Current diagnostic approaches of PCa using needle biopsies have suboptimal cancer detection rates and a significant risk of infection. Standard non-targeted random sampling results in false-negative biopsies in 15-30% of patients, which affects clinical management. RS, a non-destructive tissue interrogation technique providing vibrational molecular information, resolved the highly complex architecture of the prostate and detect cancer with high accuracy using a fibre optic probe to interrogate radical prostatectomy (RP) specimens from 32 patients (947 spectra). This proof-of-principle paves the way for the development of in vivo tumour targeting spectroscopy tools for informed biopsy collection to address the clinical need for accurate PCa diagnosis and possibly to improve surgical resection during RP as a complement to histopathological analysis.
This paper introduces a method for robotic steering of a flexible needle inside moving and deformable tissues. The method relies on a set of objective functions allowing to automatically steer the needle along a predefined path. In order to follow the desired trajectory, an inverse problem linking the motion of the robot end effector with the objective functions is solved using a Finite Element simulation. The main contribution of the article is the new constraint-based formulation of the objective functions allowing to: 1) significantly reduce the computation time; 2) increase the accuracy and stability of the simulation-guided needle insertion. The method is illustrated, and its performances are characterized in a realistic framework, using a direct simulation of the respiratory motion generated from in vivo data of a pig. Despite the highly non-linear behavior of the numerical simulation and the significant deformations occurring during the insertion, the obtained performances enable the possibility to follow the trajectory with the desired accuracy for medical purpose.
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