Intra-op Image-guided Robotics

A Robotic Platform to Navigate MRI-guided Focused Ultrasound System

[Video: A Robotic Platform to Navigate MRI-guided Focused Ultrasound System]

Focused ultrasound (FUS) technology attracts increasing interests accrediting to its non-invasive and painless treatment of tumors. Magnetic resonance imaging (MRI) guidance has been introduced to monitor this procedure, thus allowing the ultrasound foci to be precisely controlled. However, manual positioning of the FUS transducers is challenging, especially for the intra-operative (intra-op) adjustment in the MRI room. Currently, there are very few devices capable to provide robotic transducer positioning for the treatment of abdominopelvic organ diseases under MRI. The high intensity focused ultrasound (HIFU) spot would have to be “steered” to ablate large (>Ø 3.5 cm) or multiple tumors (e.g., in liver). To this end, we proposed a hydraulic-driven tele-operated robot platform that enables 5-DoF manipulation of the FUS transducer. Even operated close to the MRI iso-center, the robot can guarantee zero electromagnetic (EM) artifact to the MR image. Our proof-of-concept robot prototype can offer a large workspace (100 mm × 100 mm × 35 mm) for FUS foci steering. Accurate manipulation (0.2 mm in translation, 0.4° in rotation) of the FUS transducer holder is achieved using rolling diaphragmsealed hydraulic actuators. The robot control responsiveness (from 0.1 to 4 Hz) is also evaluated to show the potential to compensate for the spot tracking error induced by respiratory motion. We also demonstrate the use of wireless radiofrequency (RF) markers to continuously register the robot task space in the MRI coordinates.

Design of a Percutaneous MRI-guided Needle Robot with Soft Fluid-driven Actuator

[Video: Design of a Percutaneous MRI-guided Needle Robot with Soft Fluid-driven Actuator]

Percutaneous ablation is a standard therapy for most cases of hepatocellular carcinoma (HCC), which is a general type of primary liver cancer. Magnetic resonance imaging (MRI) offers high-contrast images of soft tissue to monitor the ablation procedure. However, the success of MRI-guided ablation still depends on precise intra-tumor probe placement and skin insertion positioning, both of which require highly experienced operators, and can induce inter-operator variability in ablation results. To solve this, we propose a semi-automated robotic system for MRI-guided percutaneous needle procedures. The compact and lightweight design enables the direct fixture of robot on the patient body and simultaneous needle targeting at multiple locations with several robots. Accurate (0.89 ± 0.31 mm) needle navigation is achieved by incorporating soft fluid-driven actuators with feedback control and stiffness modulation capabilities. The 3D location of the needle guide is reconfirmed by wireless MR tracking coils.  With the proposed workflow integrated with the system, the total procedure time is comparable to the MRI-guided radiofrequency ablation for hepatic malignancies.

High-performance Continuous Hydraulic Motor for MR Safe Robotic Teleoperation

[Video: High-performance Continuous Hydraulic Motor for MR Safe Robotic Teleoperation]

Magnetic resonance imaging (MRI)-guided intervention has drawn increasing attention over the last decade. It is accredited to the capability of monitoring any physiological change of soft tissue with the high-contrast MR images. This also gives rise to the demand for precise tele-manipulation of interventional instruments. However, there is still lack of choices of MR safe actuators that provide high-fidelity robot manipulation. In this project, we present a three-cylinder hydraulic motor using rolling-diaphragm-sealed cylinders, which can provide continuous bidirectional rotation with unlimited range. Both kinematics and dynamics models of the presented motor were studied, which facilitate its overall design optimization and position/torque control. Motor performance, such as step response, frequency response, and accuracy, were experimentally evaluated. We also integrate the motor into our catheter robot prototype designed for intra-operative MRI-guided cardiac electrophysiology (EP), which can provide full-degree-of-freedom and precise manipulation of a standard EP catheter.

MRI-guided Robot for Bilateral Stereotactic Neurosurgery

[Video: MRI-guided Robot for Bilateral Stereotactic Neurosurgery]

Stereotactic neurosurgery is a treatment to a variety of movement and neuropsychiatric disorders, such as Parkinson’s disease (PD), essential tremor and major depression. The operation still remains challenging due to its complicated workflow and high demand for surgical accuracy, which can be further complicated by deformation of intracranial contents, namely “brain shift”. These complications create an increasing need for intra-operative MRI-guided stereotaxy. Unlike fluoroscopy/CT, MRI can directly visualize the critical brain structures and targets of interest (e.g., the subthalamic nucleus (STN)). Currently, there are very limited choices of MR safe stereotactic systems. They generally require intensive manual adjustment of the stereotactic frame, and the patient to be transferred in-and-out of the scanner bore. This inevitably disrupts the normal surgical workflow. To this end, we have developed an intra-operative MRI-guided robot for bilateral stereotactic procedures. Its compact design enables robot’s operation within the constrained space of standard imaging head coil. MR-safe and high-performance hydraulic transmissions are incorporated, and wireless MR-based tracking coil units allow real-time positional feedback directly in MR image coordinates.

MRI-guided Robot for Intra-operative Cardiac Catheterization

[Video: MRI-guided Robot for Intra-operative Cardiac Catheterization]

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This robotic catheter platform intends to provide safe and effective electrophysiology (EP) intervention under the guidance of magnetic resonance imaging (MRI). In cardiac EP intervention, a long catheter (>1m) is delivered to the heart chamber where radiofrequency ablation (RFA) is performed to isolate the abnormal electrophysiological signals. The safety and effectiveness of EP intervention can be enhanced by providing high quality intra-operative MR images and MR-conditional robotic platform for effective catheterization. Currently, no existing commercial nor research prototype for robotic catheterization is MR-conditional. We develop the MR-conditional catheter robotic system for effective catheter manipulation that makes use of MR-safe/conditional actuation, intra-operative MRI techniques, real-time visual feedback and an advanced kinematics control method.

