Electromagnetic navigation improves minimally invasive robot-assisted lung brachytherapy

Lin, Andy; Trejos, Ana Luisa; Mohan, S.; Bassan, H.; Kashigar, Aidin; Patel, Rajni V.; Malthaner, Richard

doi:10.3109/10929080801969725

Cited by 19 publications

(10 citation statements)

References 14 publications

(22 reference statements)

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“…Most studies were found on computer-assisted bronchoscopy, where the bronchoscope can be navigated through the bronchial tree by localizing the tip and registering preoperative data, for example CT to patient [94]. Laparoscopic interventions such as lung brachytherapy [96] or Radio Frequency Ablation (RFA) [56] also have been performed. In the case of otolaryngologic (ENT) surgery, endoscopes have been localized using EM tracking to apply navigation under US/CT guidance [41,184].…”

Section: A Range Of Applicationmentioning

confidence: 99%

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Franz

Haidegger

Birkfellner

et al. 2014

IEEE Trans. Med. Imaging

378

273

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Abstract-Object tracking is a key enabling technology in the context of computer-assisted medical interventions. Allowing the continuous localization of medical instruments and patient anatomy, it is a prerequisite for providing instrument guidance to subsurface anatomical structures. The only widely used technique that enables real-time tracking of small objects without lineof-sight restrictions is electromagnetic (EM) tracking. While EM tracking has been the subject of many research efforts, clinical applications have been slow to emerge. The aim of this review paper is therefore to provide insight into the future potential and limitations of EM tracking for medical use. We describe the basic working principles of EM tracking systems, list the main sources of error, and summarize the published studies on tracking accuracy, precision and robustness along with the corresponding validation protocols proposed. State-of-the-art approaches to error compensation are also reviewed in depth. Finally, an overview of the clinical applications addressed with EM tracking is given. Throughout the paper, we report not only on scientific progress, but also provide a review on commercial systems. Given the continuous debate on the applicability of EM tracking in medicine, this paper provides a timely overview of the state-of-the-art in the field.

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Section: A Range Of Applicationmentioning

confidence: 99%

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Franz

Haidegger

Birkfellner

et al. 2014

IEEE Trans. Med. Imaging

378

273

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“…The system incorporates an experimental setup for accurate seed placement with commercially available dosimetry planning software. 5,6,[96][97][98][99] The dosimetry planning software incorporated into MIRA-V (upgraded MIRA robot) is a modified version of previously developed software for needle guidance in prostate brachytherapy. The end result is a complete system that allows planning and executing a brachytherapy procedure with increased accuracy.…”

Section: B13 Mira Robot-an Ultrasound Image-guided Lung Brachythementioning

confidence: 99%

“…The end result is a complete system that allows planning and executing a brachytherapy procedure with increased accuracy. 5 Two Automated Endoscopic Systems for Optimal Positioning (AE-SOP) arms are used to control the video camera and the instrument via voice control and the InterNAV3.0™ interface, respectively. These robotic arms are no longer commercially available.…”

Section: B13 Mira Robot-an Ultrasound Image-guided Lung Brachythementioning

confidence: 99%

“…For example, one of the brachytherapy robots described in this report has been used for lung cancer, and clinical investigations are under consideration for other sites such as liver. [5][6][7][8] In the last decade, there have been significant increases in the use of robotic systems and automation tools in brachytherapy. Several groups have adapted and integrated such systems and tools into conventional brachytherapy procedures, with the shared goals of achieving higher precision and accuracy in seed placement, improving dose distributions, minimizing surgical trauma, and further reducing radiation exposure to staffs.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

AAPM and GEC‐ESTRO guidelines for image‐guided robotic brachytherapy: Report of Task Group 192

