@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 {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 {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} } @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} } @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} } @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} }