| Prostate cancer is the most
common and deadliest form of cancer in men in the United States, with an
annual incidence over 200,000 and a death rate of approximately 33,000.
More than one million prostate biopsies are performed each year, with approximately
20% of the patients diagnosed with cancer. Many of the rest will
suffer from benign prostate hyperplasia that typically requires later surgical
intervention. Contemporary image-guided prostate interventions are
constrained to freehand techniques under ultrasound guidance. While
popular due to its real-time nature, safety, and low cost, ultrasound quality
can be suboptimal and the freehand technique can be improved.
Researchers at the NSF Engineering
Research Center (ERC) for Computer-Integrated Surgical Systems and Technology
(CISST), based at Johns Hopkins University, are seeking to eliminate both
of these shortcomings by developing novel robotic systems designed to redefine
the standard of care in prostate interventions. The robots being
developed will place needles precisely into the prostate under guidance
from Magnetic Resonance Imaging (MRI), which provides the best anatomical
picture available today. However, a number of technological challenges
have had to be overcome. First, the high magnetic field inside the
scanner precludes the use of metals and electronics. Second, the
workspace inside an MRI scanner is severely limiting. Third, there
is no room to maneuver in the rectal cavity, where a surgical needle must
“turn a corner” to enter the prostate gland across the wall of the cavity.
CISST’s MRI-guided robot
overcomes each of these problems and enables precise anatomical targeting
inside a closed high-field MRI scanner, with previously unprecedented image
quality. Initial phantom and clinical trials of a next-generation
version of the system (see figure) have recently been completed.
Johns Hopkins has applied for two patents of invention on this novel technology,
and is successfully licensing these patents for commercialization. |