et al. 2014

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In the last decade, there have been significant developments into integration of robots and automation tools with brachytherapy delivery systems. These systems aim to improve the current paradigm by executing higher precision and accuracy in seed placement, improving calculation of optimal seed locations, minimizing surgical trauma, and reducing radiation exposure to medical staff. Most of the applications of this technology have been in the implantation of seeds in patients with early-stage prostate cancer. Nevertheless, the techniques apply to any clinical site where interstitial brachytherapy is appropriate. In consideration of the rapid developments in this area, the American Association of Physicists in Medicine (AAPM) commissioned Task Group 192 to review the state-of-the-art in the field of robotic interstitial brachytherapy. This is a joint Task Group with the Groupe Européen de Curiethérapie-European Society for Radiotherapy & Oncology (GEC-ESTRO). All developed and reported robotic brachytherapy systems were reviewed. Commissioning and quality assurance procedures for the safe and consistent use of these systems are also provided. Manual seed placement techniques with a rigid template have an estimated in vivo accuracy of 3-6 mm. In addition to the placement accuracy, factors such as tissue deformation, needle deviation, and edema may result in a delivered dose distribution that differs from the preimplant or intraoperative plan. However, real-time needle tracking and seed identification for dynamic updating of dosimetry may improve the quality of seed implantation. The AAPM and GEC-ESTRO recommend that robotic systems should demonstrate a spatial accuracy of seed placement ≤1.0 mm in a phantom. This recommendation is based on the current performance of existing robotic brachytherapy systems and propagation of uncertainties. During clinical commissioning, tests should be conducted to ensure that this level of accuracy is achieved. These tests should mimic the real operating procedure as closely as possible. Additional recommendations on robotic brachytherapy systems include display of the operational state; capability of manual override; documented policies for independent check and data verification; intuitive interface displaying the implantation plan and visualization of needle positions and seed locations relative to the target anatomy; needle insertion in a sequential order; robot-clinician and robot-patient interactions robustness, reliability, and safety while delivering the correct dose at the correct site for the correct patient; avoidance of excessive force on radioactive sources; delivery confirmation of the required number or position of seeds; incorporation of a collision avoidance system; system cleaning, decontamination, and sterilization procedures. These recommendations are applicable to end users and manufacturers of robotic brachytherapy systems. C 2014 American Association of Physicists in Medicine.[http://dx

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“…[13][14][15][16][17][18][19][20][21]33 Studies have indicated that the quality of images captured by robot-assisted remote ultrasound systems correlate well with those captured by conventional ultrasound. [34][35][36] Robot technology has been reported for assistance in the diagnosis and treatment of lung diseases previously, [37][38][39] but the application of a 5G-based robot-assisted remote ultrasound system for use in lung disorders has not been reported to date. 5G networks have a high data transmission rate (peak rate up to 20 Gbps) and low network delay (approximately 1-10 ms).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a 5G-Based Robot-Assisted Remote Ultrasound System for Cardiopulmonary Assessment of Patients With Coronavirus Disease 2019

Zhou

Shao

et al. 2021

Chest

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BACKGROUND: Traditional methods for cardiopulmonary assessment of patients with coronavirus disease 2019 (COVID-19) pose risks to both patients and examiners. This necessitates a remote examination of such patients without sacrificing information quality. RESEARCH QUESTION: The goal of this study was to assess the feasibility of a 5G-based robotassisted remote ultrasound system in examining patients with COVID-19 and to establish an examination protocol for telerobotic ultrasound scanning. STUDY DESIGN AND METHODS: Twenty-three patients with COVID-19 were included and divided into two groups. Twelve were nonsevere cases, and 11 were severe cases. All patients underwent a 5G-based robot-assisted remote ultrasound system examination of the lungs and heart following an established protocol. Distribution characteristics and morphology of the lung and surrounding tissue lesions, left ventricular ejection fraction, ventricular area ratio, pericardial effusion, and examination-related complications were recorded. Bilateral lung lesions were evaluated by using a lung ultrasound score. RESULTS: The remote ultrasound system successfully and safely performed cardiopulmonary examinations of all patients. Peripheral lung lesions were clearly evaluated. Severe cases of COVID-19 had significantly more diseased regions (median [interquartile range], 6.0 [2.0-11.0] vs 1.0 [0.0-2.8]) and higher lung ultrasound scores (12.0 [4.0-24.0] vs 2.0 [0.0-4.0]) than nonsevere cases of COVID-19 (both, P < .05). One nonsevere case (8.3%; 95% CI, 1.5-35.4) and three severe cases (27.3%; 95% CI, 9.7-56.6) were complicated by pleural effusions. Four severe cases (36.4%; 95% CI, 15.2-64.6) were complicated by pericardial effusions (vs 0% of nonsevere cases, P < .05). No patients had significant examination-related complications. INTERPRETATION: Use of the 5G-based robot-assisted remote ultrasound system is feasible and effectively obtains ultrasound characteristics for cardiopulmonary assessment of patients with COVID-19. By following established protocols and considering medical history, clinical manifestations, and laboratory markers, this system might help to evaluate the severity of COVID-19 remotely.

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Electromagnetic navigation improves minimally invasive robot-assisted lung brachytherapy

Abstract: A modified integrated system for performing minimally invasive robot-assisted lung brachytherapy was developed that incorporated electromagnetic navigation and an improved robotic controller. The MIRA IV system performed significantly better than standard VATS and better than MIRA III.

Cited by 19 publications

References 14 publications

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

AAPM and GEC‐ESTRO guidelines for image‐guided robotic brachytherapy: Report of Task Group 192

Feasibility of a 5G-Based Robot-Assisted Remote Ultrasound System for Cardiopulmonary Assessment of Patients With Coronavirus Disease 2019

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