Development of a new tissue-equivalent material applied to optimizing surgical accuracy

A method for predicting needle insertion deflection in soft tissue based on cutting force identification

The deflection modeling during the insertion of bevel-tipped flexible needles into soft tissues is crucial for robot-assisted flexible needle insertion into specific target locations within the human body during percutaneous biopsy surgery. This paper proposes a mechanical model based on cutting force identification to predict the deflection of flexible needles in soft tissues. Unlike other models, this method does not require measuring Young's modulus (E ) and Poisson's ratio (ν ) of tissues, which require complex hardware to obtain. In the model, the needle puncture process is discretized into a series of uniform-depth puncture steps. The needle is simplified as a cantilever beam supported by a series of virtual springs, and the influence of tissue stiffness on needle deformation is represented by the spring stiffness coefficient of the virtual spring. By theoretical modeling and experimental parameter identification of cutting force, the spring stiffness coefficients are obtained, thereby modeling the deflection of the needle. To verify the accuracy of the proposed model, the predicted model results were compared with the deflection of the puncture experiment in polyvinyl alcohol (PVA) gel samples, and the average maximum error range predicted by the model was between 0.606 ± 0.167 mm and 1.005 ± 0.174 mm, which showed that the model can successfully predict the deflection of the needle. This work will contribute to the design of automatic control strategies for needles.

Development, evaluation, and overview of standardized training phantoms for abdominal ultrasound-guided interventions

PURPOSE

Ultrasound (US) represents the primary approach for abdominal diagnosis and is regularly used to guide diagnostic and therapeutic interventions (INVUS). Due to possible serious INVUS complications, structured training concepts are required. Phantoms can facilitate teaching, but their use is currently restricted by complex manufacturing and short durability of the materials. Hence, the aim of this study was the development and evaluation of an optimized abdominal INVUS phantom.

MATERIALS AND METHODS

Phantom requirements were defined in a structured research process: Skin-like surface texture, homogeneous matrix with realistic tissue properties, implementation of lesions and abscess cavities in different sizes and depths as well as a modular production process allowing for customized layouts. The phantom prototypes were evaluated in certified ultrasound courses.

RESULTS

In accordance with the defined specifications, a new type of matrix was developed and cast in multiple layers including different target materials. The phantom structure is based on features of liver anatomy and includes solid focal lesions, vessels, and abscess formations. For a realistic biopsy procedure, ultrasound-proof material was additionally included to imitate bone. The evaluation was performed by US novices (n=40) and experienced participants (n=41). The majority (73/81) confirmed realistic visualization of the lesions. The 3D impression was rated as "very good" in 64% of cases (52/81) and good in 31% (25/81). Overall, 86% (70/81) of the participants certified high clinical relevance of the phantom.

CONCLUSION

The presented INVUS phantom concept allows standardized and realistic training for interventions.

Modeling and Analysis of Prostate Soft Tissue Puncture Performance using Puncture Needle

When treating prostate cancer, the use of puncture robots is an effective method to perform radioactive seed implantation surgery. However, when the puncture needle enters the lesion, the soft tissue is easily deformed owing to the complex force between the puncture needle and soft tissue, which leads to a puncture deviation between the needle tip and target point. To solve this problem effectively, the prostate soft tissue puncture process is studied based on the analysis of the puncture needle–soft tissue interaction. First, the puncture force is classified into contact, friction, and cutting forces by a quantitative decomposition method, and the corresponding force model is established. Based on the theoretical analysis of the model, it is deduced that these factors can affect the deformation created by puncturing the soft tissue. Subsequently, a puncture platform is built and many biomimetic soft tissue models are established. Multiple puncture experiments on the influencing factors are conducted using the method of controlling a single variable. Using the spatial puncture deviation as the test metrics, the significance of the influencing factors of the puncture deformation is verified. Finally, it can be concluded from the experimental analysis that the main factor that affects the puncture deviation is the puncture speed, whereas the puncture depth has no significant influence. The puncture speed was optimized and verified by experiments, and the results showed that a stable puncture accuracy under different puncture depths can be obtained by selecting an optimized puncture speed (12.6 mm/s). This work provides a design reference to study the positioning accuracy of minimally invasive puncture surgery.

Influence of a Biocompatible Hydrophilic Needle Surface Coating on a Puncture Biopsy Process for Biomedical Applications

A puncture biopsy is a widely used, minimally invasive surgery process. During the needle insertion process, the needle body is always in direct contact with a biological soft tissue. Tissue adhesion and different degrees of tissue damage occur frequently. Optimization of the needle surface, and especially the lubrication of the needle surface, can deal with these problems efficiently. Therefore, in this paper, a biocompatible hydrophilic coating was applied onto the surface of a needle to improve the surface quality of the needle surface. Further, a simplified finite element model of insertion was established, and extracorporeal insertion experiments were used to verify the accuracy of the model. Then, by analyzing a simulation model of a coated needle and a conventional needle, the influence of the application of the coated needle on the insertion process was obtained. It can be seen from the results that the coating application relieved the force on the needle and the soft tissue during the insertion process and could significantly reduce friction during the insertion process. At the same time, the deformation of biological soft tissue was reduced, and the adhesion situation between the needle and tissue improved, which optimized the puncture needle.

