Image guidance became a key element of modern medical interventions. MRI, in particular, has been investigated as percutaneous tool guidance for various cancer biopsy and focal therapies due to its superior soft tissue contrast and multi-parametric image processing capabilities to precisely localize target tissues. Prostate cancer, a major health concern in the US, has been one of the pioneering areas that can benefit from MRI guidance as the survival rate, when detected at local or regional stages, is nearly 100%. The use of MRI has increased cancer detection rate and enabled early focal treatments. Despite promising results, however, MRI guided prostate intervention has not been widely implemented in clinical practice due to technical complexity of such interventions. The major resistance caused by the complexity is lengthy procedure time. MRI guided prostate biopsy takes 2~3 hours whereas only around 0.5 hour is usually required for conventional ultrasound guided biopsy. The prolonged procedure is mainly due to intervention in-bore setup and repeat image registration. Through many years of hands-on experience on MRI guided prostate intervention developments and clinical trials, it has been realized that an MRI space including moving patient table is already fully digitized, hence, complex device-to-image registration processes can be eliminated. Along with simplification of hardware and increased MRI compatibility, overall procedure time can be significantly reduced to be comparable to ultrasound guided prostate interventions. The ultimate goal is to increase cancer survival rate by enhancing early detection and enabling curable focal therapy. The overall objective of this proposal is to develop and evaluate a compact registration-free 4-DOF robotic tool guide for MRI guided prostate intervention that can be performed less than an hour in a typical diagnostic MRI setup. Our approach to achieve the objective is to implement a novel manipulator mechanism that can compact the device providing more space for clinical access, and eliminate repeat device-to-image registration processes by affixing and kinematically tracking the device, which can dramatically simplify the procedure. The rationalized intervention and procedure could enable a one-stop definitive diagnosis that could replace the current prostate cancer practice of multiple hospital visits over months. In this R15 project, a team of multidisciplinary investigators and bio inspired engineering undergraduate students will design, develop, and test the proposed intervention between a robotics laboratory and MRI suite. Facilitating hands-on experience on benchtop developments and onsite experiments will strengthen biomedical research environment of the largest undergraduate centered university in the US and provide students with inspirations and more opportunities to gain biomedical research experience.
The proposed research has relevance to public health because MRI guided interventions increase cancer detection rate and provide early focal treatment opportunities before becoming lethal. The proposed compact registration-free robotic needle guide will simplify and shorten the procedure by utilizing MRI scanner?s well- defined space and co-robotic capability.
