The goal of this research project is to extend an existing robotic system to assist the physician in accurate computed tomography (CT) fluoroscopy-guided needle biopsy of lung nodules. The research will build on a two-year collaboration between the Imaging Science and Information Systems (ISIS) Center at Georgetown University and the Urology Robotics (URobotics) Laboratory at The Johns Hopkins Medical Institutions to develop a robotic system for precision needle placement near the spine. This is an innovative project to develop new techniques for accurate lung biopsy. The successful completion of the project will provide the physician with assistance in precision lung biopsy and enable experienced practitioners to biopsy difficult lesions more quickly and easily. It should also enable less experienced practitioners to successfully perform these procedures. The robotic system developed here will also be applicable to a wide variety of other clinical applications, both existing and newly emerging, such as precision biopsy of other organs, drug and gene therapy delivery, and vascular access. The use of CT for lung cancer screening is rapidly expanding. Percutaneous image-guided biopsy of the lung is a moderately difficult procedure with the potential for morbidity from pneumothorax and hemorrhage. For those nodules less than one cm in size, biopsy is more difficult, and there are a limited number of trained personnel who can perform them. We expect the increasing utilization of screening CT will result in a rapid growth in demand for image-guided percutaneous biopsy of these nodules. Therefore, improved methods for biopsy are important. The project consists of an R21 phase and an R33 phase. The goal of the R21 phase is to demonstrate the feasibility of using a joystick-controlled robotic system to accurately hit simulated lesions in a phantom under CT fluoroscopy guidance. A prototype gripper will be developed and tested on a custom-built respiring lung phantom model. This will also establish the feasibility of our approach for the R33 phase. The goal of the R33 phase is to develop an enhanced gripper along with a path planning capability and demonstrate this approach in phantom and animal studies, In the R33 phase, the gripper will be enhanced to incorporate a force sensing capability (automatic release of the needle if a certain force level is exceeded - a safety feature which is required for clinical application) and a rotating needle (to minimize the force needed for needle placement). We will also develop visualization software to provide the operating physician a three-dimensional (3D) image of the anatomy for path planning. The system will be validated in phantom and animal studies. The R33 phase will result in a system that is ready for clinical trials.
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