Design, development and evaluation of a compact telerobotic catheter navigation system.

BACKGROUND: Remote catheter navigation systems protect interventionalists from scattered ionizing radiation. However, these systems typically require specialized catheters and extensive operator training. METHODS: A new compact and sterilizable telerobotic system is described, which allows remote navigation of conventional tip-steerable catheters, with three degrees of freedom, using an interface that takes advantage of the interventionalist's existing dexterity skills. The performance of the system is evaluated ex vivo and in vivo for remote catheter navigation and ablation delivery. RESULTS: The system has absolute errors of 0.1 ± 0.1 mm and 7 ± 6° over 100 mm of axial motion and 360° of catheter rotation, respectively. In vivo experiments proved the safety of the proposed telerobotic system and demonstrated the feasibility of remote navigation and delivery of ablation. CONCLUSION: The proposed telerobotic system allows the interventionalist to use conventional steerable catheters; while maintaining a safe distance from the radiation source, he/she can remotely navigate the catheter and deliver ablation lesions. Copyright © 2015 John Wiley & Sons, Ltd.

3D image-guided robotic needle positioning system for small animal interventions.

PURPOSE: This paper presents the design of a micro-CT guided small animal robotic needle positioning system. In order to simplify the robotic design and maintain a small targeting error, a novel implementation of the remote center of motion is used in the system. The system has been developed with the objective of achieving a mean targeting error of <200 µm while maintaining a high degree of user friendliness. METHODS: The robot is compact enough to operate within a 25 cm diameter micro-CT bore. Small animals can be imaged and an intervention performed without the need to transport the animal from one workspace to another. Not requiring transport of the animal reduces opportunities for targets to shift from their localized position in the image and simplifies the workflow of interventions. An improved method of needle calibration is presented that better characterizes the calibration using the position of the needle tip in photographs rather than the needle axis. A calibration fixture was also introduced, which dramatically reduces the time requirements of calibration while maintaining calibration accuracy. Two registration modes have been developed to correspond the robot coordinate system with the coordinate system of the micro-CT scanner. The two registration modes offer a balance between the time required to complete a registration and the overall registration accuracy. The development of slow high accuracy and fast low accuracy registration modes provides users with a degree of flexibility in selecting a registration mode best suited for their application. RESULTS: The target registration error (TRE) of the higher accuracy primary registration was TRE(primary) = 31 ± 12 µm. The error in the lower accuracy combined registration was TRE(combined) = 139 ± 63 µm. Both registration modes are therefore suitable for small-animal needle interventions. The targeting accuracy of the robotic system was characterized using targeting experiments in tissue-mimicking gelatin phantoms. The results of the targeting experiments were combined with the known calibration and needle deflection errors to provide a more meaningful measure of the needle positioning accuracy of the system. The combined targeting errors of the system were 149 ± 41 µm and 218 ± 38 µm using the primary and combined registrations, respectively. Finally, pilot in vivo experiments were successfully completed to demonstrate the performance of the system in a biomedical application. CONCLUSIONS: The device was able to achieve the desired performance with an error of <200 µm and improved repeatability when compared to other designs. The device expands the capabilities of image-guided interventions for preclinical biomedical applications.

Traceable micro-CT scaling accuracy phantom for applications requiring exact measurement of distances or volumes.

PURPOSE: Volumetric x-ray microcomputed tomography (CT) can be employed in a variety of quantitative research applications such as image-guided interventions or characterization of medical devices. To ensure the highest geometric fidelity of images for these applications, a phantom and image processing algorithm have been developed to calibrate the scaling accuracy of micro-CT scanners to a traceable standard and provide corrections to image voxel sizing. METHODS: The calibration phantom contains six borosilicate beads whose separations have been measured to a traceable standard. An image processing algorithm compares the known separations of the beads to their separations in micro-CT images. A least-squares solution is used to determine linear scaling correction factors along each of the three scanner axes to minimize errors in the bead separations within the images by correcting the image voxel size. The correction factors were applied to images of a similar phantom with beads at different positions to evaluate the ability of the correction factors to reduce errors at points independent of the fiducial locations in the calibration phantom. The calibration phantom was used to evaluate the scaling accuracy of five different micro-CT scanners representing four different scanner models. RESULTS: In two of the five scanners evaluated, the correction factors significantly reduced the mean error in bead separations in the images from 0.17% to 0.05% and from 0.37% to 0.07% of the actual bead separations, respectively. Scanners yielding similar voxel sizes possessed comparable geometric errors after correction using the phantom. CONCLUSIONS: Although the magnitude of the corrections is small, such corrections can be important for demanding micro-CT applications. Even if no voxel size correction is required, the phantom provides an easily implemented method to verify the geometric fidelity of micro-CT scanners to a traceable standard of measurement.

Design and performance evaluation of a remote catheter navigation system.

A novel remote catheter navigation system has been developed to reduce physical stress and irradiation to the interventionalist during fluoroscopic X-ray guided catheter intervention. The unique teleoperated design of this system allows the interventionalist to apply conventional axial and radial motion, as used in current practice, to an input catheter placed in a radiation-safe location to control a second catheter placed inside the procedure room. A catheter sensor (used to measure motion of the input catheter) and a catheter manipulator (used to manipulate the second catheter) are both presented. Performance evaluation of the system was assessed by first conducting bench-top experiments to quantify accuracy and precision of both sensed and replicated motion, and then conducting two experiments to evaluate the latency from sensed to replicated motion. The first study consisted of replicating motions of prescribed motion trajectories, while the second study utilized eight operators to remotely navigate a catheter through a normal carotid model. The results show the system has the ability to sense and replicate motion to within 1 mm and 1 ( degrees ) in the axial and radial directions, respectively. Remote catheter manipulation was found to be operator dependent and occurred under 300 ms. Future applications of this technology are then presented.