Needle insertion planning for obstacle avoidance in robotic biopsy

2021 ◽  
Vol 7 (2) ◽  
pp. 779-782
Author(s):  
Stefan Gerlach ◽  
Maximilian Neidhardt ◽  
Thorben Weiß ◽  
Max-Heinrich Laves ◽  
Carolin Stapper ◽  
...  
Keyword(s):  
Cost Function ◽  
Disease Transmission ◽  
Tissue Sample ◽  
Needle Insertion ◽  
Target Point ◽  
Needle Placement ◽  
Insertion Depth ◽  
Needle Path ◽  
Ct Attenuation ◽  
Conventional Autopsy

Abstract Understanding the underlying pathology in different tissues and organs is crucial when fighting pandemics like COVID-19. During conventional autopsy, large tissue sample sets of multiple organs can be collected from cadavers. However, direct contact with an infectious corpse is associated with the risk of disease transmission and relatives of the deceased might object to a conventional autopsy. To overcome these drawbacks, we consider minimally invasive autopsies with robotic needle placement as a practical alternative. One challenge in needle based biopsies is avoidance of dense obstacles, including bones or embedded medical devices such as pacemakers. We demonstrate an approach for automated planning and visualising suitable needle insertion points based on computed tomography (CT) scans. Needle paths are modeled by a line between insertion and target point and needle insertion path occlusion from obstacles is determined by using central projections from the biopsy target to the surface of the skin. We project the maximum and minimum CT attenuation, insertion depth, and standard deviation of CT attenuation along the needle path and create two-dimensional intensity-maps projected on the skin. A cost function considering these metrics is introduced and minimized to find an optimal biopsy needle path. Furthermore, we disregard insertion points without sufficient room for needle placement. For visualisation, we display the color-coded cost function so that suitable points for needle insertion become visible. We evaluate our system on 10 post mortem CTs with six biopsy targets in abdomen and thorax annotated by medical experts. For all patients and targets an optimal insertion path is found. The mean distance to the target ranges from (49.9 ± 12.9)mm for the spleen to (90.1 ± 25.8)mm for the pancreas.

scholarly journals Influence of needle-insertion depth on epidural spread and clinical outcomes in caudal epidural injections: a randomized clinical trial

2018 ◽  
Vol Volume 11 ◽  
pp. 2961-2967 ◽  
Author(s):  
Sang Jun Park ◽  
Kyung Bong Yoon ◽  
Dong Ah Shin ◽  
Kiwook Kim ◽  
Tae Lim Kim ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Clinical Outcomes ◽  
Needle Insertion ◽  
Insertion Depth ◽  
Epidural Injections ◽  
Caudal Epidural

An Experimental Method of Needle Deflection and Prostate Movement Using the Anatomically Accurate Prostate Simulator and the Electromagnetic Tracking System

2017 ◽  
Author(s):  
Dian-Ru Li ◽  
Jih-Kai Yeh ◽  
Wei-Chen Lin ◽  
Jeffrey S. Montgomery ◽  
Albert Shih
Keyword(s):  
Experimental Method ◽  
Prostate Biopsy ◽  
Tracking System ◽  
Needle Insertion ◽  
Target Point ◽  
Electromagnetic Tracking ◽  
Tissue Samples ◽  
Prostate Needle Biopsy ◽  
Needle Deflection ◽  
3D Space

