Design and validation of an MR‐conditional robot for transcranial focused ultrasound surgery in infants

Price, Karl; Sin, Vivian; Mougenot, Charles; Pichardo, Samuel; Looi, Thomas; Waspe, Adam C.; Drake, James M.

doi:10.1118/1.4955174

Cited by 13 publications

(26 citation statements)

References 31 publications

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“…MR conditional is a device that has been demonstrated to pose no known hazards in a specified MR environment with specified conditions of use such as field strength. MR conditional devices include the pneumatic stepper motor of Chen et al [21] and the prototype robot for transcranial focused ultrasound surgery of Price et al [22]. MR safe devices include the prostate biopsy robots from Stoianovici et al [9], [10] and Schouten et al [23].…”

Section: Section 2: Related Workmentioning

confidence: 99%

Robotically Assisted Long Bone Biopsy Under MRI Imaging

et al. 2018

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Section: Section 2: Related Workmentioning

confidence: 99%

Robotically Assisted Long Bone Biopsy Under MRI Imaging

et al. 2018

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“…The needle tip was commanded to puncture these targets, and the error was estimated by the distance from the centre of each target to the corresponding pierced hole 8 . Similarly, in the framework of evaluating the motion accuracy of a robot intended for transcranial focussed ultrasound (FUS) surgery, the FUS transducer was replaced by a felt‐tipped pen, which was commanded to touch multiple resolution points distributed on three perpendicular planes demonstrating the entire robot's workplace 9 . Each created mark was assigned in resolution circles having radial and angular approximation zones for facilitating targeting error measurement 9 .…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, in the framework of evaluating the motion accuracy of a robot intended for transcranial focussed ultrasound (FUS) surgery, the FUS transducer was replaced by a felt‐tipped pen, which was commanded to touch multiple resolution points distributed on three perpendicular planes demonstrating the entire robot's workplace 9 . Each created mark was assigned in resolution circles having radial and angular approximation zones for facilitating targeting error measurement 9 . Another simplified method involves mounting digital callipers on the motion stages of a robot such that their actual displacement after motion execution can be directly measured by the incremental distance of the calliper 10,11 …”

Section: Introductionmentioning

confidence: 99%

“…An MR conditional robot for transcranial FUS interventions was used to perform multiple sonications in a 2 × 3 pattern in a heat‐sensitive gel phantom located in a water tank. The thermal images acquired after each sonication were superimposed onto one image, and the positioning accuracy was defined as the spacing between the centres of adjacent ablated areas 9 . This technique was also selected for evaluating the accuracy of motion of an MR‐compatible FUS device intended for brain diseases treatment 17 .…”

Section: Introductionmentioning

confidence: 99%

“…Price et al. 9 followed a similar approach but in an MRI setting. An MR conditional robot for transcranial FUS interventions was used to perform multiple sonications in a 2 × 3 pattern in a heat‐sensitive gel phantom located in a water tank.…”

Section: Introductionmentioning

confidence: 99%

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Simple methods to test the accuracy of MRgFUS robotic systems

Antoniou

Drakos

Giannakou

et al. 2021

Robotics Computer Surgery

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Background Robotic‐assisted diagnostic and therapeutic modalities require a highly accurate performance to be certified for clinical application. In this paper, three simple methods for assessing the accuracy of motion of magnetic resonance‐guided focused ultrasound (MRgFUS) robotic systems are presented. Methods The accuracy of motion of a 4 degrees of freedom robotic system intended for preclinical use of MRgFUS was evaluated by calliper‐based and magnetic resonance imaging (MRI) methods, as well as visually by performing multiple ablations on a plastic film. Results The benchtop results confirmed a highly accurate motion in all axes of operation. The spatial positioning errors estimated by MRI evaluation were defined by the size of the imaging pixels. Lesions arrangement in discrete and overlapping patterns confirmed satisfactory alignment of motion trajectories. Conclusions We believe the methods presented here should serve as a standard for evaluating the accuracy of motion of MRgFUS robotic systems.

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A Review of the Current Therapies, Challenges, and Future Directions of Transcranial Focused Ultrasound Technology

2018

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right-handed woman in her 90s presented with essential tremor involving bilateral arms, head, and voice. The tremors started 15 years ago and progressively became disabling. She had failed propranolol hydrochloride, primidone, and gabapentin, but she had an unremarkable medical history otherwise. Her examination revealed considerable symmetric tremor, with a Clinical Rating Scale for Tremor (score range: 0-132, with the highest score indicating severe tremor) score of 88 and scores of 38 in subscale A (at rest, posture, and action), 26 in subscale B (drawing spiral, handwriting), 24 in subscale C (quality-of-life), and 26 in subscales A and B (right-side tremor). The remainder of the neurological examina-tion results were unremarkable. Preoperative magnetic resonance imaging (MRI) revealed periventricular white-matter changes and mild age-related diffuse atrophy.After a multidisciplinary evaluation, she was not recommended for ventral intermediate nucleus (VIM) deep brain stimulation (DBS) due to her advanced age. Instead, she was offered focused ultrasound (FUS) thalamotomy. Computed tomography imaging determined that her skull was suitable for ultrasonographic treatment; her skull homogeneity was greater than 0.4, as calculated by skull density ratio (SDR, which is the median ratio of skull density between cortical and trabecular bone; higher SDR IMPORTANCE Magnetic resonance imaging-guided focused ultrasound ablation has been approved for the treatment of refractory essential tremor and is being studied for other neurological indications, including dyskinesias and tremor in Parkinson disease, dystonia, neuropathic pain, obsessive-compulsive disorder, epilepsy, and brain tumors. OBJECTIVE To review the scientific foundations of FUS technology, existing neurological applications, and future advances.EVIDENCE REVIEW PubMed was searched for the past 10 years using the terms "transcranial ultrasound," "focused ultrasound," and "neurological applications." Relevant references were selected from the author's reference collection. From the 2855 unique records, 243 publications were screened. After excluding abstracts detailing in vitro studies or non-neurological applications, 86 full texts were retrieved for qualitative review.FINDINGS Advances in the transducer design and electronic phase correction have allowed efficient focusing of ultrasounds for transcranial treatment. The mid-frequency (650 kHz) transducer can make small (4-6 mm in diameter) and precise (accuracy of <2 mm) brain lesions. The treatment monitoring is achieved via "live" anatomical thermography imaging and clinical feedback. The initial results from its clinical application in movement disorders are encouraging. Emerging applications in epilepsy and neurobehavioral and cognitive disorders are being explored. The low-frequency (220 kHz) transducer coupled with microbubbles can potentially enable targeted drug delivery for novel applications, such as Alzheimer disease and brain tumors. Finally, neuromodulation with subthreshold sonications may allow...

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Design and validation of an MR‐conditional robot for transcranial focused ultrasound surgery in infants

Cited by 13 publications

References 31 publications

Robotically Assisted Long Bone Biopsy Under MRI Imaging

Robotically Assisted Long Bone Biopsy Under MRI Imaging

Simple methods to test the accuracy of MRgFUS robotic systems

A Review of the Current Therapies, Challenges, and Future Directions of Transcranial Focused Ultrasound Technology

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