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\n  \n article\n \n \n (2)\n \n \n
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\n \n\n \n \n \n \n \n \n Robotic Assisted MRI-guided interventional interstitial MR-guided focused ultrasound ablation in a swine model.\n \n \n \n \n\n\n \n MacDonell, J.; Patel, N.; Fischer, G.; Burdette, E. C.; Qian, J.; Chumbalkar, V.; Ghoshal, G.; Heffter, T.; Williams, E.; Gounis, M.; King, R.; Thibodeau, J.; Bogdanov, G.; Brooks, O. W.; Langan, E.; Hwang, R.; and Pilitsis, J. G.\n\n\n \n\n\n\n Neurosurgery, 84(5): 1138–1147. 2019.\n \n\n\n\n
\n\n\n\n \n \n \"RoboticPaper\n  \n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n  \n \n 5 downloads\n \n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{macdonell2018robotic,\nabstract = {Background: Ablative lesions are current treatments for epilepsy and brain tumors. Interstitial magnetic resonance (MR) guided focused ultrasound (iMRgFUS) may be an alternate ablation technique which limits thermal tissue charring as compared to laser therapy (LITT) and can produce larger ablation patterns nearer the surface than transcranial MR guided focused ultrasound (tcMRgFUS). Objective: To describe our experience with interstitial focused ultrasound (iFUS) ablations in swine, using MR-guided robotically assisted (MRgRA) delivery. Methods: In an initial 3 animals, we optimized the workflow of the robot in the MR suite and made modifications to the robotic arm to allow range of motion. Then, 6 farm pigs (4 acute, 2 survival) underwent 7 iMRgFUS ablations using MRgRA. We altered dosing to explore differences between thermal dosing in brain as compared to other tissues. Imaging was compared to gross examination. Results: Our work culminated in adjustments to the MRgRA, iMRgFUS probes, and dosing, culminating in 2 survival surgeries; swine had ablations with no neurological sequelae at 2 wk postprocedure. Immediately following iMRgFUS therapy, diffusionweighted imaging, and T1 weighted MR were accurate reflections of the ablation volume. T2 and fluid-attenuated inversion-recovery (FLAIR) images were accurate reflections of ablation volume 1-wk postprocedure. Conclusion:We successfully performedMRgRA iFUS ablation in swine and found intraoperative and postoperative imaging to correlate with histological examination. These data are useful to validate our system and to guide imaging follow-up for thermal ablation lesions in brain tissue from our therapy, tcMRgFUS, and LITT.},\nauthor = {MacDonell, Jacquelyn and Patel, Niravkumar and Fischer, Gregory and Burdette, E. Clif and Qian, Jiang and Chumbalkar, Vaibhav and Ghoshal, Goutam and Heffter, Tamas and Williams, Emery and Gounis, Matthew and King, Robert and Thibodeau, Juliette and Bogdanov, Gene and Brooks, Olivia W. and Langan, Erin and Hwang, Roy and Pilitsis, Julie G.},\ndoi = {10.1093/neuros/nyy266},\nissn = {15244040},\njournal = {Neurosurgery},\nkeywords = {Brain tumor,High intensity focused ultrasound,Interstitial focused ultrasound,MRI-Guided,Neural ablation,Robot assisted surgery},\nnumber = {5},\npages = {1138--1147},\npmid = {29905844},\ntitle = {{Robotic Assisted MRI-guided interventional interstitial MR-guided focused ultrasound ablation in a swine model}},\nurl = {https://doi.org/10.1093/neuros/nyy266},\nvolume = {84},\nyear = {2019}\n}\n
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\n Background: Ablative lesions are current treatments for epilepsy and brain tumors. Interstitial magnetic resonance (MR) guided focused ultrasound (iMRgFUS) may be an alternate ablation technique which limits thermal tissue charring as compared to laser therapy (LITT) and can produce larger ablation patterns nearer the surface than transcranial MR guided focused ultrasound (tcMRgFUS). Objective: To describe our experience with interstitial focused ultrasound (iFUS) ablations in swine, using MR-guided robotically assisted (MRgRA) delivery. Methods: In an initial 3 animals, we optimized the workflow of the robot in the MR suite and made modifications to the robotic arm to allow range of motion. Then, 6 farm pigs (4 acute, 2 survival) underwent 7 iMRgFUS ablations using MRgRA. We altered dosing to explore differences between thermal dosing in brain as compared to other tissues. Imaging was compared to gross examination. Results: Our work culminated in adjustments to the MRgRA, iMRgFUS probes, and dosing, culminating in 2 survival surgeries; swine had ablations with no neurological sequelae at 2 wk postprocedure. Immediately following iMRgFUS therapy, diffusionweighted imaging, and T1 weighted MR were accurate reflections of the ablation volume. T2 and fluid-attenuated inversion-recovery (FLAIR) images were accurate reflections of ablation volume 1-wk postprocedure. Conclusion:We successfully performedMRgRA iFUS ablation in swine and found intraoperative and postoperative imaging to correlate with histological examination. These data are useful to validate our system and to guide imaging follow-up for thermal ablation lesions in brain tissue from our therapy, tcMRgFUS, and LITT.\n