This study develops an experimental method to measure the needle deflection and prostate movement using an anatomically accurate prostate simulator with the electromagnetic tracking (EMT) system. Accurate needle insertion is crucial for prostate biopsy to acquire the tissue samples from cancer sites identified by magnetic resonance imaging. False negatives or inability to diagnose are the clinical challenges in the biopsy procedure. The main cause is that the needle tip missed the targeted cancer sites due to needle deflection and prostate movement. An anatomically accurate prostate simulator was developed to quantitatively and experimentally measure the deviation of needle tip from the ideal path and the movement of a target point in the prostate. The EMT system was utilized to simultaneously track the needle tip and target point positions in 3D space. Results show that the maximal needle deflection occurred at the first 60-mm insertion with 6.7 and 0.7 mm in and perpendicular to the needle insertion plane, respectively. The corresponding target point movements were 6.5 mm and 2.4 mm in and perpendicular to the needle insertion plane, respectively. Differences between multiple insertions through the same path have also been quantified. This method can be utilized to study clinical prostate biopsy techniques, evaluate the accuracy of needle devices, and train clinicians for accurate prostate needle biopsy.

scholarly journals Accuracy of flat panel detector CT with integrated navigational software with and without MR fusion for single-pass needle placement

2015 ◽  
Vol 8 (7) ◽  
pp. 731-735 ◽  
Author(s):  
Marc C Mabray ◽  
Sanjit Datta ◽  
Prasheel V Lillaney ◽  
Teri Moore ◽  
Sonja Gehrisch ◽  
...  
Keyword(s):  
Visual Assessment ◽  
Guidance System ◽  
Target Point ◽  
Needle Placement ◽  
Flat Panel ◽  
Single Pass ◽  
Flat Panel Detector ◽  
Radial Error ◽  
Intracranial Lesions ◽  
Deep Brain

PurposeFluoroscopic systems in modern interventional suites have the ability to perform flat panel detector CT (FDCT) with navigational guidance. Fusion with MR allows navigational guidance towards FDCT occult targets. We aim to evaluate the accuracy of this system using single-pass needle placement in a deep brain stimulation (DBS) phantom.Materials and methodsMR was performed on a head phantom with DBS lead targets. The head phantom was placed into fixation and FDCT was performed. FDCT and MR datasets were automatically fused using the integrated guidance system (iGuide, Siemens). A DBS target was selected on the MR dataset. A 10 cm, 19 G needle was advanced by hand in a single pass using laser crosshair guidance. Radial error was visually assessed against measurement markers on the target and by a second FDCT. Ten needles were placed using CT-MR fusion and 10 needles were placed without MR fusion, with targeting based solely on FDCT and fusion steps repeated for every pass.ResultsMean radial error was 2.75±1.39 mm as defined by visual assessment to the centre of the DBS target and 2.80±1.43 mm as defined by FDCT to the centre of the selected target point. There were no statistically significant differences in error between MR fusion and non-MR guided series.ConclusionsSingle pass needle placement in a DBS phantom using FDCT guidance is associated with a radial error of approximately 2.5–3.0 mm at a depth of approximately 80 mm. This system could accurately target sub-centimetre intracranial lesions defined on MR.

scholarly journals MRI-assisted cervix cancer brachytherapy pre-planning, based on application in paracervical anaesthesia: final report

2014 ◽  
Vol 48 (3) ◽  
pp. 293-300 ◽  
Author(s):  
Primoz Petric ◽  
Robert Hudej ◽  
Omar Hanuna ◽  
Primoz Marolt ◽  
Noora Mohammed A A Al-Hammadi ◽  
...  
Keyword(s):  
At Risk ◽  
Organs At Risk ◽  
Target Volume ◽  
Needle Insertion ◽  
Cervix Cancer ◽  
Final Report ◽  
Insertion Depth ◽  
Pelvic Mri ◽  
Dose Planning ◽  
Planning Procedure

