FFF print defect characterization through in-situ electrical resistance monitoring.

Fused filament fabrication is a popular fabrication technique. Currently there is a need for in-situ monitoring modalities to gather real-time information on prints, both for quality control and closed-loop control. Despite current advancements, effective and affordable in-situ monitoring techniques for non-destructive defect detection of voids and bonding quality are still limited. This work demonstrates in-situ monitoring of fused filament fabrication through electrical resistance measurements as an alternative to thermal and optical methods. A new, easy-to-implement setup is demonstrated which measures the electrical resistance of a conductively doped filament between the nozzle and single or multi-electrodes on the bed. Defects can be located in an unprecedented way with the use of encoded axes in combination with the observed resistance variations throughout the part. A model of the anisotropic electrical conduction is used to interpret the measurements, which matches well with the data. Warping, inter-layer adhesion, under-extrusion and overhang sagging print defects can be observed in the measurements of parts with a complex geometry, which would be difficult to measure otherwise. Altogether in-situ electrical resistance monitoring offers a tool for optimising prints by online studying the influence of the print parameters for quality assessment and it opens up possibilities for closed-loop control.

3-D and 2-D reconstruction of bladders for the assessment of inter-session detection of tissue changes: a proof of concept.

PURPOSE: Abnormalities in the bladder wall require careful investigation regarding type, spatial position and invasiveness. Construction of a 3-D model of the bladder is helpful to ensure adequate coverage of the scanning procedure, quantitative comparison of bladder wall textures between successive sessions and finding back previously discovered abnormalities. METHODS: Videos of both an in vivo bladder and a textured bladder phantom were acquired. Structure-from-motion and bundle adjustment algorithms were used to construct a 3-D point cloud, approximate it by a surface mesh, texture it with the back-projected camera frames and draw the corresponding 2-D atlas. Reconstructions of successive sessions were compared; those of the bladder phantom were co-registered, transformed using 3-D thin plate splines and post-processed to highlight significant changes in texture. RESULTS: The reconstruction algorithms of the presented workflow were able to construct 3-D models and corresponding 2-D atlas of both the in vivo bladder and the bladder phantom. For the in vivo bladder the portion of the reconstructed surface area was 58% and 79% for the pre- and post-operative scan, respectively. For the bladder phantom the full surface was reconstructed and the mean reprojection error was 0.081 mm (range 0-0.79 mm). In inter-session comparison the changes in texture were correctly indicated for all six locations. CONCLUSION: The proposed proof of concept was able to perform 3-D and 2-D reconstruction of an in vivo bladder wall based on a set of monocular images. In a phantom study the computer vision algorithms were also effective in co-registering reconstructions of successive sessions and highlighting texture changes between sessions. These techniques may be useful for detecting, monitoring and revisiting suspicious lesions.

Ultrasound-guided breast biopsy using an adapted automated cone-based ultrasound scanner: a feasibility study.

