ABSTRACT
Magnetic Resonance (MR) Imaging-guided High Intensity focused Ultrasound (MRgHIFU) is a non-invasive, non-ionizing thermal ablation therapy that is particularly interesting for the palliative or curative treatment of musculoskeletal tumors. We introduce a new modular MRgHIFU device that allows the ultrasound transducer to be positioned precisely and interactively over the body part to be treated. A flexible, MR-compatible supporting structure allows free positioning of the transducer under MRI/optical fusion imaging guidance. The same structure can be rigidified using pneumatic depression, holding the transducer rigidly in place. Targeting accuracy was first evaluated in vitro. The average targeting error of the complete process was found to be equal to 5.4 ± 2.2 mm in terms of focus position, and 4.7° ± 2° in terms of transducer orientation. First-in-man feasibility is demonstrated on a patient suffering from important, uncontrolled pain from a bone metastasis located in the forearm. The 81 × 47 × 34 mm3 lesion was successfully treated using five successive positions of the transducer, under real-time monitoring by MR Thermometry. Significant pain palliation was observed 3 days after the intervention. The system described and characterized in this study is a particularly interesting modular, low-cost MRgHIFU device for musculoskeletal tumor therapy.
Subject(s)
High-Intensity Focused Ultrasound Ablation , Neoplasms, Connective and Soft Tissue , Thermometry , High-Intensity Focused Ultrasound Ablation/methods , Humans , Magnetic Resonance Imaging/methods , PainABSTRACT
In this paper, we present a novel robotic assistant dedicated to medical interventions under computed tomography scan guidance. This compact and lightweight patient-mounted robot is designed so as to fulfill the requirements of most interventional radiology procedures. It is built from an original 5 DOF parallel structure with a semispherical workspace, particularly well suited to CT-scan interventional procedures. The specifications, the design, and the choice of compatible technological solutions are detailed. A preclinical evaluation is presented, with the registration of the robot in the CT-scan.