Abstract Background. Optimal applicator insertion is a precondition for the success of cervix cancer brachytherapy (BT). We aimed to assess feasibility and efficacy of MRI-assisted pre-planning, based on applicator insertion in para-cervical anaesthesia (PCA). Patients and methods. Five days prior to BT, the pre-planning procedure was performed in 18 cervix cancer patients: tandem-ring applicator was inserted under PCA, pelvic MRI obtained and applicator removed. Procedure tolerability was assessed. High risk clinical target volume (HR CTV) and organs at risk were delineated on the pre-planning MRI, virtual needles placed at optimal positions, and dose planning performed. At BT, insertion was carried out in subarachnoidal anaesthesia according to pre-planned geometry. Pre-planned and actual treatment parameters were compared. Results. Pre-planning procedure was well tolerated. Median difference between the pre-planned and actual needle insertion depth and position were 2 (0―10) mm and 4 (0―30) degrees, respectively. The differences between the pre-planned and actual geometric and dosimetric parameters were statistically non-significant. All actual needles were positioned inside the HR CTV and outside the organs at risk (OAR). Conclusions. Our pre-planning approach is well tolerated and effective. Pre-planned geometry and dose distribution can be reproduced at BT.

Tissue Deformation and Insertion Force of Bee-Stinger Inspired Surgical Needles

2018 ◽  
Vol 12 (3) ◽  
Author(s):  
Mohammad Sahlabadi ◽  
Parsaoran Hutapea
Keyword(s):  
Three Dimensional ◽  
Needle Insertion ◽  
The Body ◽  
Image Correlation ◽  
Tissue Deformation ◽  
Insertion Force ◽  
Needle Path ◽  
Percutaneous Procedures ◽  
Target Locations ◽  
Path Deviation

Surgical needles are commonly used to reach target locations inside of the body for percutaneous procedures. The major issues in needle steering in tissues are the insertion force which causes tissue damage and tissue deformation that causes the needle path deviation (i.e., tip deflection) resulting in the needle missing the intended target. In this study, honeybee-inspired needle prototypes were proposed and studied to decrease the insertion force and to reduce the tissue deformation. Three-dimensional (3D) printing technology was used to manufacture scaled-up needle prototypes. Needle insertion tests on tissue-mimicking polyvinyl chloride (PVC) gel were performed to measure the insertion force and the tip deflection. Digital image correlation (DIC) study was conducted to determine the tissue deformation during the insertion. It was demonstrated that the bioinspired needles can be utilized to decrease the insertion force by 24% and to minimize the tip deflection. It was also observed that the bioinspired needles decrease the tissue deformation by 17%. From this study, it can be concluded that the proposed bee-inspired needle design can be used to develop and manufacture innovative surgical needles for more effective and less invasive percutaneous procedures.

scholarly journals Appropriate Needle Insertion Depth for Intramuscular Injection Based on Assessment of BMI

2014 ◽  
Vol 34 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Yuri Takahashi ◽  
Kazuko Kikuchi ◽  
Natsuko Miura ◽  
Yoko Ishida
Keyword(s):  
Intramuscular Injection ◽  
Needle Insertion ◽  
Insertion Depth

A MECHANICS-BASED MODEL FOR SIMULATING THE NEEDLE DEFLECTION IN TRANSVERSE ISOTROPIC TISSUE FOR A PERCUTANEOUS PUNCTURE

2019 ◽  
Vol 19 (06) ◽  
pp. 1950060 ◽  
Author(s):  
WANYU LIU ◽  
ZHIYONG YANG ◽  
SHAN JIANG
Keyword(s):  
Needle Insertion ◽  
Robot Assisted ◽  
Insertion Depth ◽  
Interaction Forces ◽  
Percutaneous Puncture ◽  
Needle Deflection ◽  
Isotropic Elasticity ◽  
Transverse Isotropic ◽  
Radioactive Seeds ◽  
Medical Needle

During the percutaneous puncture for robot-assisted brachytherapy, a medical needle is usually inserted into fiber-structured soft tissue which has transverse isotropic elasticity, such as muscle and skin, to deliver radioactive seeds that kill cancer cells. To place the radioactive seeds more accurately, it is necessary to assess the effect of the transverse isotropic elasticity on the needle deflection. A mechanics-based model for simulating the needle deflection in transverse isotropic tissue is developed in this paper. The anisotropic needle–tissue interaction forces are estimated and used as inputs to drive the model for simulating needle deflections for different insertion orientation angles. Automatic insertion experiments were performed on a single-layered porcine muscle at five different insertion orientation angles. The results show that the maximum difference in the tip deflection for the different insertion orientation angles is 2.99[Formula: see text]mm when the insertion depth is 50[Formula: see text]mm. The maximum simulated error of the needle axis deflection is 0.62[Formula: see text]mm for all insertion orientation angles. The developed model can successfully simulate the needle deflections inside transverse isotropic tissue for different insertion orientation angles. This work is useful for predicting and compensating for the deflection error for automatic needle insertion.

