Chintalapani and Jack Blevins and Le Yi and Elwood Armour and E. Clif Burdette and Danny Y Song and Gabor Fichtinger} } @conference {Jain2007c, title = {Intra-operative dosimetry optimization of TRUS-guided prostate brachytherapy requires localization of seeds relative to the prostate}, booktitle = {Innovative Minds in Prostate Cancer Today - IMPaCT}, year = {2007}, author = {Ameet K. Jain and Anton Degeut and Iulian Iordachita and Gouthami Chintalapani and Jack Blevins and Le Yi and Elwood Armour and E. Clif Burdette and Danny Y Song and Gabor Fichtinger} } @conference {Krieger2007, title = {Phantom Experiments with a Novel MR-Guided Transrectal Prostate Interventional System}, booktitle = {International Society of Magnetic Resonance in Medicine (ISMRM)}, year = {2007}, author = {Axel Krieger and Csaba Csoma and Peter Guion and Iulian Iordachita and Greg Metzger and Di Qian and Anurag K. Singh and Whitcomb, Louis L. and Gabor Fichtinger} } @article {Fichtinger2007c, title = {Robotic assistance for ultrasound guided prostate brachytherapy}, journal = {Medical Image Computing and Computer-Assisted Intervention (MICCAI)}, volume = {4791}, year = {2007}, pages = {119{\textendash}127}, publisher = {The Johns Hopkins University, Baltimore, Maryland, USA gabor@cs jhu edu}, abstract = {

We present a robotically assisted prostate brachytherapy system, test results in training phantoms The system consists of a transrectal ultrasound (TRUS), a spatially co-registered robot integrated with an FDA-approved commercial treatment planning system The salient feature of the system is a small parallel robot affixed to the mounting posts of the template The robot replaces the template interchangeably, uses the same coordinate system Established clinical hardware, workflow, calibration are left intact In these experiments, we recorded the first insertion attempt without adjustment All clinically relevant locations were reached Non-parallel needle trajectories were achieved The pre-insertion transverse, rotational errors (measured with Polaris optical tracker relative to the template{\textquoteright}s coordinate frame) were 0 25mm (STD = 0 17mm), 0 75 degrees (STD = 0 37 degrees) The needle tip placement errors measured in TRUS were 1 04mm (STD = 0 50mm) The system is in Phase-I clinical feasibility, safety trials, under Institutional Review Board approval

}, keywords = {Brachytherapy, Computer-Assisted, Equipment Design, Equipment Failure Analysis, Humans, instrumentation/methods, Interventional, Male, Prostatic Neoplasms, Radiotherapy, Radiotherapy Planning, radiotherapy/ultrasonography, Robotics, Ultrasonography}, author = {Gabor Fichtinger and Jonathan Fiene and Christopher Kennedy and Gernot Kronreif and Iulian Iordachita and Danny Y Song and E. Clif Burdette and Peter Kazanzides} } @conference {Fichtinger2007d, title = {Robotic Assistance for Ultrasound Guided Prostate Brachytherapy}, booktitle = {The Fourth AdMeTech Foundation Conference: Ending the Era of Blind Cancer Care \& Creating a Future of Image-Guided, Minimally Invasive Diagnosis \& Treatment}, year = {2007}, author = {Gabor Fichtinger and Jonathan Fiene and Christopher Kennedy and Iulian Iordachita and Gernot Kronreif and Danny Y Song and E. Clif Burdette and Peter Kazanzides} } @article {Fischer2007b, title = {Robotic assistant for transperineal prostate interventions in 3T closed MRI}, journal = {Medical image computing and computer-assisted intervention (MICCAI)}, volume = {10}, number = {Pt 1}, year = {2007}, pages = {425{\textendash}433}, publisher = {Center for Computer Integrated Surgery, Johns Hopkins University, USA gfischer@jhu edu}, abstract = {

Numerous studies have demonstrated the efficacy of image-guided needle-based therapy, biopsy in the management of prostate cancer The accuracy of traditional prostate interventions performed using transrectal ultrasound (TRUS) is limited by image fidelity, needle template guides, needle deflection, tissue deformation Magnetic Resonance Imaging (MRI) is an ideal modality for guiding, monitoring such interventions due to its excellent visualization of the prostate, its sub-structure, surrounding tissues We have designed a comprehensive robotic assistant system that allows prostate biopsy, brachytherapy procedures to be performed entirely inside a 3T closed MRI scanner We present a detailed design of the robotic manipulator, an evaluation of its usability, MR compatibility