BACKGROUND: Among available breast biopsy techniques, ultrasound (US)-guided biopsy is preferable because it is relatively inexpensive and provides live imaging feedback. The availability of magnetic resonance imaging (MRI)-3D US image fusion would facilitate US-guided biopsy even for US occult lesions to reduce the need for expensive and time-consuming MRI-guided biopsy. In this paper, we propose a novel Automated Cone-based Breast Ultrasound Scanning and Biopsy System (ACBUS-BS) to scan and biopsy breasts of women in prone position. It is based on a previously developed system, called ACBUS, that facilitates MRI-3D US image fusion imaging of the breast employing a conical container filled with coupling medium. PURPOSE: The purpose of this study was to introduce the ABCUS-BS system and demonstrate its feasibility for biopsy of US occult lesions. METHOD: The biopsy procedure with the ACBUS-BS comprises four steps: target localization, positioning, preparation, and biopsy. The biopsy outcome can be impacted by 5 types of errors: due to lesion segmentation, MRI-3D US registration, navigation, lesion tracking during repositioning, and US inaccuracy (due to sound speed difference between the sample and the one used for image reconstruction). For the quantification, we use a soft custom-made polyvinyl alcohol phantom (PVA) containing eight lesions (three US-occult and five US-visible lesions of 10 mm in diameter) and a commercial breast mimicking phantom with a median stiffness of 7.6 and 28 kPa, respectively. Errors of all types were quantified using the custom-made phantom. The error due to lesion tracking was also quantified with the commercial phantom. Finally, the technology was validated by biopsying the custom-made phantom and comparing the size of the biopsied material to the original lesion size. The average size of the 10-mm-sized lesions in the biopsy specimen was 7.00 ± 0.92 mm (6.33 ± 1.16 mm for US occult lesions, and 7.40 ± 0.55 mm for US-visible lesions). RESULTS: For the PVA phantom, the errors due to registration, navigation, lesion tracking during repositioning, and US inaccuracy were 1.33, 0.30, 2.12, and 0.55 mm. The total error was 4.01 mm. For the commercial phantom, the error due to lesion tracking was estimated at 1.10 mm, and the total error was 4.11 mm. Given these results, the system is expected to successfully biopsy lesions larger than 8.22 mm in diameter. Patient studies will have to be carried out to confirm this in vivo. CONCLUSION: The ACBUS-BS facilitates US-guided biopsy of lesions detected in pre-MRI and therefore might offer a low-cost alternative to MRI-guided biopsy. We demonstrated the feasibility of the approach by successfully taking biopsies of five US-visible and three US-occult lesions embedded in a soft breast-shaped phantom.

Modelling of Anisotropic Electrical Conduction in Layered Structures 3D-Printed with Fused Deposition Modelling.

3D-printing conductive structures have recently been receiving increased attention, especially in the field of 3D-printed sensors. However, the printing processes introduce anisotropic electrical properties due to the infill and bonding conditions. Insights into the electrical conduction that results from the anisotropic electrical properties are currently limited. Therefore, this research focuses on analytically modeling the electrical conduction. The electrical properties are described as an electrical network with bulk and contact properties in and between neighbouring printed track elements or traxels. The model studies both meandering and open-ended traxels through the application of the corresponding boundary conditions. The model equations are solved as an eigenvalue problem, yielding the voltage, current density, and power dissipation density for every position in every traxel. A simplified analytical example and Finite Element Method simulations verify the model, which depict good correspondence. The main errors found are due to the limitations of the model with regards to 2D-conduction in traxels and neglecting the resistance of meandering ends. Three dimensionless numbers are introduced for the verification and analysis: the anisotropy ratio, the aspect ratio, and the number of traxels. Conductive behavior between completely isotropic and completely anisotropic can be modeled, depending on the dimensionless properties. Furthermore, this model can be used to explain the properties of certain 3D-printed sensor structures, like constriction-resistive strain sensors.

Quantitative Evaluation of an Automated Cone-Based Breast Ultrasound Scanner for MRI-3D US Image Fusion.

Breast cancer is one of the most diagnosed types of cancer worldwide. Volumetric ultrasound breast imaging, combined with MRI can improve lesion detection rate, reduce examination time, and improve lesion diagnosis. However, to our knowledge, there are no 3D US breast imaging systems available that facilitate 3D US - MRI image fusion. In this paper, a novel Automated Cone-based Breast Ultrasound System (ACBUS) is introduced. The system facilitates volumetric ultrasound acquisition of the breast in a prone position without deforming it by the US transducer. Quality of ACBUS images for reconstructions at different voxel sizes (0.25 and 0.50 mm isotropic) was compared to quality of the Automated Breast Volumetric Scanner (ABVS) (Siemens Ultrasound, Issaquah, WA, USA) in terms of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and resolution using a custom made phantom. The ACBUS image data were registered to MRI image data utilizing surface matching and the registration accuracy was quantified using an internal marker. The technology was also evaluated in vivo. The phantom-based quantitative analysis demonstrated that ACBUS can deliver volumetric breast images with an image quality similar to the images delivered by a currently commercially available Siemens ABVS. We demonstrate on the phantom and in vivo that ACBUS enables adequate MRI-3D US fusion. To our conclusion, ACBUS might be a suitable candidate for a second-look breast US exam, patient follow-up, and US guided biopsy planning.

Forging global cooperation and collaboration.

As researchers create better robots, major robotics initiatives and government funding programs need better international cooperation and collaboration.