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\n \n\n \n \n \n \n \n \n Magnetic resonance-guided interstitial high-intensity focused ultrasound for brain tumor ablation.\n \n \n \n \n\n\n \n MacDonell, J.; Patel, N.; Rubino, S.; Ghoshal, G.; Fischer, G.; Clif Burdette, E.; Hwang, R.; and Pilitsis, J. G.\n\n\n \n\n\n\n Neurosurgical Focus, 44(2): E11. 2018.\n \n\n\n\n
\n\n\n\n \n \n \"MagneticPaper\n  \n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{macdonell2018magnetic,\nabstract = {Currently, treatment of brain tumors is limited to resection, chemotherapy, and radiotherapy. Thermal ablation has been recently explored. High-intensity focused ultrasound (HIFU) is being explored as an alternative. Specifically, the authors propose delivering HIFU internally to the tumor with an MRI-guided robotic assistant (MRgRA). The advantage of the authors' interstitial device over external MRI-guided HIFU (MRgHIFU) is that it allows for conformal, precise ablation and concurrent tissue sampling. The authors describe their workflow for MRgRA HIFU delivery.},\nauthor = {MacDonell, Jacquelyn and Patel, Niravkumar and Rubino, Sebastian and Ghoshal, Goutam and Fischer, Gregory and {Clif Burdette}, E. and Hwang, Roy and Pilitsis, Julie G.},\ndoi = {10.3171/2017.11.FOCUS17613},\nissn = {10920684},\njournal = {Neurosurgical Focus},\nkeywords = {Brain tumor,High-intensity focused ultrasound,MRI guided,Neural ablation},\nnumber = {2},\npages = {E11},\npmid = {29385926},\npublisher = {American Association of Neurological Surgeons},\ntitle = {{Magnetic resonance-guided interstitial high-intensity focused ultrasound for brain tumor ablation}},\nurl = {https://doi.org/10.3171/2017.11.FOCUS17613},\nvolume = {44},\nyear = {2018}\n}\n
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\n Currently, treatment of brain tumors is limited to resection, chemotherapy, and radiotherapy. Thermal ablation has been recently explored. High-intensity focused ultrasound (HIFU) is being explored as an alternative. Specifically, the authors propose delivering HIFU internally to the tumor with an MRI-guided robotic assistant (MRgRA). The advantage of the authors' interstitial device over external MRI-guided HIFU (MRgHIFU) is that it allows for conformal, precise ablation and concurrent tissue sampling. The authors describe their workflow for MRgRA HIFU delivery.\n
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\n  \n inproceedings\n \n \n (2)\n \n \n
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\n \n\n \n \n \n \n \n \n Mechanical validation of an MRI compatible stereotactic neurosurgery robot in preparation for pre-clinical trials.\n \n \n \n \n\n\n \n Nycz, C. J.; Gondokaryono, R.; Carvalho, P.; Patel, N.; Wartenberg, M.; Pilitsis, J. G.; and Fischer, G. S.\n\n\n \n\n\n\n In IEEE International Conference on Intelligent Robots and Systems, volume 2017-Septe, pages 1677–1684, 2017. IEEE\n \n\n\n\n
\n\n\n\n \n \n \"MechanicalPaper\n  \n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n\n\n\n
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@inproceedings{nycz2017mechanical,\nabstract = {The use of magnetic resonance imaging (MRI) for guiding robotic surgical devices has shown great potential for performing precisely targeted and controlled interventions. To fully realize these benefits, devices must work safely within the tight confines of the MRI bore without negatively impacting image quality. Here we expand on previous work exploring MRI guided robots for neural interventions by presenting the mechanical design and assessment of a device for positioning, orienting, and inserting an interstitial ultrasound-based ablation probe. From our previous work we have added a 2 degree of freedom (DOF) needle driver for use with the aforementioned probe, revised the mechanical design to improve strength and function, and performed an evaluation of the mechanism's accuracy and effect on MR image quality. The result of this work is a 7-DOF MRI robot capable of positioning a needle tip and orienting it's axis with accuracy of 1.37 ± 0.06mm and 0.79° ± 0.41°, inserting it along it's axis with an accuracy of 0.06 ± 0.07mm, and rotating it about it's axis to an accuracy of 0.77° ± 1.31°. This was accomplished with no significant reduction in SNR caused by the robot's presence in the MRI bore, < 10.3% reduction in SNR from running the robot's motors during a scan, and no visible paramagnetic artifacts.},\nauthor = {Nycz, Christopher J. and Gondokaryono, Radian and Carvalho, Paulo and Patel, Nirav and Wartenberg, Marek and Pilitsis, Julie G. and Fischer, Gregory S.},\nbooktitle = {IEEE International Conference on Intelligent Robots and Systems},\ndoi = {10.1109/IROS.2017.8205979},\nisbn = {9781538626825},\nissn = {21530866},\norganization = {IEEE},\npages = {1677--1684},\ntitle = {{Mechanical validation of an MRI compatible stereotactic neurosurgery robot in preparation for pre-clinical trials}},\nurl = {https://doi.org/10.1109/IROS.2017.8205979},\nvolume = {2017-Septe},\nyear = {2017}\n}\n
