Sunghwan Lim1, Karun Sharma2, Pan Li1, Doru Petrisor1, Stanley Fricke2, Dan Stoianovici1, Kevin Cleary3. 1. Robotics Laboratory, Brady Urological Institute, Johns Hopkins University, Baltimore, MD, USA. 2. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan Avenue, Washington, DC, USA. 3. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan Avenue, Washington, DC, USA. kcleary@childrensnational.org.
Abstract
RATIONALE AND OBJECTIVES: We have designed and constructed an MR-safe robot made entirely of nonmetallic components with pneumatic actuators and optical encoders. The robot was developed to enable bone biopsies to be performed under magnetic resonance imaging (MRI) guidance in pediatric patients. The purpose of this study was to show the feasibility of using the robot for biopsy of the femur and tibia in a cadaver leg. Our long-term goal is to eliminate radiation exposure during bone biopsy procedures and provide more timely and accurate diagnosis for children with bone cancers and bone infections. METHODS: The MR-safe robot was mounted on the MRI table. A cadaver leg was procured from an anatomy supply house and placed on the MRI table. All required hospital precautions for infection control were taken. A total of 10 biopsy targets were sampled using MRI guidance: five from the femur and five from the tibia. A handheld, commercially available battery-powered bone drill was used to facilitate drilling through the cortex. After the study, the leg was scanned with CT to better visualize and document the bone biopsy sites. Both the MRI and CT images were used to analyze the results. RESULTS: All of the targets were successfully reached with an average targeting accuracy of 1.43 mm. A workflow analysis showed the average time for the first biopsy was 41 min including robot setup time and 22 min for each additional biopsy including the time for the repeat MRI scan used to confirm accurate targeting. The robot was shown to be MRI transparent, as no image quality degradation due to the use of the robot was detected. CONCLUSION: The results showed the feasibility of using an MR-safe robotic system to assist the interventional radiologist in performing precision bone biopsy under MRI guidance. Future work will include developing an MR-safe drill, improving the mounting of the robot and fixation of the leg, and moving toward first in child clinical trials.
RATIONALE AND OBJECTIVES: We have designed and constructed an MR-safe robot made entirely of nonmetallic components with pneumatic actuators and optical encoders. The robot was developed to enable bone biopsies to be performed under magnetic resonance imaging (MRI) guidance in pediatric patients. The purpose of this study was to show the feasibility of using the robot for biopsy of the femur and tibia in a cadaver leg. Our long-term goal is to eliminate radiation exposure during bone biopsy procedures and provide more timely and accurate diagnosis for children with bone cancers and bone infections. METHODS: The MR-safe robot was mounted on the MRI table. A cadaver leg was procured from an anatomy supply house and placed on the MRI table. All required hospital precautions for infection control were taken. A total of 10 biopsy targets were sampled using MRI guidance: five from the femur and five from the tibia. A handheld, commercially available battery-powered bone drill was used to facilitate drilling through the cortex. After the study, the leg was scanned with CT to better visualize and document the bone biopsy sites. Both the MRI and CT images were used to analyze the results. RESULTS: All of the targets were successfully reached with an average targeting accuracy of 1.43 mm. A workflow analysis showed the average time for the first biopsy was 41 min including robot setup time and 22 min for each additional biopsy including the time for the repeat MRI scan used to confirm accurate targeting. The robot was shown to be MRI transparent, as no image quality degradation due to the use of the robot was detected. CONCLUSION: The results showed the feasibility of using an MR-safe robotic system to assist the interventional radiologist in performing precision bone biopsy under MRI guidance. Future work will include developing an MR-safe drill, improving the mounting of the robot and fixation of the leg, and moving toward first in child clinical trials.
Entities:
Keywords:
Cadaver; Long bone biopsy; MR-safe; MRI; Robot
Authors: Axel Krieger; Iulian I Iordachita; Peter Guion; Anurag K Singh; Aradhana Kaushal; Cynthia Ménard; Peter A Pinto; Kevin Camphausen; Gabor Fichtinger; Louis L Whitcomb Journal: IEEE Trans Biomed Eng Date: 2011-11 Impact factor: 4.538
Authors: Andreas Melzer; Bernd Gutmann; Thomas Remmele; Renate Wolf; Andreas Lukoscheck; Michael Bock; Hubert Bardenheuer; Harald Fischer Journal: IEEE Eng Med Biol Mag Date: 2008 May-Jun
Authors: Dan Stoianovici; Alexandru Patriciu; Doru Petrisor; Dumitru Mazilu; Louis Kavoussi Journal: IEEE ASME Trans Mechatron Date: 2007-02-01 Impact factor: 5.303
Authors: Dan Stoianovici; Danny Song; Doru Petrisor; Daniel Ursu; Dumitru Mazilu; Michael Muntener; Michael Mutener; Michael Schar; Alexandru Patriciu Journal: Minim Invasive Ther Allied Technol Date: 2007 Impact factor: 2.442
Authors: Vanitha Vasudevan; Michael C Cheung; Relin Yang; Ying Zhuge; Anne C Fischer; Leonidas G Koniaris; Juan E Sola Journal: J Surg Res Date: 2009-06-21 Impact factor: 2.192