MR-guided HDR prostate brachytherapy with teleoperated steerable needles

Area of Science:

• Medical Robotics
• Image-Guided Therapy
• Prostate Cancer Treatment

Background:

• Prostate brachytherapy (BT) faces challenges like needle deflection and access limitations, impacting treatment conformity.
• Current methods struggle to navigate complex anatomy and avoid critical structures during needle placement.

Purpose of the Study:

• To validate a teleoperated robotic system with an active steerable needle for MR-guided prostate brachytherapy.
• To assess the system's ability to counteract perturbations and access difficult-to-reach areas within the prostate.

Main Methods:

• Development of a novel steerable needle integrated with the MIRIAM (Minimally Invasive Robotics in an MR environment) system and daVinci Research Kit (dVRK).
• Utilizing real-time MR imaging for visual feedback to the operator controlling the dVRK.
• Performing needle steering along curved trajectories to target simulated tumour tissue in a prostate phantom.

Main Results:

• The system achieved a targeting error of 1.2 ± 1.0 mm in a prostate phantom.
• Demonstrated successful needle steering along curved paths to avoid the urethra.
• Validated the ability to counteract perturbations and navigate to target locations.

Conclusions:

• Teleoperated robotic control of an active steerable needle in an MR environment is feasible for prostate brachytherapy.
• The system shows potential for improving precision and safety in prostate BT by enabling access to challenging areas.
• This technology could enhance treatment conformity and patient outcomes in prostate cancer management.