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\n The use of magnetic resonance imaging (MRI) for guiding robotic surgical devices has shown great potential for performing precisely targeted and controlled interventions. To fully realize these benefits, devices must work safely within the tight confines of the MRI bore without negatively impacting image quality. Here we expand on previous work exploring MRI guided robots for neural interventions by presenting the mechanical design and assessment of a device for positioning, orienting, and inserting an interstitial ultrasound-based ablation probe. From our previous work we have added a 2 degree of freedom (DOF) needle driver for use with the aforementioned probe, revised the mechanical design to improve strength and function, and performed an evaluation of the mechanism's accuracy and effect on MR image quality. The result of this work is a 7-DOF MRI robot capable of positioning a needle tip and orienting it's axis with accuracy of 1.37 ± 0.06mm and 0.79° ± 0.41°, inserting it along it's axis with an accuracy of 0.06 ± 0.07mm, and rotating it about it's axis to an accuracy of 0.77° ± 1.31°. This was accomplished with no significant reduction in SNR caused by the robot's presence in the MRI bore, < 10.3% reduction in SNR from running the robot's motors during a scan, and no visible paramagnetic artifacts.\n
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\n \n\n \n \n \n \n \n \n Closed-loop asymmetric-tip needle steering under continuous intraoperative MRI guidance.\n \n \n \n \n\n\n \n Patel, N. A.; Van Katwijk, T.; Li, G.; Moreira, P.; Shang, W.; Misra, S.; and Fischer, G. S.\n\n\n \n\n\n\n In Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS, volume 2015-Novem, pages 4869–4874, 2015. IEEE\n \n\n\n\n
\n\n\n\n \n \n \"Closed-loopPaper\n  \n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n  \n \n 3 downloads\n \n \n\n \n \n \n \n \n \n \n\n  \n \n \n\n\n\n
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@inproceedings{patel2015closed,\nabstract = {Magnetic resonance imaging (MRI) provides excellent image contrast for various types of tissues, making it a suitable choice over other imaging modalities for various image-guided needle interventions. Furthermore, robot-assistance is maturing for surgical procedures such as percutaneous prostate and brain interventions. Although MRI-guided, robot-assisted needle interventions are approaching clinical usage, they are still typically open-loop in nature due to the lack of continuous intraoperative needle tracking. Closed-loop needle-based procedures can improve the accuracy of needle tip placement by correcting the needle trajectory during insertion. This paper proposes a system for robot-assisted, flexible asymmetric-tipped needle interventions under continuous intraoperative MRI guidance. A flexible needle's insertion depth and rotation angle are manipulated by an MRI-compatible robot in the bore of the MRI scanner during continuous multi-planar image acquisition to reach a desired target location. Experiments are performed on gelatin phantoms to assess the accuracy of needle placement into the target location. The system was able to successfully utilize live MR imaging to guide the path of the needle, and results show an average total targeting error of 2.5±0.47mm, with an average in-plane error of 2.09±0.33mm.},\nauthor = {Patel, Niravkumar A. and {Van Katwijk}, Tim and Li, Gang and Moreira, Pedro and Shang, Weijian and Misra, Sarthak and Fischer, Gregory S.},\nbooktitle = {Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS},\ndoi = {10.1109/EMBC.2015.7319484},\nisbn = {9781424492718},\nissn = {1557170X},\norganization = {IEEE},\npages = {4869--4874},\npmid = {26737384},\ntitle = {{Closed-loop asymmetric-tip needle steering under continuous intraoperative MRI guidance}},\nurl = {https://doi.org/10.1109/EMBC.2015.7319484},\nvolume = {2015-Novem},\nyear = {2015}\n}\n
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\n Magnetic resonance imaging (MRI) provides excellent image contrast for various types of tissues, making it a suitable choice over other imaging modalities for various image-guided needle interventions. Furthermore, robot-assistance is maturing for surgical procedures such as percutaneous prostate and brain interventions. Although MRI-guided, robot-assisted needle interventions are approaching clinical usage, they are still typically open-loop in nature due to the lack of continuous intraoperative needle tracking. Closed-loop needle-based procedures can improve the accuracy of needle tip placement by correcting the needle trajectory during insertion. This paper proposes a system for robot-assisted, flexible asymmetric-tipped needle interventions under continuous intraoperative MRI guidance. A flexible needle's insertion depth and rotation angle are manipulated by an MRI-compatible robot in the bore of the MRI scanner during continuous multi-planar image acquisition to reach a desired target location. Experiments are performed on gelatin phantoms to assess the accuracy of needle placement into the target location. The system was able to successfully utilize live MR imaging to guide the path of the needle, and results show an average total targeting error of 2.5±0.47mm, with an average in-plane error of 2.09±0.33mm.\n
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