Design of an end-effector for robot-assisted ultrasound-guided breast biopsies.

PURPOSE: The biopsy procedure is an important phase in breast cancer diagnosis. Accurate breast imaging and precise needle placement are crucial in lesion targeting. This paper presents an end-effector (EE) for robotic 3D ultrasound (US) breast acquisitions and US-guided breast biopsies. The EE mechanically guides the needle to a specified target within the US plane. The needle is controlled in all degrees of freedom (DOFs) except for the direction of insertion, which is controlled by the radiologist. It determines the correct needle depth and stops the needle accordingly. METHOD: In the envisioned procedure, a robotic arm performs localization of the breast, 3D US volume acquisition and reconstruction, target identification and needle guidance. Therefore, the EE is equipped with a stereo camera setup, a picobeamer, US probe holder, a three-DOF needle guide and a needle stop. The design was realized by prototyping techniques. Experiments were performed to determine needle placement accuracy in-air. The EE was placed on a seven-DOF robotic manipulator to determine the biopsy accuracy on a cuboid phantom. RESULTS: Needle placement accuracy was 0.3 ± 1.5 mm in and 0.1 ± 0.36 mm out of the US plane. Needle depth was regulated with an accuracy of 100 µm (maximum error 0.89 mm). The maximum holding force of the stop was approximately 6 N. The system reached a Euclidean distance error of 3.21 mm between the needle tip and the target and a normal distance of 3.03 mm between the needle trajectory and the target. CONCLUSION: An all in one solution was presented which, attached to a robotic arm, assists the radiologist in breast cancer imaging and biopsy. It has a high needle placement accuracy, yet the radiologist is in control like in the conventional procedure.

Production and clinical evaluation of breast lesion skin markers for automated three-dimensional ultrasonography of the breast: a pilot study.

OBJECTIVES: Automated ultrasound of the breast has the advantage to have the whole breast scanned by technicians. Consequently, feedback to the radiologist about concurrent focal abnormalities (e.g., palpable lesions) is lost. To enable marking of patient- or physician-reported focal abnormalities, we aimed to develop skin markers that can be used without disturbing the interpretability of the image. METHODS: Disk-shaped markers were casted out of silicone. In this IRB-approved prospective study, 16 patients were included with a mean age of 57 (39-85). In all patients, the same volume was imaged twice using an automated breast ultrasound system, once with and once without a marker in place. Nine radiologists from two medical centers filled scoring forms regarding image quality, image interpretation, and confidence in providing a diagnosis based on the images. RESULTS: Marker adhesion was sufficient for automated scanning. Observer scores showed a significant shift in scores from excellent to good regarding diagnostic yield/image quality (χ2, 15.99, p < 0.01), and image noise (χ2, 21.20, p < 0.01) due to marker presence. In 93% of cases, the median score of observers "agree" with the statement that marker-induced noise did not influence image interpretability. Marker presence did not interfere with confidence in diagnosis (χ2, 6.00, p = 0.20). CONCLUSION: Inexpensive, easy producible skin markers can be used for accurate lesion marking in automated ultrasound examinations of the breast while image interpretability is preserved. Any marker-induced noise and decreased image quality did not affect confidence in providing a diagnosis. KEY POINTS: • The use of a skin marker enables the reporting radiologist to identify a location which a patient is concerned about. • The developed skin marker can be used for accurate breast lesion marking in ultrasound examinations.

A review on recent advances in soft surgical robots for endoscopic applications.

BACKGROUND: Soft materials, with their compliant properties, enable conformity and safe interaction with human body. With the advance in actuation and sensing of soft materials, new paradigm in robotics called "soft robotics" emerges. Soft robotics has become a new approach in designing medical devices such as wearable robotic gloves and exoskeleton. However, application of soft robotics in surgical instrument inside human body is still in its infancy. AIMS: In this paper, current application and design of soft robots specifically applied for endoscopy are reviewed. MATERIALS & METHODS: Different aspects in the implementation of soft robotics in endoscope design were reviewed. The key studies about MIS and NOTES were reviewed to establish the clinical background and extract the limitations of current endoscopic device in the last decade. RESULTS AND DISCUSSION: In this review study, the implementation of soft robotics concepts in endoscopic application, with highlights on different features of several soft endoscopes, were evaluated. The progress in different aspects of soft robotics endoscope, current state, and future perspectives were also discussed. CONCLUSION: Based on the survey on the structural specification, actuation, sensing, and stiffening the future soft surgical endoscopes are recommended to fulfil the following specifications: safe especially from pressure leakage, fully biocompatible materials, MR-compatible, capable for large bending in at least two antagonistic directions, modularity, adjustable stiffness.

