Linear actuation is a basic need in robotized manipulation of surgical instruments, that must comply with a challenging environment in terms of safety, compactness and now often compatibility with imaging modalities like CT or MRI. In this paper, we focus on needle manipulation for interventional radiology. We propose a needle driver, i.e. a linear actuator for needle insertion, based on the inchworm principle combined with pneumatic energy. Our first contribution is to propose, model and implement the device using a so-called auxetic structure. Its use increases achievable displacement under pressure and provides sufficient off-axis stiffness to use the actuator without additional guidance. Simplified modeling is introduced for the actuator synthesis. Our second contribution is to implement the actuator with multimaterial additive manufacturing combining rigid and flexible materials to increase compactness. As a third contribution, initial assessment of component sterilization and compatibility with X-ray and MRI imaging modalities is presented.
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Objective: Realistic tissue-mimicking phantoms are essential for the development, the investigation and the calibration of medical imaging techniques and protocols. Because it requires taking both mechanical and imaging properties into account, the development of robust, calibrated phantoms is a major challenge in elastography. Soft polyvinyl chloride gels in a liquid plasticizer (plastisol or PVCP) have been proposed as soft tissue-mimicking phantoms (TMP) for elasticity imaging. PVCP phantoms are relatively low-cost and can be easily stored over long time periods without any specific requirements. In this work, the preparation of a PVCP gel phantom for both MR and ultrasound-elastography is proposed and its acoustic, NMR and mechanical properties are studied.Materials and methods: The acoustic and magnetic resonance imaging properties of PVCP are measured for different mass ratios between ultrasound speckle particles and PVCP solution, and between resin and plasticizer. The linear mechanical properties of plastisol samples are then investigated over time using not only indentation tests, but also MR and ultrasound-elastography clinical protocols. These properties are compared to typical values reported for biological soft tissues and to the values found in the literature for PVCP gels.Results and conclusions: After a period of two weeks, the mechanical properties of the plastisol samples measured with indentation testing are stable for at least the following 4 weeks (end of follow-up period 43 days after gelation-fusion). Neither the mechanical nor the NMR properties of plastisol gels were found to be affected by the addition of cellulose as acoustic speckle. Mechanical properties of the proposed gels were successfully characterized by clinical, commercially-available MR Elastography and sonoelastography protocols. PVCP with a mass ratio of ultrasound speckle particles of 0.6%–0.8% and a mass ratio between resin and plasticizer between 50 and 70% appears as a good TMP candidate that can be used with both MR and ultrasound-based elastography methods.
Magnetic Resonance (MR) Imaging-guided High Intensity focused Ultrasound (MRgHIFU) is a non-invasive, non-ionizing thermal ablation therapy that is particularly interesting for the palliative or curative treatment of musculoskeletal tumors. We introduce a new modular MRgHIFU device that allows the ultrasound transducer to be positioned precisely and interactively over the body part to be treated. A flexible, MR-compatible supporting structure allows free positioning of the transducer under MRI/optical fusion imaging guidance. The same structure can be rigidified using pneumatic depression, holding the transducer rigidly in place. Targeting accuracy was first evaluated in vitro. The average targeting error of the complete process was found to be equal to 5.4 ± 2.2 mm in terms of focus position, and 4.7° ± 2° in terms of transducer orientation. First-in-man feasibility is demonstrated on a patient suffering from important, uncontrolled pain from a bone metastasis located in the forearm. The 81 × 47 × 34 mm3 lesion was successfully treated using five successive positions of the transducer, under real-time monitoring by MR Thermometry. Significant pain palliation was observed 3 days after the intervention. The system described and characterized in this study is a particularly interesting modular, low-cost MRgHIFU device for musculoskeletal tumor therapy.
This paper presents a method for manufacturing a soft pneumatic linear actuator. The linear actuator is based on a deformable chamber reinforced by a cylindrical auxetic structure. The objective of this work is to create a hermetic silicone chamber inside the auxetic structure previously machined in PVC. The manufacturing process is based on 3D silicone printing using an anthropomorphic robotic arm. The proposed strategy increases the versatility of the process compared to overmolding strategies, especially in regard to the dimensions of the actuator. In this paper we present an experimental setup integrating a robotic arm, the system for the registration of the different elements and the control of the print head trajectories. The actuator has been designed, built and implemented, allowing us to evaluate its performances and life span.
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