Teleoperated MRI‐Guided Prostate Needle Placement

Abstract

Most robotic systems reported for MRI-guided prostate interventions use manual needle insertion, based on a previously acquired image, which requires withdrawing the patient from the scanner multiple times during the procedure. This makes the intervention longer, more expensive and elongating the discomfort to patient and, most importantly, less accurate due to the virtually inevitable motion of the target. As a remedy, automated needle placement methods were proposed, putting human supervision out of the control loop. This thesis presents the development of enabling technologies for human-operated in-room master-slave needle placement under real-time MRI guidance, while the patient is kept in the scanner and having the process of needle placement under continuos control of the physician. The feasibility of teleoperated needle insertion was demonstrated by developing a 1-DOF (degree of freedom) MRI-compatible master-slave system, which was integrated with a 4-DOF robot for transperineal prostate biopsy and brachytherapy. An accuracy study was conducted on a robotic system for MRI-guided prostate needle placement. Different error sources were identified and quantified. This study concluded that errors occurring during needle insertion have the most significant contribution to needle placement error. In order to compensate for these errors, teleoperated needle steering under real-time MRI guidance was proposed. A 2-DOF piezo-actuated MRI-compatible needle steering module was developed and integrated with the aforementioned 4-DOF transperineal robot, yielding a fully actuated 6-DOF (x, y, z, yaw, pitch, roll) robotic platform for MRI-guided prostate interventions. A novel MRI-compatible master robot was also developed to enable teleoperated needle steering inside the MRI room. MRI-compatible controller hardware and software were developed. A novel MRI-compatible force/torque sensor was devised using Fiber Bragg Grating for force measurement in MRI room. Phantom experiments proved the feasibility iii of teleoperated needle steering under real-time MRI guidance. A system was also developed for real-time 3D shape tracking of a bevel-tip needle with Fiber Bragg Grating sensors embedded along the needle shaft. The needle profile was overlaid on the real-time MR image, yielding real time navigation with accuracy better than 0.5 mm. The experimental system is presently being refitted for clinical safety and feasibility trials on real patients.