Iterative simulations to estimate the elastic properties from a series of MRI images followed by MRI-US validation.

The modeling of breast deformations is of interest in medical applications such as image-guided biopsy, or image registration for diagnostic purposes. In order to have such information, it is needed to extract the mechanical properties of the tissues. In this work, we propose an iterative technique based on finite element analysis that estimates the elastic modulus of realistic breast phantoms, starting from MRI images acquired in different positions (prone and supine), when deformed only by the gravity force. We validated the method using both a single-modality evaluation in which we simulated the effect of the gravity force to generate four different configurations (prone, supine, lateral, and vertical) and a multi-modality evaluation in which we simulated a series of changes in orientation (prone to supine). Validation is performed, respectively, on surface points and lesions using as ground-truth data from MRI images, and on target lesions inside the breast phantom compared with the actual target segmented from the US image. The use of pre-operative images is limited at the moment to diagnostic purposes. By using our method we can compute patient-specific mechanical properties that allow compensating deformations. Graphical Abstract Workflow of the proposed method and comparative results of the prone-to-supine simulation (red volumes) validated using MRI data (blue volumes).

Conceptual Design of a Fully Passive Transfemoral Prosthesis to Facilitate Energy-Efficient Gait.

In this paper, we present the working principle and conceptual design toward the realization of a fully-passive transfemoral prosthesis that mimics the energetics of the natural human gait. The fundamental property of the conceptual design consists of realizing an energetic coupling between the knee and ankle joints of the mechanism. Simulation results show that the power flow of the working principle is comparable with that in human gait and a considerable amount of energy is delivered to the ankle joint for the push-off generation. An initial prototype in half scale is realized to validate the working principle. The construction of the prototype is explained together with the test setup that has been built for the evaluation. Finally, experimental results of the prosthesis prototype during walking on a treadmill show the validity of the working principle.

Analytical derivation of elasticity in breast phantoms for deformation tracking.

PURPOSE: Patient-specific biomedical modeling of the breast is of interest for medical applications such as image registration, image guided procedures and the alignment for biopsy or surgery purposes. The computation of elastic properties is essential to simulate deformations in a realistic way. This study presents an innovative analytical method to compute the elastic modulus and evaluate the elasticity of a breast using magnetic resonance (MRI) images of breast phantoms. METHODS: An analytical method for elasticity computation was developed and subsequently validated on a series of geometric shapes, and on four physical breast phantoms that are supported by a planar frame. This method can compute the elasticity of a shape directly from a set of MRI scans. For comparison, elasticity values were also computed numerically using two different simulation software packages. RESULTS: Application of the different methods on the geometric shapes shows that the analytically derived elongation differs from simulated elongation by less than 9% for cylindrical shapes, and up to 18% for other shapes that are also substantially vertically supported by a planar base. For the four physical breast phantoms, the analytically derived elasticity differs from numeric elasticity by 18% on average, which is in accordance with the difference in elongation estimation for the geometric shapes. The analytic method has shown to be multiple orders of magnitude faster than the numerical methods. CONCLUSION: It can be concluded that the analytical elasticity computation method has good potential to supplement or replace numerical elasticity simulations in gravity-induced deformations, for shapes that are substantially supported by a planar base perpendicular to the gravitational field. The error is manageable, while the calculation procedure takes less than one second as opposed to multiple minutes with numerical methods. The results will be used in the MRI and Ultrasound Robotic Assisted Biopsy (MURAB) project.

Stormram 4: An MR Safe Robotic System for Breast Biopsy.

