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Interactive Multi-Stage Robotic Positioner for Intra-Operative MRI-Guided Stereotactic Neurosurgery.

Zhuoliang He1, Jing Dai1, Justin Di-Lang Ho1

  • 1Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, 999077, China.

Advanced Science (Weinheim, Baden-Wurttemberg, Germany)
|December 10, 2023
PubMed
Summary
This summary is machine-generated.

A novel robotic positioner enhances MRI-guided neurosurgery by enabling precise intra-operative instrument control. This system overcomes limitations of static imaging, improving accuracy for complex procedures.

Keywords:
MRI-guided interventionsframeless stereotaxissoft roboticsstereotactic neurosurgerysurgical robotics

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Area of Science:

  • Neurosurgery
  • Medical Robotics
  • Medical Imaging

Background:

  • Magnetic resonance imaging (MRI) offers superior visualization for neurosurgery but is limited to pre/post-operative imaging.
  • Static imaging leads to errors from stereotactic frame setup, image registration, and brain shift.

Purpose of the Study:

  • To develop a multi-stage robotic positioner for real-time, MRI-guided neurosurgical interventions.
  • To enable intra-operative functions like instrument tracking and physiological monitoring during bilateral stereotactic neurosurgery.

Main Methods:

  • A compact, skull-mounted robotic system with two-stage positioning: manual coarse adjustment and precise soft robotic fine adjustment.
  • The system utilizes a lightweight design compatible with MRI head coils and features orientation locking for instrument stability.
  • Validation through lab-based, MRI-based phantom testing, and cadaveric trials, incorporating wireless tracking markers for robot registration.

Main Results:

  • The robotic positioner achieved precise (<0.2° orientation error) and responsive (1.4 Hz bandwidth) soft robotic positioning.
  • Accuracy was validated at <0.8 mm in lab settings, <1.7 mm on skull phantoms, and <2.2 mm in a cadaver subject.
  • Sufficient transmission stiffness (4.07 N/mm) was demonstrated for instrument advancement.

Conclusions:

  • The proposed multi-stage robotic positioner effectively enables precise intra-operative MRI-guided neurosurgery.
  • The system overcomes limitations of static imaging, offering enhanced accuracy and real-time instrument control for complex procedures.