Toward MR-Guided Robotic Intracerebral Hemorrhage Evacuation: Aiming Device Design and ex vivo Ovine Head Trial

Stereotactic neurosurgery is a well-established surgical technique for navigation and guidance during treatment of intracranial pathologies. Intracerebral hemorrhage (ICH) is an example of various neurosurgical conditions that can benefit from stereotactic neurosurgery. As a part of our ongoing work...

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Bibliographic Details
Published in:IEEE transactions on medical robotics and bionics 2024-05, Vol.6 (2), p.577-588
Main Authors: Gunderman, Anthony L., Sengupta, Saikat, Huang, Zhefeng, Sigounas, Dimitri, Oluigbo, Chima, Godage, Isuru S., Cleary, Kevin, Chen, Yue
Format: Article
Language:English
Subjects:
Accuracy
concentric tube robot
Connectors
Evacuation
Hematoma
Hemorrhage
Hemorrhaging
intracerebral hemorrhage evacuation
Kinematics
Magnetic resonance imaging
Medical robotics
MRI
Neurosurgery
Optical fiber cables
Robotics
Skull
stereotactic
Stroke
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Summary:Stereotactic neurosurgery is a well-established surgical technique for navigation and guidance during treatment of intracranial pathologies. Intracerebral hemorrhage (ICH) is an example of various neurosurgical conditions that can benefit from stereotactic neurosurgery. As a part of our ongoing work toward real-time MR-guided ICH evacuation, we aim to address an unmet clinical need for a skull-mounted frameless stereotactic aiming device that can be used with minimally invasive robotic systems for MR-guided interventions. In this paper, we present NICE-Aiming, a Neurosurgical, Interventional, Configurable device for Effective-Aiming in MR-guided robotic neurosurgical interventions. A kinematic model was developed and the system was used with a concentric tube robot (CTR) for ICH evacuation in (i) a skull phantom and (ii) in the first ever reported ex vivo CTR ICH evacuation using an ex vivo ovine head. The NICE-Aiming prototype provided a tip accuracy of 1.41±0.35 mm in free-space. In the MR-guided gel phantom experiment, the targeting accuracy was 2.07±0.42 mm and the residual hematoma volume was 12.87 mL (24.32% of the original volume). In the MR-guided ex vivo ovine head experiment, the targeting accuracy was 2.48±0.48 mm and the residual hematoma volume was 1.42 mL (25.08% of the original volume).
ISSN:2576-3202
2576-3202
DOI:10.1109/TMRB.2024.3385794