Tissue mimicking materials in image-guided needle-based interventions: A review

Image-guided interventions are widely employed in clinical medicine, which brings significant revolution in healthcare in recent years. However, it is impossible for medical trainees to experience the image-guided interventions physically in patients due to the lack of certificated skills. Therefore, training phantoms, which are normally tissue mimicking materials, are widely used in medical research, training, and quality assurance. This review focuses on the tissue mimicking materials used in image-guided needle-based interventions. In this case, we need to investigate the microstructure characteristics and mechanical properties (for needle intervention), optical properties and acoustical properties (for imaging) of these training phantoms to compare with the related properties of human real tissues. The widely used base materials, additives and the corresponding concentrations of the training phantoms are summarized from the literatures in recent ten years. The microstructure characteristics, mechanical behavior, optical properties and acoustical properties of the tissue mimicking materials are investigated, accompanied with the common experimental methods, apparatus and theoretical algorithm. The influence of the concentrations of the base materials and additives on these characteristics are compared and classified. In this review, we assess a comprehensive overview of the existing techniques with the main accomplishments, and limitations as well as recommendations for tissue mimicking materials used in image-guided needle-based interventions.

Influence of processing parameters on the macroscopic mechanical behavior of PVA hydrogels

This paper investigates the influence of three different processing parameters on the global mechanical behavior of PVA (Polyvinyl alcohol)/DMSO (Dimethylsulfoxide) hydrogels: the initial concentration of PVA, the DMSO:H₂O ratio and the number of freeze/thaw cycle applied to the material. A specific thermo-regulated testing apparatus for hydrophilic materials is presented, along with the performed cyclic and rupture tests. The observed mechanical responses are explained by an in-depth analysis of the cross-linking phenomenon. Using the Neo-Hookean hyperelastic model, the experimental data is fitted and a link between the density of macro-molecular chains in the material and its mechanical behavior is established. Strong differences are observed and discussed.

Simulation and experiment of soft-tissue deformation in prostate brachytherapy

Soft-tissue deformation is one of the major reasons for the inaccurate positioning of percutaneous needle insertion process. In this article, simulations and experiments of the needle insertion soft-tissue process are both applied to study soft-tissue deformation. A needle deflection model based on the mechanics is used to calculate the needle deflection during the interaction process. The obtained needle deflection data are applied into finite element analysis process as the system input. The uniaxial tensile strength tests, compression tests, and static indentation experiments are used to obtain the soft-tissue parameters and choose the best strain-energy function to model in the simulation. Magnetic resonance imaging is used to reconstruct the prostate, establishing both prostate three-dimensional finite element model and artificial prostate model. The needle–soft tissue interaction simulation results are compared with those of the needle insertion experiment. The displacement data of the mark point in the experiment are comparable to the simulation results. It is concluded that, using this simulation method, the surgeon can predict the deformation of the tissue and the displacement of the target in advance.

STUDY OF THE TARGETING ERROR FOR PERCUTANEOUS NEEDLE INSERTION INTO SOFT PHANTOM MATERIAL

Percutaneous needle insertion is widely used in minimally invasive procedures, in which the flexible needle is steered to reach a specific target inside the human body. The targeting error is due to a combination of flexible needle deflection and target displacement in soft tissue and only a very limited number of studies have focused on both two factors. This paper presents a targeting error calculation method which incorporates an energy-based needle deflection model into a soft tissue finite-element (FE) model. The needle insertion process is discretized into several increments on the basis of the quasi-static method. Needle deflection in each step is obtained by the needle-soft tissue interaction model which is applied into the FE model as the displacement input. A 2D-planar FE model is used to model the target displacement by imposing needle distribution forces and needle deflection at different steps on the appointed reference nodes. The soft tissue is modeled as a non-linear hyperelastic material with geometrical non-linearity. Uniaxial tensile strength tests are utilized to determine the soft tissue parameters. Needle targeting experiments are conducted to validate the simulation results. Results show that the proposed method can predict the needle targeting errors while the averaged prediction error stays below 0.4[Formula: see text]mm. At last, we conduct different experiments to compensate the obtained targeting error and thus, reaching preferable effects.

Morphological and swelling behavior of cellulose nanofiber (CNF)/poly(vinyl alcohol) (PVA) hydrogels: poly(ethylene glycol) (PEG) as porogen

Novel interconnected PVA-based hydrogels with controlled porous structure prepared by freezing/thawing and porogen technique are presented in this study.

Evaluation of a ferrous benzoic xylenol orange transparent PVA cryogel radiochromic dosimeter

A stable cryogel dosimeter was prepared using ferrous benzoic xylenol orange (FBX) in a transparent poly-(vinyl alcohol) (PVA) cryogel matrix. Dose response was evaluated for different numbers of freeze-thaw cycles (FTCs), different concentrations of PVA, and ratios of water/dimethyl sulfoxide. Linear relationships between dose and absorbance were obtained in the range of 0-1000 cGy for all formulations. Increasing the concentration of PVA and number of FTCs resulted in increased absorbance and sensitivity. The effects of energy and dose rate were also evaluated. No significant dose rate dependence was observed over the range 1.05 to 6.33 Gy min(-1). No energy response was observed over photon energies of 6, 10, and 18 MV.