The objective of this proposal is to create and validate a minimally-invasive Magnetic Resonance (MR) - compatible concentric tube robot for Intracerebral Hemorrhage (ICH) evacuation. About 1 in 50 people suffer from ICH in their lifetime. ICH occurs when blood leaked from a ruptured vessel accumulates and forms a blood clot (hematoma) in the cerebrum. The 30-day mortality for ICH is about 40% with half of all deaths occurring in the acute phase, especially in the first 48 hours. Blood spilled outside of the intracranial vessels is toxic to surrounding neurons, causing inflammation and perihematomal edema seen as early as 12-24 hours after hemorrhage. These deleterious effects motivate emergent treatment to save at-risk brain tissue. We propose three specific aims as follows.
Specific Aim 1 : Create the Robot. We will optimize the current robot prototype design to construct a new, compact, and precise MRI-compatible robot to deploy the aspiration cannula within the MRI scanner. We will develop the robot path planning algorithm and embedded electronics to enable accurate robot control.
Specific Aim 2 : Enable Image Guidance. We will track the aspiration cannula in MRI space by integrating wireless MRI microcoils on the cannula. Real-time MRI will allow the surgeon to monitor the cannula position and hematoma-brain boundary during the procedure. We will create a navigation workstation to control the robot, enable treatment monitoring including diffusion tensor imaging, and provide a virtual boundary to enhance safety.
Specific Aim 3 : Experimental Validation. We will first characterize robot targeting accuracy and its path- following ability in the benchtop environment. We will then perform phantom studies in a 3T MRI scanner to evaluate system accuracy and optimize the navigation workstation. We will conclude with four sheep studies to evaluate the system with realistic tissue properties, perfusion, and other relevant biological effects. We will collect robot accuracy data, quantify hematoma evacuation percentage, and determine damage to healthy brain tissue.
Current treatment options for blood in the brain (intracerebral hemorrhage) are not optimal and overall success rates are not as high as desired. By developing an MR compatible robot, we aim to improve the treatment process and offer new options for these patients.
