Tissue elasticity is universally recognized as a diagnostic and prognostic biomarker for prostate cancer. As the first diagnostic test, the digital rectal examination is used since malignancy changes the prostate morphology and affects its mechanical properties. Currently, this examination is performed manually by the physician, with an unsatisfactory positive predictive value of 42%. A more objective and spatially selective technique is expected to provide a better prediction degree and understanding of the disease. To this aim, here we propose a miniaturized probe, based on optical fiber sensor technology, for mechanical characterization of the prostate with sub-millimeter resolution. Specifically, the optical system incorporates a customized Fiber Bragg Grating, judiciously integrated in a metallic cannula and moved by a robotic arm. The probe enables the local measurement of the force upon tissue indentation with a resolution of 0.97 mN. The system has been developed in such a way to be potentially used directly in vivo. Measurements performed on phantom tissues mimicking different stages of the prostatic carcinoma demonstrated the capability of our device to distinguish healthy from diseased zones of the prostate. The study on phantoms has been complemented with preliminary ex vivo experiments on real organs obtained from radical surgeries. Our findings lay the foundation for the development of advanced optical probes that, when integrated inside biopsy needle, are able to perform in vivo direct mechanical measurements with high sensitivity and spatial resolution, opening to new scenarios for early diagnosis and enhanced diagnostic accuracy of prostate cancer.
Modern robots act in dynamic and partially unknown environments where path replanning can be mandatory if changes in the environment are observed. Task-prioritized control strategies are well known and effective solutions to ensure local adaptation of robot behaviour. The highest priority in a stack of tasks is typically given to the management of correct robot operation or safe interaction with the environment such as obstacles or joint limits avoidance, that we can consider as constraints. If a constraint makes impossible achieving a certain task, such as tracking a Cartesian trajectory, a local control algorithm partially sacrifices the latter which is only accomplished to the best of the robot's ability to generate internal motions. In this control framework, problems may occur in some applications, like in the surgical domain, where it is not safe that some tasks are simply sacrificed without prior notice. The contribution of this work is to introduce a coordinate invariant index, that is used to provide a geometrical interpretation of task conflicts in a task-priority control framework and to develop a method for on-line detection of algorithmic singularities, with the goal of increasing safety and performances during robot operations.
Despite technological progress in instrumental diagnostic investigations of the last decade, prostate cancer remains one of the most frequent malignant tumors and the second leading cause of cancer death among men. Although prostate biopsy remains the reference among all diagnosis procedures, it still exposes patients to the risk of developing complications. In this paper, the authors present a novel robotic system for prostate cancer diagnosis aimed at improving the current diagnostic procedures and reducing their undesired effects. The purpose of this work is to validate the proposed methodology by considering experimental analysis on both phantom and ex-vivo prostate tissues.
We developed a miniaturized optical probe, based on a customized Fiber Bragg Grating, for mechanical characterization of biological tissues with sub-millimeter spatial resolution. The probe is integrated inside a metallic cannula (16 gauge) used for clinical applications, and it is driven by a robotic arm (KUKA LBR Med 7). The optical sensor has a resolution of less than 1 mN and measures the force on controlled tissue indentations. The functionality of the sensor was assessed by means of different tests carried out on real prostates obtained from radically surgeries of patients at different stages of the carcinoma (Gleason score from 6 to 8). Specifically, in this work, we demonstrate that our system provides results that are on line with to the biopsy analysis performed before and the surgery. Our findings lay the foundation for the development of compact optical fiber probes, with size compatible with needle/catheter, able to perform in vivo mechanical characterizations of the prostatic tissue with high sensitivity and spatial resolution.
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