M Anvari, N Duchesne, T Fielding, K G Chan, P D Bevan, T Chapman. Center for Surgical Invention and Innovation, Hamilton, Ontario, Canada.
Objective: The IGAR (Image Guided Autonomous Robot) is a novel robotic technology that facilitates image-guided medical interventions. The IGAR’s high level of accuracy and MR environment compatibility enable early detection, diagnosis, and intervention in small lesions, creating a new and comprehensive cancer management strategy.
Method: The first IGAR application is MRI-guided breast biopsy and ablation using cryotherapy. MR images are pushed to an IGAR workstation that registers the MR image space to the patient reference frame via MRI-lucent fiducial markers embedded in the base of a modified patient support structure. The robotic manipulator then drives tools to a target and along a trajectory selected by the supervising physician. In addition to accurate tool positioning, the IGAR is capable of anesthesia injection and tool roll. The IGAR is MRI-compatible, and remains in the MR bore during image acquisition and capable of real-time action.
Results: On the benchtop, IGAR demonstrates an average error of 0.29mm with a repeatability of 0.20mm. The IGAR has minimal (to no) impact on image quality, with geometric distortions under 1mm. End-to-end demonstrations have been conducted in phantom models with successful targeting. Clinical trials will begin in January 2014 with results available for presentation at conference.
Future Directions: IGAR is currently indicated for breast biopsy and ablation but may also be suitable for lung, liver, kidney, and sentinel node biopsy and ablation. The accurate tool placement may be utilized for therapeutic interventions including cryotherapy and radioactive seed placement. The IGAR is teleoperable, and its remote operation may improve access to high quality healthcare in remote communities.