Pneumatic Robot for MRI-Guided Pediatrics Long Bone Biopsy

用于 MRI 引导儿科长骨活检的气动机器人

• 批准号: 8577657
• 负责人: Kevin R. Cleary
• 金额: $ 58.37万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8577657
• 关键词: Acute; Affect; Anesthesia procedures; Appearance; Area; Biopsy; Case Study; Child; Childhood; Childhood Solid Neoplasm; Clinical; Clinical Engineering; Clinical Management; Clinical Trials; Custom; Diagnosis; Disease; Doctor of Philosophy; Environment; Evaluation; Ewings sarcoma; Exposure to; Fever; Goals; Goat; Hematogenous; Histologic; Hospitals; Image; Image Guided Biopsy; In Vitro; Infection; Ionizing radiation; Joints; Lead; Leg; Lesion; Limb structure; Location; Lymphoma; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Bone Neoplasm; Malignant Neoplasms; Malignant neoplasm of brain; Manuals; Marrow; Medical; Morbidity - disease rate; Motor; Multi-Institutional Clinical Trial; Musculoskeletal; Needles; Operating Rooms; Operative Surgical Procedures; Organism; Orthopedics; Osteomyelitis; Pathology; Patient Care; Patients; Pediatrics; Physicians; Principal Investigator; Procedures; Process; Protocols documentation; Radiation; Radiation therapy; Radiology Specialty; Research; Resolution; Robot; Robotics; Safety; Sampling; School-Age Population; Sedation procedure; Speed; Symptoms; System; Time; Tissue Sample; Trauma; Universities; base; bone; chemotherapy; clinical decision-making; design and construction; experience; improved; innovation; long bone; neoplastic; novel; osteosarcoma; public health relevance; robot assistance; soft tissue

DESCRIPTION (provided by applicant): The goal of this proposal is to develop and evaluate an innovative MRI compatible robot for improved bone biopsy in pediatrics. The robot will enable a new paradigm for rapidly evaluating suspicious bone lesions through image-guided biopsy. This will enable a novel clinical workflow defined with the goal of minimizing trauma and radiation exposure. The robot would have important applications in diagnosing and distinguishing bone cancers and bone infections, greatly facilitating clinical decision-making and therapy management. Malignant bone cancers are the third most common pediatric solid tumors after lymphoma and brain cancers and include osteosarcoma and Ewing sarcoma, with thousands of cases in the US alone. Accurate histologic diagnosis is critical for the planning and initiation of surgery, chemotherapy, and or radiation therapy. Osteomyelitis is a bone infection, with over 50% of reported cases seen in pre-school age children. Accurate diagnosis of the presence of bone infection and the infecting organism is critical for optimal therapy. Importantly, the imaging appearance of neoplastic and infectious pathology can be indistinguishable, making targeted and rapid tissue sampling key to clinical management. Our specific aims are to: 1. Design, construct, and evaluate a pneumatic, MRI compatible robotic-assistant system for long bone biopsy in pediatric patients. The robot will be placed along the limb of the child in the MRI scanner and will precisely orient a needle-guide for biopsy based on the images. The physician will perform the biopsy manually through the needle-guide. 2. Develop a path planning workstation for image-to-robot registration, selecting the location of the target, navigation and targeting based on the images, and means of trajectory verification before manual needle insertion for biopsy. 3. Integrate the robot with the planning workstation and evaluate the system in the MRI environment using custom anthropomorphic pediatric phantoms and goat legs. Modify the system as needed and repeat the evaluations to validate the system in-vitro. 4. Conduct a pilot safety and feasibility clinical trial on ten subjects.

描述（由申请人提供）：本提案的目标是开发和评估一种创新的 MRI 兼容机器人，以改进儿科骨活检。该机器人将为通过图像引导活检快速评估可疑骨病变提供新的范例。这将实现一种新颖的临床工作流程，其目标是最大限度地减少创伤和辐射暴露。该机器人将在诊断和区分骨癌和骨感染方面具有重要应用，极大地促进临床决策和治疗管理。 恶性骨癌是继淋巴瘤和脑癌之后第三大常见的儿科实体瘤，包括骨肉瘤和尤文肉瘤，仅在美国就有数千例。准确的组织学诊断对于手术、化疗和/或放射治疗的计划和开始至关重要。骨髓炎是一种骨感染，超过 50% 的报告病例见于学龄前儿童。准确诊断骨感染和感染微生物的存在对于最佳治疗至关重要。重要的是， 肿瘤和感染性病理学的影像学表现可能无法区分，因此有针对性的快速组织取样对于临床管理至关重要。我们的具体目标是： 1. 设计、构建和评估用于儿科患者长骨活检的气动、MRI 兼容机器人辅助系统。机器人将沿着 MRI 扫描仪中的儿童肢体放置，并根据图像精确定向活检针导向器。医生将通过针引导手动进行活检。 2. 开发路径规划工作站，用于图像到机器人配准、选择目标位置、基于图像进行导航和瞄准，以及手动插入活检之前的轨迹验证手段。 3. 将机器人与规划工作站集成，并使用定制的拟人儿科模型和山羊腿在 MRI 环境中评估系统。根据需要修改系统并重复评估以在体外验证系统。 4.开展10个受试者的先导安全性和可行性临床试验。