PUBLICATIONS

[1]  J. Dai, Z. He, G. Fang, X. Wang, Y. Li, C.L. Cheung, L. Liang, I.I. Iordachita, H.C. Chang, K.W. Kwok, “A Robotic Platform to Navigate MRI-guided Focused Ultrasound System”, IEEE Robotics and Automation Letters (RA-L), 6(3):5137-5144, 2021 Detail

[2] Z. He, Z. Dong, G. Fang, J.D.L. Ho, C.L. Cheung, H.C. Chang, C.N. Chong, Y.K. Chan, T.M. Chan, K.W. Kwok, “Design of a Percutaneous MRI-guided Needle Robot with Soft Fluid-driven Actuator,” IEEE Robotics and Automation Letters (RA-L), 5(2):2100-2107, 2020. Detail

[3]  Z. Dong, Z. Guo, K.H. Lee, G. Fang, W.L. Tang, H.C. Chang, D.T.M. Chan and K.W. Kwok,"High-performance Continuous Hydraulic Motor for MR Safe Robotic Teleoperation," IEEE Robotics and Automation Letters (RA-L) 4(2):1964-1971, 2019  Detail

[4]  Z. Guo, Z. Dong, K.H. Lee, C.L. Cheung, H.C. Fu, J.D.L. Ho, H. He, W.S. Poon, D.T.M. Chan, K.W. Kwok,"Compact Design of a Hydraulic Driving Robot for Intra-operative MRI-guided Bilateral Stereotactic Neurosurgery," IEEE Robotics and Automation Letters (RA-L), vol. 3, no. 3, pp. 2515-2522. 2018.  Detail

[5]  K.H. Lee, D.K.C. Fu, Z. Guo, Z. Dong, M.C.W. Leong, C.L. Cheung, A.P.W. Lee, K.W. Kwok,"MR Safe Robotic Manipulator for MRI-guided Intra-cardiac Catheterization," IEEE/ASME Transactions on Mechatronics (TMech), vol. 23, no. 2, pp. 586-595, 2018.   Detail

[6]  Z. Guo, T. L. T. Lun, Y. Chen, H. Su, D.T.M. Chan, K.W. Kwok,"Novel Design of an MR-safe Pneumatic Stepper Motor for MRI-guided Robotic Interventions," Proceedings of Hamlyn Symposium on Medical Robotics, 2016, pp. 50-51.  Detail

AWARDS

1.  Best Conference Paper Award in the IEEE International Conference on Robotics and Automation, 2018 (ICRA’18).
[The best out of 2,539 papers accepted by this top leading conference in robotics]
Authors and title: Z. Guo, Z. Dong, K.H. Lee, C.L. Cheung, H.C. Fu, J.D.L. Ho, H. He, W.S. Poon, D.T.M. Chan, K.W. Kwok, "Compact Design of a Hydraulic Driving Robot for Intra-operative MRI-guided Bilateral Stereotactic Neurosurgery."

2.  Finalist for ICRA Best Medical Robotics Paper Award in the IEEE International Conference on Robotics and Automation, 2018 (ICRA’18).
[sponsored by Intuitive Surgical Inc.]
Authors and title: Z. Guo, Z. Dong, K.H. Lee, C.L. Cheung, H.C. Fu, J.D.L. Ho, H. He, W.S. Poon, D.T.M. Chan, K.W. Kwok, "Compact Design of a Hydraulic Driving Robot for Intra-operative MRI-guided Bilateral Stereotactic Neurosurgery."

3.  Merit Poster Award in the IEEE International Conference on Robotics and Automation, 2017 (ICRA’17), presented by the workshop C4 Surgical Robots: Compliant, Continuum, Cognitive, and Collaborative.

Authors and title: Z. Dong, Z. Guo, K.C.D. Fu, K.H. Lee, M.C.W. Leong, C.L. Cheung, A.P.W. Lee, W. Luk and K.W. Kwok, "A Robotic Catheter System for MRI-guided Cardiac Electrophysiological Intervention."

4.  Best Live Demonstration prize – Surgical Robot Challenge 2016, organized by EPSRC UK-RAS Network.

Title: "MR-conditional Catheter Robot for MRI-guided Cardiac Electrophysiological Intervention."

PATENTS

1.  US Provisional Pat: “MRI Tracking Device Design, Fabrication, and Methods of use for MRI-Guided Robotic System”: US 62/640,798 (Filed on 9 Mar, 2018)

 

2.  US Provisional Pat: “Fluid Powered Master-Slave Actuation for MRI-Guided Interventions”: US 62/640,302 (Filed on 8 Mar, 2018)

 

3.  US Provisional Pat: “Robotic Stereotactic System for MRI-Guided Neurosurgery”: US 62/623,280 (Filed on 29 Jan, 2018)

 

4.  PCT Provisional Pat: Robotic Catheter System for MRI-guided Cardiovascular Interventions: PCT/CN2017/089701 (Filed on 2017. Licensed by APTUS Therapeutics Limited.)

 

5.  US Provisional Pat: Robotic Catheter System for MRI-guided Cardiovascular Interventions: 04435/005210-US0 (Filed on Jun 24, 2016. Licensed by APTUS Therapeutics Limited.)