An MRI-Compatible robotic aspiration device has been developed with the goal of improving minimally invasive treatment for intracerebral hemorrhage (ICH). Current minimally invasive approaches have demonstrated promising clinical outcomes in preliminary trials when compared to conservative treatment or surgery. However, these approaches do not allow for hemorrhage evacuation while monitoring for evacuation progress and brain tissue involvement under MRI. The robotic aspiration device has a concentric tube mechanism which consists of a straight outer tube and an elastic inner aspiration cannula to allow for access to hematomas when deployed. We started evaluating the robot in MRI-guided human brain phantom studies. As a next step, we assessed the workflow of the robot system in an MRI-guided sheep brain phantom study. The phantom was created using Humimic Medical gel that was melted and poured into a 3D-printed sheep brain model. The gel was left to solidify, and a cavity was created for a clot. The measured clot volume prior to evacuation was 9.04mL. The robot was advanced into the clot and aspiration was performed with real-time intraoperative MR imaging. The volume of clot was reduced by 83% and the phantom did not have any unexpected damage when it was physically analyzed after the procedure. Our long-term goal is to develop a safe MRI-compatible minimally invasive robotic procedure for ICH evacuation. We are currently preparing for live sheep animal studies.
Computed Tomography (CT) guided procedures are common minimally invasive technique used to perform diagnostic and therapeutic procedures. These applications include obtaining biopsy samples, delivering medications, aspiring/draining fluids, and ablating regions of interest. This minimally invasive approach is especially common in pediatrics. Approximately five to nine million children receive CTs each year. Despite the excellent boney region discrimination and high resolution possible with CT, there are concerns regarding the risks of ionizing radiation exposure. Exposure is often minimized, as CT exposure in children has been linked to the development cancer in the future.
In this paper we introduce a novel and enabling MRI-compatible needle guidance toolkit intended to streamline arthrography procedures, eliminating the need for ionizing radiation exposure during this diagnostic procedure. We developed a flexible 2D grid template with unique patterns in which each point on the grid can be uniquely represented and denoted with respect to surrounding patterns. This MRI-visible non-repeating grid template sits on top of the patient’s skin in the region of interest and allows the radiologist to visualize the skin surface in the MR images and correlates each point in MR image with the corresponding point on the grid. In this manner, the radiologist can intuitively find the entry point on the skin according to their plan. An MRI-compatible handheld positioning device consisting of a needle guide, two baseline bubble inclinometers, and an MRI-compatible stabilizer arm allows the radiologist to adjust the orientation of the needle in two directions. The radiologist selects an entry point on MR images, identifies a grid location through which the needle would be projected to pass on the image, and then reproduces this needle position and angulation using the MRI-compatible handheld device and the physical grid. To evaluate the accuracy of needle targeting with the MRI-compatible needle guidance toolkit, we used the kit to target 10 locations in a phantom in a Philips Achieva 1.5T MRI. The average targeting error was 2.2±0.7 mm. Average targeting procedure time was around 20 minutes for each target.
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