}, keywords = {anatomy /\&/ histology/surgery, Computer-Assisted, Equipment Design, Equipment Failure Analysis, Image Interpretation, instrumentation/methods, Interventional, Magnetic Resonance Imaging, Perineum, Prostatectomy, Robotics, Surgery}, author = {Gregory Fischer and Simon DiMaio and Iulian Iordachita and Gabor Fichtinger} } @conference {Krieger2006a, title = {Accuracy of Hybrid Tracking for a Novel MR-Guided Transrectal Prostate Interventional Device}, booktitle = {6th Interventional MRI Symposium}, year = {2006}, pages = {143-145}, author = {Axel Krieger and Iulian Iordachita and Greg Metzger and Peter Guion and Ergin Atalar and Gabor Fichtinger and Whitcomb, Louis L.} } @article {Boctor2006a, title = {Bootstrapped ultrasound calibration}, journal = {Studies in health technology and informatics}, volume = {119}, year = {2006}, pages = {61{\textendash}66}, publisher = {Engineering Research Center, Johns Hopkins University, USA}, abstract = {

This paper introduces an enhanced (bootstrapped) method for tracked ultrasound probe calibration Prior to calibration, a position sensor is used to track an ultrasound probe in 3D space, while the US image is used to determine calibration target locations within the image From this information, an estimate of the transformation matrix of the scan plane with respect to the position sensor is computed While all prior calibration methods terminate at this phase, we use this initial calibration estimate to bootstrap an additional optimization of the transformation matrix on independent data to yield the minimum reconstruction error on calibration targets The bootstrapped workflow makes use of a closed-form calibration solver, associated sensitivity analysis, allowing for rapid, robust convergence to an optimal calibration matrix Bootstrapping demonstrates superior reconstruction accuracy

}, keywords = {Calibration, Imaging, standards, Three-Dimensional, Ultrasonography, United States}, author = {Emad Boctor and Iulian Iordachita and Michael Choti and Gregory D. Hager and Gabor Fichtinger} } @conference {DiMaio2006c, title = {Design of a Prostate Needle Placement Robot in MRI Scanner}, booktitle = {IEEE International Conference on Biomedical Robotics}, year = {2006}, author = {Simon DiMaio and Gregory Fischer and Steven Haker and Nobuhiko Hata and Iulian Iordachita and Clare M Tempany and Gabor Fichtinger} } @conference {Fischer2006d, title = {Design of a Robot for Transperineal Prostate Needle Placement in MRI Scanner}, booktitle = {Procedings IEEE International Conference on Mechatronics}, year = {2006}, month = {3{\textendash}5 July}, pages = {592{\textendash}597}, doi = {10 1109/ICMECH 2006 252593}, author = {Gregory Fischer and Iulian Iordachita and Simon DiMaio and Gabor Fichtinger} } @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} } @conference {Fischer2006f, title = {Robotic Assistant for MR-Guided Prostate Biopsy}, booktitle = {6th Interventional MRI Symposium}, year = {2006}, pages = {243-245}, author = {Gregory Fischer and Simon DiMaio and Iulian Iordachita and Gabor Fichtinger} } @conference {Fischer2006g, title = {Robotic MRI-guided Prostate Needle Placement}, booktitle = {Medical Robotics workshop to the 9th MICCAI Conference}, year = {2006}, author = {Gregory Fischer and Simon DiMaio and Iulian Iordachita and Gabor Fichtinger} } @article {Kennedy2006, title = {Robotically Assisted Needle Placement for Prostate Brachytherapy}, journal = {Journal of Medical Physics}, volume = {33}, number = {6}, year = {2006}, pages = {2264-2264}, publisher = {AAPM}, doi = {10 1118/1 2241837}, url = {http://link aip org/link/?MPH/33/2264/3}, author = {Christopher Kennedy and Iulian Iordachita and E. Clif Burdette and Gernot Kronreif and Wolfgang Ptacek and Peter Kazanzides and Danny Y Song and Gabor Fichtinger} } @conference {Jain2006, title = {Small size fiducial for c-arm tracking (FTRAC)}, booktitle = {6th Annual Meeting of the International Society for Computer Assisted Surgery,}, year = {2006}, pages = {235-238}, author = {Ameet K. Jain and Iulian Iordachita and Gabor Fichtinger} } @conference {DiMaio2006a, title = {A System for MRI-guided Prostate Interventions}, booktitle = {Procedings First IEEE/RAS-EMBS International Conference on Biomedical Robotics and Biomechatronics BioRob 2006}, year = {2006}, month = {20{\textendash}22 Feb}, pages = {68{\textendash}73}, doi = {10 1109/BIOROB 2006 1639062}, author = {Simon DiMaio and Gregory Fischer and Maker, S. J. and Nobuhiko Hata and Iulian Iordachita and Clare M Tempany and Ron Kikinis and Gabor Fichtinger} } @conference {Boctor2006, title = {Ultrasound self-calibration}, booktitle = {Medical Imaging 2006: Visualization, Image-Guided Procedures, and Display}, volume = {6141}, number = {1}, year = {2006}, pages = {61412N}, publisher = {SPIE}, organization = {SPIE}, doi = {10 1117/12 659594}, url = {http://link aip org/link/?PSI/6141/61412N/1}, author = {Emad Boctor and Iulian Iordachita and Gabor Fichtinger and Gregory D. Hager} } @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} } @conference {Li2005, title = {Image-Guided Robot System for Small Animal Research}, booktitle = {Conference on Complex Medical Engineering (CME2005)}, year = {2005}, pages = {194-198}, author = {Jack Li and Emese Balogh and Iulian Iordachita and Gabor Fichtinger and Peter Kazanzides} } @article {Boctor2005, title = {Real-time quality control of tracked ultrasound}, journal = {Medical image computing and computer-assisted intervention (MICCAI)}, volume = {8}, number = {Pt 1}, year = {2005}, pages = {621{\textendash}630}, abstract = {

