Development and Evaluation of an Actuated MRI-Compatible Robotic System for MRI-Guided Prostate Intervention

This paper reports the design, development, and magnetic resonance imaging (MRI) compatibility evaluation of an actuated transrectal prostate robot for MRI-guided needle intervention in the prostate. The robot performs actuated needle MRI guidance with the goals of providing 1) MRI compatibility; 2) MRI-guided needle placement with accuracy sufficient for targeting clinically significant prostate cancer foci; 3) reducing interventional procedure times (thus increasing patient comfort and reducing opportunity for needle targeting error due to patient motion); 4) enabling real-time MRI monitoring of interventional procedures; and 5) reducing the opportunities for error that arise in manually actuated needle placement. The design of the robot, employing piezoceramic-motor actuated needle guide positioning and manual needle insertion, is reported. Results of an MRI compatibility study show no reduction of MRI signal-to-noise ratio (SNR) with the disabled motors. Enabling the motors reduces the SNR by 80% without radio frequency (RF) shielding, but the SNR is only reduced by 40-60% with RF shielding. The addition of RF shielding is shown to significantly reduce image SNR degradation caused by the presence of the robotic device. An accuracy study of MRI-guided biopsy needle placements in a prostate phantom is reported. The study shows an average in-plane targeting error of 2.4 mm with a maximum error of 3.7 mm. These data indicate that the system's needle targeting accuracy is similar to that obtained with a previously reported manually actuated system, and is sufficient to reliably sample clinically significant prostate cancer foci under MRI guidance.

[1]  A. D'Amico,et al.  Real-time magnetic resonance image-guided interstitial brachytherapy in the treatment of select patients with clinically localized prostate cancer. , 1998, International journal of radiation oncology, biology, physics.

[2]  J. Barentsz,et al.  Title : MR-compatible transrectal prostate biopsy robot : a feasibility study , 2009 .

[3]  Bob Djavan,et al.  Biopsy standards for detection of prostate cancer , 2007, World Journal of Urology.

[4]  S. Zangos,et al.  MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results , 2004, European Radiology.

[5]  Gabor Fichtinger,et al.  Simultaneous integrated boost of biopsy proven, MRI defined dominant intra-prostatic lesions to 95 Gray with IMRT: early results of a phase I NCI study , 2007, Radiation oncology.

[6]  Alexandru Patriciu,et al.  “MRI Stealth” robot for prostate interventions , 2007, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[7]  Gabor Fichtinger,et al.  Patient selection determines the prostate cancer yield of dynamic contrast‐enhanced magnetic resonance imaging‐guided transrectal biopsies in a closed 3‐Tesla scanner , 2007, BJU international.

[8]  M. Terris,et al.  Comparison of mid-lobe versus lateral systematic sextant biopsies in the detection of prostate cancer. , 1997, Urologia internationalis.

[9]  R Kikinis,et al.  Robot-assisted needle placement in open MRI: System architecture, integration and validation , 2007, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[10]  T. Stamey,et al.  PATTERNS OF PROGRESSION IN PROSTATE CANCER , 1986, The Lancet.

[11]  Andras Lasso,et al.  Accuracy validation for MRI-guided robotic prostate biopsy , 2010, Medical Imaging.

[12]  E Atalar,et al.  Endourethral MRI , 2001, Magnetic resonance in medicine.

[13]  M. Barry,et al.  Detection of prostate cancer via biopsy in the Medicare-SEER population during the PSA era. , 2007, Journal of the National Cancer Institute.

[14]  C. N. Coleman,et al.  System for prostate brachytherapy and biopsy in a standard 1.5 T MRI scanner , 2004, Magnetic resonance in medicine.

[15]  M. Bronskill,et al.  Analysis of changes in MR properties of tissues after heat treatment , 1999, Magnetic resonance in medicine.

[16]  D. Chan,et al.  Nonpalpable stage T1c prostate cancer: prediction of insignificant disease using free/total prostate specific antigen levels and needle biopsy findings. , 1998, The Journal of urology.

[17]  Gabor Fichtinger,et al.  Development and preliminary evaluation of an actuated MRI-compatible robotic device for MRI-guided prostate intervention , 2010, 2010 IEEE International Conference on Robotics and Automation.

[18]  C. Csoma,et al.  Design and Preliminary Clinical Studies of an MRI-Guided Transrectal Prostate Intervention System , 2008 .

[19]  Gleason Df Classification of prostatic carcinomas. , 1966 .