scholarly journals Demonstration of Optical Coherence Tomography Guided Big Bubble Technique for Deep Anterior Lamellar Keratoplasty (DALK)

Sensors ◽  
2020 ◽  
Vol 20 (2) ◽  
pp. 428
Author(s):  
Shoujing Guo ◽  
Nicolas R. Sarfaraz ◽  
William G. Gensheimer ◽  
Axel Krieger ◽  
Jin U. Kang
Keyword(s):  
Optical Coherence Tomography ◽  
Rejection Rate ◽  
Cell Loss ◽  
Needle Insertion ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Optical Coherence ◽  
Insertion Depth ◽  
Anterior Lamellar Keratoplasty ◽  
Big Bubble

Deep anterior lamellar keratoplasty (DALK) is a highly challenging procedure for cornea transplant that involves removing the corneal layers above Descemet’s membrane (DM). This is achieved by a “big bubble” technique where a needle is inserted into the stroma of the cornea down to DM and the injection of either air or liquid. DALK has important advantages over penetrating keratoplasty (PK) including lower rejection rate, less endothelial cell loss, and increased graft survival. In this paper, we successfully designed and evaluated the optical coherence tomography (OCT) distal sensor integrated needle for a precise big bubble technique. We successfully used this sensor for micro-control of a robotic DALK device termed AUTO-DALK for autonomous big bubble needle insertion. The OCT distal sensor was integrated inside a 25-gauge needle, which was used for pneumo-dissection. The AUTO-DALK device is built on a manual trephine platform which includes a vacuum ring to fix the device on the eye and add a needle driver at an angle of 60 degrees from vertical. During the test on five porcine eyes with a target depth of 90%, the measured insertion depth as a percentage of cornea thickness for the AUTO-DALK device was 90.05 % ± 2.33 % without any perforation compared to 79.16 % ± 5.68 % for unassisted free-hand insertion and 86.20 % ± 5.31 % for assisted free-hand insertion. The result showed a higher precision and consistency of the needle placement with AUTO-DALK, which could lead to better visual outcomes and fewer complications.

Insertion Behavior of Microneedles for Drug Delivery

2008 ◽  
Vol 47-50 ◽  
pp. 1442-1445
Author(s):  
K.T. Shek ◽  
David C.C. Lam
Keyword(s):  
Drug Delivery ◽  
Needle Insertion ◽  
Drug Dosage ◽  
Porcine Skin ◽  
Insertion Depth ◽  
Test Frame ◽  
Needle Diameter ◽  
Gripping Force ◽  
Insertion Length ◽  
Precision Test

Drug dosage delivered by drug-coated microneedle is dependent on needle insertion behavior. The insertion length and gripping force at varied insertion speeds are determined quantitatively using a precision test frame. The ratio of inserted depth to pressed depth was found to rise asymptotically to a plateau, but decreased rapidly to zero insertion when the needles are pressed less than 1000 microns deep for both silicone rubber and porcine skin. No insertion was observed when the needles are pressed less than 200 microns. The gripping force exerted onto the inserted needle by the skin decreased by 0.1N per mm of needle diameter and insertion depth. The short insertion depth and low force suggest that drug delivery using short 300 micron microneedles would be tenuous. High insertion speeds can help to improve drug delivery, but the improvement is limited to large needles since the results from this study showed that insertions become speedindependent when the needle diameter is less than 130 microns.

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