Suspicious lesions in the breast that are only visible on magnetic resonance imaging (MRI) need to be biopsied under MR guidance with high accuracy and efficiency for accurate diagnosis. The aim of this study is to present a novel robotic system, the Stormram 4, and to perform preclinical tests in an MRI environment. Excluding racks and needle, its dimensions are 72 × 51 × 40 mm. The Stormram 4 is driven by two linear and two curved pneumatic stepper motors. The linear motor is capable of exerting 63 N of force at a pressure of 0.65 MPa. In an MRI environment the maximum observed stepping frequency is 30 Hz (unloaded), or 8 Hz when full force is needed. The Stormram 4's mean positioning error is 0.73 ± 0.47 mm in free air, and 1.29 ± 0.59 mm when targeting breast phantoms in MRI. Excluding the off-the-shelf needle, the robot is inherently MR safe. The robot is able to accurately target lesions under MRI guidance, reducing tissue damage and risk of false negatives. These results are promising for clinical experiments, improving the quality of healthcare in the field of MRI-guided breast biopsies.

A General Approach to Achieving Stability and Safe Behavior in Distributed Robotic Architectures.

This paper proposes a unified energy-based modeling and energy-aware control paradigm for robotic systems. The paradigm is inspired by the layered and distributed control system of organisms, and uses the fundamental notion of energy in a system and the energy exchange between systems during interaction. A universal framework that models actuated and interacting robotic systems is proposed, which is used as the basis for energy-based and energy-limited control. The proposed controllers act on certain energy budgets to accomplish a desired task, and decrease performance if a budget has been depleted. These budgets ensure that a maximum amount of energy can be used, to ensure passivity and stability of the system. Experiments show the validity of the approach.

An Overview on Principles for Energy Efficient Robot Locomotion.

Despite enhancements in the development of robotic systems, the energy economy of today's robots lags far behind that of biological systems. This is in particular critical for untethered legged robot locomotion. To elucidate the current stage of energy efficiency in legged robotic systems, this paper provides an overview on recent advancements in development of such platforms. The covered different perspectives include actuation, leg structure, control and locomotion principles. We review various robotic actuators exploiting compliance in series and in parallel with the drive-train to permit energy recycling during locomotion. We discuss the importance of limb segmentation under efficiency aspects and with respect to design, dynamics analysis and control of legged robots. This paper also reviews a number of control approaches allowing for energy efficient locomotion of robots by exploiting the natural dynamics of the system, and by utilizing optimal control approaches targeting locomotion expenditure. To this end, a set of locomotion principles elaborating on models for energetics, dynamics, and of the systems is studied.

Clinical pedicle screw accuracy and deviation from planning in robot-guided spine surgery: robot-guided pedicle screw accuracy.

STUDY DESIGN: A retrospective chart review was performed for 112 consecutive minimally invasive spinal surgery patients who underwent pedicular screw fixation in a community hospital setting. OBJECTIVE: To assess the clinical accuracy and deviation in screw positions in robot-assisted pedicle screw placement. SUMMARY OF BACKGROUND DATA: Accuracy of pedicle screw placement in in vivo studies varies widely, especially when minimally invasive techniques are used. Robotic guidance was recently introduced to increase screw placement accuracy but still reported accuracies vary. METHODS: Reproducibility of the surgeon's plan using robotic guidance was assessed by fusing individual vertebras from the preoperative computed tomography (CT) containing the planning with a postoperative CT. Deviation in entry point and difference in angle of insertion was measured on axial and sagittal planes. Grading of pedicle screw placement was performed on postoperative CTs using the Gertzbein-Robbins classification. RESULTS: CT-to-CT fusion succeeded for 178 screws, but these appeared to be random, with no apparent selection bias. Mean deviation in entry point was 2.0 ± 1.2 mm. Mean difference in angle of insertion was 2.2° ± 1.7° on the axial plane and 2.9° ± 2.4° on the sagittal plane. Assessment of pedicle screw accuracy showed that 477 of 487 screws (97.9%) were safely placed (<2 mm, category A+B), 8 screws in category C and 1 in category D. None of the screws necessitated resurgery for revised placement. CONCLUSION: Preoperative planning of robotic guidance is reproduced intraoperatively within acceptable deviations. We conclude that robotic guidance allows for highly accurate execution of the preoperative plan, leading to accurate screw placement. LEVEL OF EVIDENCE: 3.