[20]  Dan Stoianovici,et al.  Image-Guided Robotic Assisted Interventions , 2009 .

[21]  D. Bostwick,et al.  Staging of early prostate cancer: a proposed tumor volume-based prognostic index. , 1993, Urology.

[22]  William Wells,et al.  Detection of prostate cancer by integration of line-scan diffusion, T2-mapping and T2-weighted magnetic resonance imaging; a multichannel statistical classifier. , 2003, Medical physics.

[23]  A.A. Goldenberg,et al.  Robotic System for Closed-Bore MRI-Guided Prostatic Interventions , 2008, IEEE/ASME Transactions on Mechatronics.

[24]  Jurgen J Fütterer,et al.  Imaging modalities for prostate cancer , 2009, Expert review of anticancer therapy.

[25]  Carl-Fredrik Westin,et al.  Processing and visualization for diffusion tensor MRI , 2002, Medical Image Anal..

[26]  Jun Nakashima,et al.  Endorectal MRI for prediction of tumor site, tumor size, and local extension of prostate cancer. , 2004, Urology.

[27]  William J Catalona,et al.  Serial biopsy results in prostate cancer screening study. , 2002, The Journal of urology.

[28]  Gabor Fichtinger,et al.  Development of a pneumatic robot for MRI-guided transperineal prostate biopsy and brachytherapy: New approaches , 2010, 2010 IEEE International Conference on Robotics and Automation.

[29]  Constantinos Mavroidis,et al.  Magnetic resonance-compatible robotic and mechatronics systems for image-guided interventions and rehabilitation: a review study. , 2007, Annual review of biomedical engineering.

[30]  A S Whittemore,et al.  Localized prostate cancer. Relationship of tumor volume to clinical significance for treatment of prostate cancer , 1993, Cancer.

[31]  G.S. Fischer,et al.  MRI-Compatible Pneumatic Robot for Transperineal Prostate Needle Placement , 2008, IEEE/ASME Transactions on Mechatronics.

[32]  B. Kiefer,et al.  Prostate biopsy in the supine position in a standard 1.5-T scanner under real time MR-imaging control using a MR-compatible endorectal biopsy device , 2006, European Radiology.

[33]  Gabor Fichtinger,et al.  Design of a novel MRI compatible manipulator for image guided prostate interventions , 2005, IEEE Transactions on Biomedical Engineering.

[34]  Hessel Wijkstra,et al.  Transrectal ultrasound imaging and prostate cancer. , 2003, Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica.

[35]  Martha K. Terris Strategies for repeat prostate biopsies , 2009 .

[36]  L. Holmberg,et al.  The sextant protocol for ultrasound-guided core biopsies of the prostate underestimates the presence of cancer. , 1997, Urology.

[37]  J Kurhanewicz,et al.  Sextant localization of prostate cancer: comparison of sextant biopsy, magnetic resonance imaging and magnetic resonance spectroscopic imaging with step section histology. , 2000, The Journal of urology.

[38]  Zion Tsz Ho Tse,et al.  The case for MR‐compatible robotics: a review of the state of the art , 2008, The international journal of medical robotics + computer assisted surgery : MRCAS.

[39]  W. Fair,et al.  Incidence and clinical significance of false-negative sextant prostate biopsies. , 1998, The Journal of urology.

[40]  Katarzyna J Macura,et al.  MR-guided biopsy of the prostate: an overview of techniques and a systematic review. , 2008, European urology.

[41]  S. Dubowsky,et al.  MRI Compatible Device for Robotic Assisted Interventions to Prostate Cancer , 2009 .

[42]  Jan J W Lagendijk,et al.  MRI-guided robotic system for transperineal prostate interventions: proof of principle , 2010, Physics in medicine and biology.

[43]  K. Wallner,et al.  Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting , 2009, Prostate Cancer and Prostatic Diseases.

[44]  Gabor Fichtinger,et al.  A hybrid method for 6-DOF tracking of MRI-compatible robotic interventional devices , 2006, Proceedings 2006 IEEE International Conference on Robotics and Automation, 2006. ICRA 2006..

[45]  Ralph Buchert,et al.  Magnetic Resonance Imaging of Prostate Cancer: Diffusion-Weighted Imaging in Comparison With Sextant Biopsy , 2011, Journal of computer assisted tomography.

[46]  John B. Bak,et al.  Characterization of prostate cancer missed by sextant biopsy. , 2003, Clinical prostate cancer.

