Abstract:
Conformity of tumour volumes and dose plans in prostate brachytherapy (BT) can be constrained by unwanted needle deflections, needle access restrictions and visualisation limitations. This work validates the feasibility of teleoperated robotic control of an active steerable needle using magnetic resonance (MR) for guidance. With this system, perturbations can be counteracted and critical structures can be circumvented to access currently inaccessible areas. The system comprises of (1) a novel steerable needle, (2) the minimally invasive robotics in an MR environment (MIRIAM) system, and (3) the daVinci Research Kit (dVRK). MR scans provide visual feedback to the operator controlling the dVRK. Needle steering is performed along curved trajectories to avoid the urethra towards targets (representing tumour tissue) in a prostate phantom with a targeting error of 1.2 ± 1.0 mm. This work shows the potential clinical applicability of active needle steering for prostate BT with a teleoperated robotic system in an MR environment.
摘要:
前列腺近距离放射治疗(BT)中肿瘤体积和剂量计划的一致性可能会受到不必要的针头偏转的限制,针头访问限制和可视化限制。这项工作验证了使用磁共振(MR)进行引导对主动可操纵针进行远程操作机器人控制的可行性。有了这个系统,可以抵消扰动,可以规避关键结构以进入当前无法进入的区域。该系统包括(1)新型可操纵针,(2)MR环境中的微创机器人(MIRIAM)系统,和(3)达芬奇研究试剂盒(dVRK)。MR扫描向控制dVRK的操作员提供视觉反馈。沿着弯曲的轨迹进行针转向,以避免尿道朝向前列腺体模中的目标(代表肿瘤组织),目标误差为1.2±1.0mm。这项工作显示了在MR环境中使用遥控机器人系统对前列腺BT进行主动针操纵的潜在临床适用性。