TY - JOUR
T1 - Fully Actuated Body-Mounted Robotic System for MRI-Guided Lower Back Pain Injections
T2 - Initial Phantom and Cadaver Studies
AU - Li, Gang
AU - Patel, Niravkumar A.
AU - Wang, Yanzhou
AU - Dumoulin, Charles
AU - Loew, Wolfgang
AU - Loparo, Olivia
AU - Schneider, Katherine
AU - Sharma, Karun
AU - Cleary, Kevin
AU - Fritz, Jan
AU - Iordachita, Iulian
N1 - Funding Information:
Valdastri upon evaluation of the reviewers’ comments. This work was supported back pain, which is commonly performed in the lower back and by the National Institutes of Health grant R01 EB025179. (Corresponding pelvis area, involving delivery of pain-relief medications to the GangLi,Niravkumar A. Patel, Yanzhou Wang, and Iulian Iordachita areauthor:GangLi.) facet joint, the narrow epidural space, the spinal nerve root, or the with the Laboratory for Computational Sensing and Robotics (LCSR), Johns medial branches of dorsal rami [3]. Conventional lumbar spinal Hopkins University, Baltimore, MD USA (e-mail: gangli.hit@gmail.com; injections use X-ray, i.e. fluoroscopy or computed tomography CharlesDumoulin,WolfgangLoew,OliviaLoparo,andKatherineSchnei-nirav.robotics@gmail.com;ywang521@jh.edu;iordachita@jhu.edu). (CT), to provide intervention guidance, which involves ionizing der are with the Cincinnati Children’s Hospital Medical Center, Cincinnati, radiation exposure to both patients and physicians. Ultrasound OHUSA(e-mail:charles.dumoulin@cchmc.org;wolfgang.loew@cchmc.org; is free of ionizing radiation, however, nerve visualization can KarunSharmaandKevinClearyarewiththeSheikhZayedInstituteforPedi-loparoom@mail.uc.edu;schnek5@mail.uc.edu). be difficult, particularly for deep nerves such as those in obese atric Surgical Innovation, Children’s National Hospital, Washington, DC USA patients and in the pelvis area. Conversely, magnetic resonance (e-mail:kvsharma@childrensnational.org;kcleary@childrensnational.org). imaging (MRI) is an ideal imaging modality for lumbar spinal JohnsHopkinsUniversitySchoolofMedicine,Baltimore,MDUSA(e-mail:JanFritziswiththeDepartmentofRadiologyandRadiologicalScience, injections. MRI is able to provide unmatched soft tissue contrast janfritz777@gmail.com). and excellent anatomical details in real-time without exposing This letter has supplementary downloadable the patient or clinician to ionizing radiation, which is particularly https://ieeexplore.ieee.org,providedbytheauthors. critical for the reproductive organs in the lumbar spinal region
Publisher Copyright:
© 2016 IEEE.
PY - 2020/10
Y1 - 2020/10
N2 - This letter reports the improved design, system integration, and initial experimental evaluation of a fully actuated body-mounted robotic system for real-time MRI-guided lower back pain injections. The 6-DOF robot is composed of a 4-DOF needle alignment module and a 2-DOF remotely actuated needle driver module, which together provide a fully actuated manipulator that can operate inside the scanner bore during imaging. The system minimizes the need to move the patient in and out of the scanner during a procedure, and thus may shorten the procedure time and streamline the clinical workflow. The robot is devised with a compact and lightweight structure that can be attached directly to the patient's lower back via straps. This approach minimizes the effect of patient motion by allowing the robot to move with the patient. The robot is integrated with an image-based surgical planning module. A dedicated clinical workflow is proposed for robot-assisted lower back pain injections under real-time MRI guidance. Targeting accuracy of the system was evaluated with a real-time MRI-guided phantom study, demonstrating the mean absolute errors (MAE) of the tip position to be 1.50 \pm 0.68 mm and of the needle angle to be 1.56 \pm \; \text{0.93}^\circ. An initial cadaver study was performed to validate the feasibility of the clinical workflow, indicating the maximum error of the position to be less than 1.90 mm and of the angle to be less than 3.14 ^\circ.
AB - This letter reports the improved design, system integration, and initial experimental evaluation of a fully actuated body-mounted robotic system for real-time MRI-guided lower back pain injections. The 6-DOF robot is composed of a 4-DOF needle alignment module and a 2-DOF remotely actuated needle driver module, which together provide a fully actuated manipulator that can operate inside the scanner bore during imaging. The system minimizes the need to move the patient in and out of the scanner during a procedure, and thus may shorten the procedure time and streamline the clinical workflow. The robot is devised with a compact and lightweight structure that can be attached directly to the patient's lower back via straps. This approach minimizes the effect of patient motion by allowing the robot to move with the patient. The robot is integrated with an image-based surgical planning module. A dedicated clinical workflow is proposed for robot-assisted lower back pain injections under real-time MRI guidance. Targeting accuracy of the system was evaluated with a real-time MRI-guided phantom study, demonstrating the mean absolute errors (MAE) of the tip position to be 1.50 \pm 0.68 mm and of the needle angle to be 1.56 \pm \; \text{0.93}^\circ. An initial cadaver study was performed to validate the feasibility of the clinical workflow, indicating the maximum error of the position to be less than 1.90 mm and of the angle to be less than 3.14 ^\circ.
KW - MRI-guided robot
KW - body-mounted robot
KW - lower back pain injection
KW - robot-assisted intervention
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U2 - 10.1109/LRA.2020.3007459
DO - 10.1109/LRA.2020.3007459
M3 - Article
AN - SCOPUS:85088703642
SN - 2377-3766
VL - 5
SP - 5245
EP - 5251
JO - IEEE Robotics and Automation Letters
JF - IEEE Robotics and Automation Letters
IS - 4
M1 - 9134864
ER -