Amack Stephanie, Rox Margaret, Mitchell Jason, Ertop Tayfun Efe, Emerson Maxwell, Kuntz Alan, Maldonado Fabien, Akulian Jason, Gafford Joshua, Alterovitz Ron, Webster Robert J
Mechanical Engineering, Vanderbilt University, Nashville, TN, USA.
Computer Science, University of North Carolina at Chapel Hill, NC, USA.
Proc SPIE Int Soc Opt Eng. 2019 Feb;10951. doi: 10.1117/12.2513967. Epub 2019 Mar 8.
Lung cancer is one of the most prevalent and deadly forms of cancer, claiming more than 154,000 lives in the USA per year. Accurate targeting and biopsy of pulmonary abnormalities is key for early diagnosis and successful treatment. Many cancerous lesions originate in the peripheral regions of the lung which are not directly accessible from the bronchial tree, thereby requiring percutaneous approaches to collect biopsies, which carry a higher risk of pneumothorax, hemorrhage, and death in extreme cases. In prior work, our group proposed a concept for accessing the peripheral lung through the airways, via a bronchscope deployed steerable needle. In this paper, we present a more compact, modular, multi-stage robot, designed to deploy a steerable needle through a standard flexible bronchoscope, to retrieve biopsies from lesions in the peripheral regions of the lung. The robot has several stages that can control a steerable biopsy needle, as well as concentric tubes, which act as an aiming conduit. The functionality of this robot is demonstrated via closed-loop lesion targeting in a CT scanner. The steerable needle is controlled using a previously proposed sliding mode controller, based on feedback from a magnetic tracker embedded in the steerable needle's tip. Towards developing a clinically viable platform, this system builds on prior work through its modular, compact form factor, and workflow-conscious design that provides precise homing and the ability to interchange tools as needed.
肺癌是最常见且致命的癌症形式之一，在美国每年导致超过15.4万人死亡。准确靶向和活检肺部异常是早期诊断和成功治疗的关键。许多癌性病变起源于肺部的外周区域，而这些区域无法通过支气管树直接到达，因此需要经皮穿刺方法来采集活检样本，这种方法在极端情况下会有更高的气胸、出血和死亡风险。在之前的工作中，我们团队提出了一种通过气道，利用可操纵的支气管镜针进入外周肺的概念。在本文中，我们展示了一种更紧凑、模块化、多阶段的机器人，其设计目的是通过标准的柔性支气管镜部署可操纵的针，以从肺部外周区域的病变中获取活检样本。该机器人有几个阶段，可以控制可操纵的活检针以及作为瞄准导管的同心管。通过在CT扫描仪中进行闭环病变靶向，展示了该机器人的功能。基于嵌入在可操纵针尖端的磁跟踪器的反馈，使用先前提出的滑模控制器来控制可操纵针。为了开发一个临床上可行的平台，该系统基于先前的工作，采用模块化、紧凑的外形尺寸以及注重工作流程的设计，提供精确的归位功能以及根据需要更换工具的能力。
