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Charalampopoulos G, Bale R, Filippiadis D, Odisio BC, Wood B, Solbiati L. Navigation and Robotics in Interventional Oncology: Current Status and Future Roadmap. Diagnostics (Basel) 2023; 14:98. [PMID: 38201407 PMCID: PMC10795729 DOI: 10.3390/diagnostics14010098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/26/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
Interventional oncology (IO) is the field of Interventional Radiology that provides minimally invasive procedures under imaging guidance for the diagnosis and treatment of malignant tumors. Sophisticated devices can be utilized to increase standardization, accuracy, outcomes, and "repeatability" in performing percutaneous Interventional Oncology techniques. These technologies can reduce variability, reduce human error, and outperform human hand-to-eye coordination and spatial relations, thus potentially normalizing an otherwise broad diversity of IO techniques, impacting simulation, training, navigation, outcomes, and performance, as well as verification of desired minimum ablation margin or other measures of successful procedures. Stereotactic navigation and robotic systems may yield specific advantages, such as the potential to reduce procedure duration and ionizing radiation exposure during the procedure and, at the same time, increase accuracy. Enhanced accuracy, in turn, is linked to improved outcomes in many clinical scenarios. The present review focuses on the current role of percutaneous navigation systems and robotics in diagnostic and therapeutic Interventional Oncology procedures. The currently available alternatives are presented, including their potential impact on clinical practice as reflected in the peer-reviewed medical literature. A review of such data may inform wiser investment of time and resources toward the most impactful IR/IO applications of robotics and navigation to both standardize and address unmet clinical needs.
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Affiliation(s)
- Georgios Charalampopoulos
- 2nd Department of Radiology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str, 12462 Athens, Greece;
| | - Reto Bale
- Interventional Oncology/Stereotaxy and Robotics, Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Dimitrios Filippiadis
- 2nd Department of Radiology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str, 12462 Athens, Greece;
| | - Bruno C. Odisio
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Bradford Wood
- Interventional Radiology and Center for Interventional Oncology, NIH Clinical Center and National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Luigi Solbiati
- Department of Radiology, IRCCS Humanitas Research Hospital, Rozzano (Milano), Italy and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milano), 20072 Milano, Italy;
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Manjila S, Rosa B, Price K, Manjila R, Mencattelli M, Dupont PE. Robotic Instruments Inside the MRI Bore: Key Concepts and Evolving Paradigms in Imaging-enhanced Cranial Neurosurgery. World Neurosurg 2023; 176:127-139. [PMID: 36639101 DOI: 10.1016/j.wneu.2023.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/08/2023] [Indexed: 01/12/2023]
Abstract
Intraoperative MRI has been increasingly used to robotically deliver electrodes and catheters into the human brain using a linear trajectory with great clinical success. Current cranial MR guided robotics do not allow for continuous real-time imaging during the procedure because most surgical instruments are not MR-conditional. MRI guided robotic cranial surgery can achieve its full potential if all the traditional advantages of robotics (such as tremor-filtering, precision motion scaling, etc.) can be incorporated with the neurosurgeon physically present in the MRI bore or working remotely through controlled robotic arms. The technological limitations of design optimization, choice of sensing, kinematic modeling, physical constraints, and real-time control had hampered early developments in this emerging field, but continued research and development in these areas over time has granted neurosurgeons far greater confidence in using cranial robotic techniques. This article elucidates the role of MR-guided robotic procedures using clinical devices like NeuroBlate and Clearpoint that have several thousands of cases operated in a "linear cranial trajectory" and planned clinical trials, such as LAANTERN for MR guided robotics in cranial neurosurgery using LITT and MR-guided putaminal delivery of AAV2 GDNF in Parkinson's disease. The next logical improvisation would be a steerable curvilinear trajectory in cranial robotics with added DOFs and distal tip dexterity to the neurosurgical tools. Similarly, the novel concept of robotic actuators that are powered, imaged, and controlled by the MRI itself is discussed in this article, with its potential for seamless cranial neurosurgery.
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Affiliation(s)
- Sunil Manjila
- Department of Cardiovascular Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
| | - Benoit Rosa
- ICube Laboratory, UMR 7357 CNRS-University of Strasbourg, Strasbourg, France
| | - Karl Price
- Department of Cardiovascular Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Rehan Manjila
- Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Margherita Mencattelli
- Department of Cardiovascular Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Pierre E Dupont
- Department of Cardiovascular Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Limpabandhu C, Hu Y, Ren H, Song W, Ho Tse ZT. Magnetically steerable catheters: State of the art review. Proc Inst Mech Eng H 2023; 237:297-308. [PMID: 36704957 PMCID: PMC10052423 DOI: 10.1177/09544119221148799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Magnetically steerable catheters (MSCs) have caught the interest of researchers due to their various potential uses in clinical applications, for example, minimally invasive surgery. Many significant advances in the design, implementation and analysis of MSCs have been accomplished in the last decade. This review concentrates on the configurations of current MSCs with an in depth look at control of the device and the specific workspace. This review also evaluates MSCs and references possible future system designs and difficulties. The concept of magnetic manipulation is briefly presented. Then, by category, the MSC is introduced. Following that, a discussion of future works and challenges of the review systems is provided. The conclusions are finally addressed.