[47]  B. Davies,et al.  Robotic System for Transrectal Biopsy of the Prostate: Real-Time Guidance Under MRI , 2010, IEEE Engineering in Medicine and Biology Magazine.

[48]  Saroja Adusumilli,et al.  Magnetic resonance imaging of prostate cancer. , 2002, Seminars in urologic oncology.

[49]  D. Beyersdorff,et al.  MR imaging-guided prostate biopsy with a closed MR unit at 1.5 T: initial results. , 2005, Radiology.

[50]  Gabor Fichtinger,et al.  A MRI Compatible Device for MRI Guided Transrectal Prostate Biopsy , 2002 .

[51]  Jean-Sébastien Plante,et al.  The experimental study of a precision parallel manipulator with binary actuation: With application to MRI cancer treatment , 2008, 2008 IEEE International Conference on Robotics and Automation.

[52]  J. A. Derbyshire,et al.  System for MR image-guided prostate interventions: canine study. , 2003, Radiology.

[53]  Yi Wang,et al.  MRI compatibility evaluation of a piezoelectric actuator system for a neural interventional robot , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[54]  Nobuhiko Hata,et al.  Magnetic Resonance-guided Prostate Interventions , 2005, Topics in magnetic resonance imaging : TMRI.

[55]  C. N. Coleman,et al.  Transrectal prostate biopsy and fiducial marker placement in a standard 1.5T magnetic resonance imaging scanner. , 2006, The Journal of urology.

[56]  Gabor Fichtinger,et al.  Design and Preliminary Accuracy Studies of an MRI-Guided Transrectal Prostate Intervention System , 2007, MICCAI.

[57]  L P Panych,et al.  Needle artifact localization in 3T MR images. , 2006, Studies in health technology and informatics.

[58]  J C Presti,et al.  Prostate cancer: assessment of risk using digital rectal examination, tumor grade, prostate-specific antigen, and systematic biopsy. , 2000, Radiologic clinics of North America.

[59]  M W Kattan,et al.  Distinguishing clinically important from unimportant prostate cancers before treatment: value of systematic biopsies. , 1996, The Journal of urology.

[60]  Gabor Fichtinger,et al.  A preliminary analysis and model of prostate injection distributions , 2006, The Prostate.

[61]  R L Somorjai,et al.  Magnetic resonance spectroscopy of the malignant prostate gland after radiotherapy: a histopathologic study of diagnostic validity. , 2001, International journal of radiation oncology, biology, physics.

[62]  R M Henkelman,et al.  Prostate cancer: MR imaging and thermometry during microwave thermal ablation-initial experience. , 2000, Radiology.

[63]  T. Stamey,et al.  Morphometric and clinical studies on 68 consecutive radical prostatectomies. , 1988, The Journal of urology.

[64]  Thomas J Vogl,et al.  Prostate cancer: MR imaging-guided galvanotherapy--technical development and first clinical results. , 2007, Radiology.

[65]  Peter H Gann,et al.  Risk factors for prostate cancer detection after a negative biopsy: a novel multivariable longitudinal approach. , 2010, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[66]  Gabor Fichtinger,et al.  MRI Compatibility of Robot Actuation Techniques - A Comparative Study , 2008, MICCAI.

[67]  H. Hricak,et al.  Imaging of prostate cancer. , 2007, Radiologic clinics of North America.

[68]  Nobuhiko Hata,et al.  MR Compatible Surgical Assist Robot: System Integration and Preliminary Feasibility Study , 2000, MICCAI.

[69]  E. Burdet,et al.  Opportunities and Challenges in MR-Compatible Robotics , 2008, IEEE Engineering in Medicine and Biology Magazine.

[70]  A. D'Amico,et al.  Transperineal magnetic resonance image guided prostate biopsy. , 2000, The Journal of urology.

[71]  Thomas J. Vogl,et al.  MR-compatible assistance system for punction in a high-field system: device and feasibility of transgluteal biopsies of the prostate gland , 2007, European Radiology.

[72]  U G Mueller-Lisse,et al.  [Imaging modalities for primary diagnosis and staging of prostate cancer]. , 2010, Der Urologe. Ausg. A.

[73]  Axel Krieger,et al.  An Interventional Magnetic Resonance Imaging Technique for the Molecular Characterization of Intraprostatic Dynamic Contrast Enhancement , 2005, Molecular imaging.