Motion compensation for MRI-compatible patient-mounted needle guide device: estimation of targeting accuracy in MRI-guided kidney cryoablations

Abstract

Patient-mounted needle guide devices for percutaneous ablation are vulnerable to patient motion. The objective of this study is to develop and evaluate a software system for an MRI-compatible patient-mounted needle guide device that can adaptively compensate for displacement of the device due to patient motion using a novel image-based automatic device-to-image registration technique. We have developed a software system for an MRI-compatible patient-mounted needle guide device for percutaneous ablation. It features fully-automated image-based device-to-image registration to track the device position, and a device controller to adjust the needle trajectory to compensate for the displacement of the device. We performed: (a) a phantom study using a clinical MR scanner to evaluate registration performance; (b) simulations using intraoperative time-series MR data acquired in 20 clinical cases of MRI-guided renal cryoablations to assess its impact on motion compensation; and (c) a pilot clinical study in three patients to test its feasibility during the clinical procedure. FRE, TRE, and success rate of device-to-image registration were [Formula: see text] mm, [Formula: see text] mm, and 98.3% for the phantom images. The simulation study showed that the motion compensation reduced the targeting error for needle placement from 8.2 mm to 5.4 mm (p < 0.0005) in patients under general anesthesia (GA), and from 14.4 mm to 10.0 mm ([Formula: see text]) in patients under monitored anesthesia care (MAC). The pilot study showed that the software registered the device successfully in a clinical setting. Our simulation study demonstrated that the software system could significantly improve targeting accuracy in patients treated under both MAC and GA. Intraprocedural image-based device-to-image registration was feasible.

State of the Art and Future Opportunities in MRI-Guided Robot-Assisted Surgery and Interventions

“…Because dedicated supporting frames are not required, body-mounted robots must be compact, lightweight, and easily attachable to the patient body [92]. Body-mounted robotic systems have been used for MRIguided renal cancer interventions [97], abdominal interventions [98], [99], shoulder arthrography [100], [18], and lower back percutaneous [48] procedures.…”

Feasibility test of a sapphire cryoprobe with optical monitoring of tissue freezing

“…The process of tissue freezing requires continuous monitoring of the ice ball volume during cryoprobe application, aimed at complete freezing of the region of interest and preventing the damage of healthy adjacent tissues. Various approaches are applied for this purpose, including visualization by ultrasound (US) [21,28,29], magnetic resonance imaging (MRI) [30][31][32], computed tomography (CT) [16,[33][34][35], and temperature measurements [36,37]. While MRI and CT remain expensive and are quite hard to be integrated into surgical workflow, US is more available, but less accurate and needs additional US-sensor placed aside to the cryoprobe.…”

Fully Actuated Body-Mounted Robotic System for MRI-Guided Lower Back Pain Injections: Initial Phantom and Cadaver Studies

“…By contrast, because dedicated supporting bases or frames are not required, body-mounted robots can be designed with compact and lightweight structures. Body-mounted robots have been developed for MRI-guided cryoablation [16], renal cancer interventions [17], abdominal interventions [18], and liver ablation [19]. Although these body-mounted robots have shown promise, they are not designed to provide six actuated degrees of freedom.…”