Evaluation of robotically controlled advanced endoscopic instruments.

BACKGROUND: Advanced flexible endoscopes and instruments with multiple degrees of freedom enable physicians to perform challenging procedures such as the removal of large sections of mucosal tissue. However, these advanced endoscopes are difficult to control and require several physicians to cooperate. METHODS: In this article, we present a robotic system that allows the physician to control an instrument in an intuitive way, using a haptic device. Performance with the robotic and conventional control methods were compared in a human subjects experiment. Subjects used both methods to tap a series of targets. They performed four trials while looking at the endoscopic monitor, and two trials while looking at the instrument directly. RESULTS: Subjects were significantly faster using the robotic method, 54 s vs 164 s. Their performance in the second trial was significantly improved with respect to the first trial. CONCLUSIONS: This study provides evidence that the robotic control method can be implemented to improve the performance of physicians using advanced flexible endoscopes.

3D position estimation of flexible instruments: marker-less and marker-based methods.

PURPOSE: Endoscopic images can be used to allow accurate flexible endoscopic instrument control. This can be implemented using a pose estimation algorithm, which estimates the actual instrument pose from the endoscopic images. METHODS: In this paper, two pose estimation algorithms are compared: a marker-less and a marker-based method. The marker-based method uses the positions of three markers in the endoscopic image to update the state of a kinematic model of the endoscopic instrument. The marker-less method works similarly, but uses the positions of three feature points instead of the positions of markers. The algorithms are evaluated inside a colon model. The endoscopic instrument is manually operated, while an X-ray imager is used to obtain a ground-truth reference position. RESULTS: The marker-less method achieves an RMS error of 1.5, 1.6, and 1.8 mm in the horizontal, vertical, and away-from-camera directions, respectively. The marker-based method achieves an RMS error of 1.1, 1.7, and 1.5 mm in the horizontal, vertical, and away-from-camera directions, respectively. The differences between the two methods are not found to be statistically significant. CONCLUSIONS: The proposed algorithms are suitable to realize accurate robotic control of flexible endoscopic instruments, enabling the physician to perform advanced procedures in an intuitive way.

Myoelectric forearm prostheses: state of the art from a user-centered perspective.

User acceptance of myoelectric forearm prostheses is currently low. Awkward control, lack of feedback, and difficult training are cited as primary reasons. Recently, researchers have focused on exploiting the new possibilities offered by advancements in prosthetic technology. Alternatively, researchers could focus on prosthesis acceptance by developing functional requirements based on activities users are likely to perform. In this article, we describe the process of determining such requirements and then the application of these requirements to evaluating the state of the art in myoelectric forearm prosthesis research. As part of a needs assessment, a workshop was organized involving clinicians (representing end users), academics, and engineers. The resulting needs included an increased number of functions, lower reaction and execution times, and intuitiveness of both control and feedback systems. Reviewing the state of the art of research in the main prosthetic subsystems (electromyographic [EMG] sensing, control, and feedback) showed that modern research prototypes only partly fulfill the requirements. We found that focus should be on validating EMG-sensing results with patients, improving simultaneous control of wrist movements and grasps, deriving optimal parameters for force and position feedback, and taking into account the psychophysical aspects of feedback, such as intensity perception and spatial acuity.

Evaluation of flexible endoscope steering using haptic guidance.

BACKGROUND: Steering the tip of a flexible endoscope relies on the physician's dexterity and experience. For complex flexible endoscopes, conventional controls may be inadequate. METHODS: A steering method based on a multi-degree-of-freedom haptic device is presented. Haptic cues are generated based on the endoscopic images. The method is compared against steering using the same haptic device without haptic cues, and against conventional steering. Human-subject studies were conducted in which 12 students and 6 expert gastroenterologists participated. RESULTS: Experts are significantly faster when using the conventional method compared with using the haptic device, either with or without haptic cues. However, it is expected that the performance of the subjects with the haptic device will increase with experience. CONCLUSIONS: Using a haptic device may be a viable alternative to the conventional method for the control of complex flexible endoscopes. The results suggest that the use of haptic cues may reduce the patient discomfort.