The overwhelming majority of intra-operative hazard situations in tracked ultrasound (US) systems are attributed to failure of registration between tracking, imaging coordinate frames We introduce a novel methodology for eal-time in-vivo quality control of tracked US systems, in order to capture registration failures during the clinical procedure In effect, we dynamically recalibrate the tracked US system for rotation, scale factor, and in-plane position offset up to a scale factor We detect any unexpected change in these parameters through capturing discrepancies in the resulting calibration matrix, thereby assuring quality (accuracy, consistency) of the tracked system No phantom is used for the recalibration We perform the task of quality control in the background, transparently to the clinical user while the subject is being scanned We present the concept, mathematical formulation, and experimental evaluation in-vitro This new method can play an important role in guaranteeing accurate, consistent, and reliable performance of tracked ultrasound

}, keywords = {Algorithms, Computer Systems, Computer-Assisted, Health Care, Humans, Image Enhancement, Image Interpretation, Interventional, methods, Quality Assurance, Quality Control, Reproducibility of Results, Sensitivity, Specificity, Surgery, Ultrasonography, User-Computer Interface}, author = {Emad Boctor and Iulian Iordachita and Gabor Fichtinger and Gregory D. Hager} } @conference {Boctor2005b, title = {Ultrasound Self-Calibration and Real-Time Quality Control for Interventions}, booktitle = {IEEE International Ultrasonics Symposium}, year = {2005}, author = {Emad Boctor and Iulian Iordachita and Gabor Fichtinger and Gregory D. Hager} } @conference {Li2005a, title = {Validation of an image-guided robot system for measurement, biopsy and injection in rodents}, booktitle = {Procedings IEEE 31st Annual Northeast Bioengineering Conference}, year = {2005}, month = {2{\textendash}3 April}, pages = {131{\textendash}133}, doi = {10 1109/NEBC 2005 1431959}, author = {Jack Li and Iulian Iordachita and Emese Balogh and Gabor Fichtinger and Peter Kazanzides} } @conference {Iordachita2004, title = {Controllable motorized devices for accurate percutaneous needle placement in soft tissue target}, booktitle = {The Eleventh World Congress in Mechanism and Machine Science}, year = {2004}, pages = {82-86}, author = {Iulian Iordachita and Richard Wiard and Gabor Fichtinger and Ichiro Sakuma and Dan Stoianovici} }