Robot-assisted MRI-guided prostatic interventions

摘要

SUMMARY This paper reports on recent progress made toward the development of a new magnetic resonance imaging (MRI)-compatible robot-assisted surgical system for closed-bore image-guided prostatic interventions: thermal ablation, radioactive seed implants (brachytherapy), and biopsy. Each type of intervention will be performed with a different image-guided, robot-based surgical tool mounted on the same MRI-guided robot through a modular trocar. The first stage of this development addresses only laser-based focal ablation. The robot mechanical structure, modular surgical trocar, control architecture, and current stage of performance evaluation in the MRI environment are presented. The robot actuators are ultrasonic motors. A methodology of using such motors in the MRI environment is presented. The robot prototype with surgical ablation tool is undergoing tests on phantoms in the MRI bore. The tests cover MRI compatibility, image visualization, robot accuracy, and thermal mapping. To date, (i) the images are artifact- and noise-free for certain scanning pulse sequences; (ii) the robot tip positioning error is less than 1.2 mm even at positions closer than 0.3 m from the MRI isocenter; (iii) penetration toward the target is image-monitored in near-real time; and (iv) thermal ablation and temperature mapping are achieved using a laser delivered on an optical fiber and MRI, respectively.