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Affiliation(s)
- Chayabhan Limpabandhu
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | - Yihua Hu
- Department of Electronic Engineering, University of York, York, UK
| | - Hongliang Ren
- Department of Electronic Engineering, University of York, York, UK
| | - Wenzhan Song
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong
| | - Zion Tsz Ho Tse
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
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Application of postmortem MRI for identification of medulla oblongata contusion as a cause of death: a case report. Int J Legal Med 2023; 137:115-121. [PMID: 36303078 DOI: 10.1007/s00414-022-02909-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 10/19/2022] [Indexed: 01/10/2023]
Abstract
Whiplash injury is common in traffic accidents, and severe whiplash is characterized by cervical spinal cord injuries with cervical dislocation or fracture, that can be diagnosed by postmortem computed tomography (PMCT), postmortem magnetic resonance (PMMR), or conventional autopsy. However, for cervical spinal cord injury without fracture and dislocation, PMMR can be more informative because it provides higher resolution of soft tissues. We report the case of a 29-year-old male who died immediately following a traffic accident, in which the vehicle hit an obstacle at a high speed, causing deformation of the bumper and severe damage of the vehicle body. PMCT indicated no significant injuries or diseases related to death, but PMMR showed patchy abnormal signals in the medulla oblongata, and the lower edge of the cerebellar tonsil was herniated out of the foramen magnum. The subsequent pathological and histological results confirmed that death was caused by medulla oblongata contusion combined with cerebellar tonsillar herniation. Our description of this case of a rare but fatal whiplash injury in which there was no fracture or dislocation provides a better understanding of the potentially fatal consequences of cervical spinal cord whiplash injury without fracture or dislocation and of the underlying lethal mechanisms. Compared with PMCT, PMMR provides important diagnostic information in forensic practice for the identification of soft tissue injuries, and is therefore an important imaging modality for diagnosis of whiplash injury when there is no fracture or dislocation.
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The diagnostic performance of 18F-FDG PET/CT in recurrent renal cell carcinoma: a systematic review and meta-analysis. Clin Transl Imaging 2022. [DOI: 10.1007/s40336-022-00533-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Lahoti HS, Jogdand SD. Bioimaging: Evolution, Significance, and Deficit. Cureus 2022; 14:e28923. [PMID: 36225412 PMCID: PMC9541884 DOI: 10.7759/cureus.28923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/08/2022] [Indexed: 12/02/2022] Open
Abstract
Bioimaging is a digital technology-based medical advancement which is still relatively new. It has to do with real-time visualization of biological processes. This innovative imaging technology combines anatomical structure with functional data such as electric and magnetic fields, motion which is mechanical, and metabolism to provide information on anatomical structure. It's a non-invasive procedure that gives you a bird's-eye view of the human body, with more depth and detail as you go. As a result, bioimaging is a strong tool for seeing the interior functioning of the organism and its disorders. Examples of bioimaging in the medical industry include X-ray and ultrasound pictures, MRI, 3D and 4D body images utilizing Computed Tomography (CT) scans, DEXA scans which is useful for assessing bone density in osteoporosis, and so on. Maximum-resolution, two-positive charge fluorescent excitation microscopy, fluorescence redistribution after photobleaching, and fluorescence resonance energy transfer are some of the recent advancements in biological imaging. It provides us a cellular-level means of obtaining photographs of the entire body, anatomical locations, organs, tissues, and biological indicators. It may be used to aid illness management and therapy, as well as to detect, diagnose, and characterize the problems in clinical settings.
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Vazquez F, Marrufo O, Solis-Najera SE, Martin R, Rodriguez AO. External Waveguide Magnetic Resonance Imaging for lower limbs at 3 T. Med Phys 2021; 49:158-168. [PMID: 34633673 DOI: 10.1002/mp.15281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION We report a method based on the travelling-wave MRI approach, in order to acquire images of human lower limbs with an external waveguide at 3 T. METHOD We use a parallel-plate waveguide and an RF surface coil for reception, while a whole-body birdcage is used for transmission. The waveguide and the surface coil are located right outside the magnet, in the MR conditional devices zone. We ran numerical simulations to investigate the B1 field generated by the surface coil located at one of the waveguides, as well as a saline-solution phantom positioned on the opposite side (150 cm away) inside the magnet. RESULTS We obtained phantom images by varying the distance between the coil and the phantom, in order to investigate the signal-to-noise ratio and to validate our numerical simulations. Lower limb images of a healthy volunteer were also acquired, demonstrating the viability of this approach. Standard pulse sequences were used and no physical modifications were made to the MR imager. CONCLUSIONS These numerical and experimental results show that travelling-wave MRI can produce high-quality images with only a simple waveguide and an RF coil located outside the magnet. This can be particularly favorable when acquiring images of lower limbs requiring a larger field of view.
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Affiliation(s)
- F Vazquez
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - O Marrufo
- Department of Neuroimage, Instituto Nacional de Neurologia y Neurocirugia MVS, Mexico City, 14269, Mexico
| | - S E Solis-Najera
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - R Martin
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - A O Rodriguez
- Department of Electrical Engineering, Universidad Autonoma Metropolitama Iztapalapa, Mexico City, 09340, Mexico
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