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多斜面穿刺针设计可实现癌症诊断活检中的精准插入。

Multi-Bevel Needle Design Enabling Accurate Insertion in Biopsy for Cancer Diagnosis.

出版信息

IEEE Trans Biomed Eng. 2021 May;68(5):1477-1486. doi: 10.1109/TBME.2021.3054922. Epub 2021 Apr 22.


DOI:10.1109/TBME.2021.3054922
PMID:33507862
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8104469/
Abstract

OBJECTIVE: To obtain definitive cancer diagnosis for suspicious lesions, accurate needle deployment and adequate tissue sampling in needle biopsy are essential. However, the single-bevel needles in current biopsy devices often induce deflection during insertion, potentially causing lesion missampling/undersampling and cancer misdiagnosis. This study aims to reveal the biopsy needle design criteria enabling both low deflection and adequate tissue sampling. METHODS: A novel model capable of predicting needle deflection and tissue deformation was first established to understand needle-tissue interaction with different needle tip geometries. Experiments of needle deflection and ex-vivo tissue biopsy were conducted for model validation. RESULTS: The developed model showed a reasonably good prediction on the correlation of needle tip type vs. the resultant needle deflection and tissue sampling length. A new multi-bevel needle with the tissue separation point below the needle groove face has demonstrated to be an effective design with an 87% reduction in deflection magnitude and equivalently long tissue sampling length compared to the current single-bevel needle. CONCLUSION: This study has revealed two critical design criteria for biopsy needles: 1) multiple bevel faces at the needle tip can generate forces to balance bending moments during insertion to enable a low needle deflection and 2) the tissue separation point should be below the needle groove face to ensure long tissue sampling length. SIGNIFICANCE: The developed methodologies and findings in this study serve as proof-of-concept and can be utilized to investigate various biopsy procedures to improve cancer diagnostic accuracy as well as other procedures requiring accurate needle insertion.

摘要

目的:为了对可疑病变进行明确的癌症诊断,在针吸活检中,准确的置针和足够的组织取样是至关重要的。然而,目前活检设备中的单斜面针在插入时经常会发生偏斜,这可能导致病变取样不足/漏取和癌症误诊。本研究旨在揭示能够实现低偏斜和足够组织取样的活检针设计标准。

方法:首先建立了一个能够预测针偏转和组织变形的新型模型,以了解不同针尖几何形状的针-组织相互作用。进行了针偏转和离体组织活检实验以验证模型。

结果:所开发的模型在针尖类型与所得针偏转和组织取样长度的相关性方面显示出了相当好的预测。与目前的单斜面针相比,一种新的多斜面针,其组织分离点位于针槽面下方,具有有效的设计,其偏转幅度降低了 87%,组织取样长度相等。

结论:本研究揭示了活检针的两个关键设计标准:1)针尖上的多个斜面可以产生力来平衡插入过程中的弯矩,从而实现低针偏转;2)组织分离点应低于针槽面,以确保长组织取样长度。

意义:本研究中开发的方法和发现提供了概念验证,可以用于研究各种活检程序,以提高癌症诊断准确性以及其他需要准确插入针的程序。

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本文引用的文献

[1]
Needle deflection and tissue sampling length in needle biopsy.

J Mech Behav Biomed Mater. 2020-4

[2]
Trucut Biopsy vs FNAC of Pelvic Tumors-Who Wins the Match?

J Cytol. 2018

[3]
Assessment of Needle Tip Deflection During Transrectal Guided Prostate Biopsy: Implications for Targeted Biopsies.

J Endourol. 2018-3

[4]
Multi-Imager Compatible, MR Safe, Remote Center of Motion Needle-Guide Robot.

IEEE Trans Biomed Eng. 2017-4-25

[5]
Polyvinyl chloride as a multimodal tissue-mimicking material with tuned mechanical and medical imaging properties.

Med Phys. 2016-10

[6]
Prostate cancer detection with magnetic resonance-ultrasound fusion biopsy: The role of systematic and targeted biopsies.

Cancer. 2016-3-15

[7]
Magnetic Resonance Imaging-Ultrasound Fusion Targeted Prostate Biopsy in a Consecutive Cohort of Men with No Previous Biopsy: Reduction of Over Detection through Improved Risk Stratification.

J Urol. 2015-12

[8]
Can Clinically Significant Prostate Cancer Be Detected with Multiparametric Magnetic Resonance Imaging? A Systematic Review of the Literature.

Eur Urol. 2015-2-2

[9]
Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis.

Eur Urol. 2014-12-3

[10]
Detection of Clinically Significant Prostate Cancer Using Magnetic Resonance Imaging-Ultrasound Fusion Targeted Biopsy: A Systematic Review.

Eur Urol. 2014-11-1

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