Publications

@article{pmid40213929,

title = {Feasibility of MRI-Guided Transperineal Implantation of Microdevices for Drug Delivery and Response Assessment in Prostate Cancer},

author = {Quinn Rainer and Kemal Tuncali and Wooseok Ahn and Fanni Viktoria Santa and Michelle Hirsch and Sharath Bhagavatula and Fumitaro Masaki and Clarissa Therese Young and Courtney Marlin and Samantha Martin and Destiny U Matthew and Filipe De Carvalho and Christine A Dominas and Benjamin V Stone and Clare Tempany and Oliver Jonas and Adam Stuart Kibel and Nobuhiko Hata},

doi = {10.1002/jmri.29784},

issn = {1522-2586},

year  = {2025},

date = {2025-04-01},

journal = {J Magn Reson Imaging},

abstract = {BACKGROUND: Prostate cancer (PCa) treatment often involves systemic therapies with varying mechanisms of action, affecting individuals differently. Implantable microdevices (IMDs) are designed to test multiple drugs within a patient's tumor, but the feasibility of MRI-guided placement in PCa has not been evaluated.nnPURPOSE: To provide proof of concept for placing IMDs into lesions with MRI guidance to predict patient-specific responses to therapies.nnSTUDY TYPE: Prospective.nnPOPULATION: Fifteen participants undergoing prostatectomy for PCa.nnFIELD STRENGTH/SEQUENCE: 3T MRI With T2-weighted (T2W).nnASSESSMENT: In-bore MRI-targeted placement of IMDs was performed. Intra-procedural MRI scans were reviewed by a radiologist, using needle artifacts on T2W images to guide IMD placement. A genitourinary pathologist performed Gleason scoring around the IMDs. Drug response analysis included Enzalutamide + Nivolumab, Enzalutamide + Docetaxel, and single-agent Enzalutamide.nnSTATISTICAL TESTS: Mann-Whitney U test for continuous variables, p < 0.05 for significance.nnRESULTS: Of 53 IMDs implanted into suspicious lesions in 14 participants, 48 (90%) were successfully placed within the lesions. The average distance from the needle tip to the tumor was 8.32 ± 4.02 mm. Larger lesion size (p = 0.009) and lower prostate imaging-reporting and data system score (p = 0.031) were significantly associated with successful IMD placement. Of the 53 IMDs, 49 (92.4%) were retrieved for histopathology and drug response analysis. In four participants, Gleason scores around the device were lower than preplacement biopsy in two and equal in two. Additionally, drug analysis in one patient demonstrated the feasibility of drug response analysis, revealing differences in apoptotic index, lymphocyte infiltration, dysplastic cell composition, and cellular profiles for each treatment. No complications or adverse events occurred.nnCONCLUSION: IMDs can be effectively and safely placed in prostate lesions using MRI guidance, with feasible histological and drug response analyses.nnEVIDENCE LEVEL: 2. Technical Efficacy: Stage 1.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40305248,

title = {Conditional Autonomy in Robot-Assisted Transbronchial Interventions},

author = {Artur Banach and Fumitaro Masaki and Lambros Athanasiou and Franklin King and Hussein Kharroubi and Bassel Tfayli and Hisashi Tsukada and Yolonda Colson and Nobuhiko Hata},

doi = {10.1109/TBME.2025.3565915},

issn = {1558-2531},

year  = {2025},

date = {2025-04-01},

urldate = {2025-04-01},

journal = {IEEE Trans Biomed Eng},

volume = {PP},

abstract = {Lung cancer is one of the leading causes of cancer-related deaths, and accurate staging is critical for determining the appropriate treatment. Robotic Navigation Bronchoscopy has shown advantages over traditional manual procedures, offering benefits in safety, efficiency, and accessibility. Although there is ongoing discussion regarding autonomous RNB, there is limited focus on the autonomy in advancing the bronchoscope. In this study, we introduce a novel method for conditional autonomy in advancing and aligning a robotic bronchoscope, which was validated in vitro, ex vivo, and in vivo. This conditional autonomy utilizes a monoscopic bronchoscopic view as input, with operators guiding the system by specifying the next airway to enter at branching points. The reachability of target lesions using this conditional autonomy was 73.3% in the phantom study and 77.5% in the ex vivo study. Statistical significance was found in success rates between bifurcations and trifurcations (p = 0.03) and across lobe segments (p = 0.005). The presence of breathing motion did not affect lesion reachability or the success of turns at branching points in the ex vivo studies. In the in vivo study, when comparing conditional automation to humanoperated navigation, the conditional automation took less time to reach the target lesions than human operators. The median time for passing each bifurcation was 2.5 seconds for human operators and 1.3 seconds for conditional automation. By improving precision and consistency in tissue sampling, this technology could redefine the standard of care for lung cancer patients, leading to more accurate diagnoses and therapies.},

key = {MRI; interventional radiology; microdevice; prostate cancer},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39348711,

title = {Novel Intraprostatic Magnetic Resonance-Guided Implantation of Multidrug-Eluting Microdevice for Testing of Systemic Therapy Agents In Situ: Proof of Concept in Intermediate-Risk and High-Risk Prostate Cancer},

author = {Benjamin V Stone and Christine A Dominas and Sharath K Bhagavatula and Sebastian W Ahn and Zuzana Tatarova and Juraj Jakubik and Destiny Matthew and Matthew Mossanen and Daniella Furtado and Kemal Tuncali and Michelle S Hirsch and Nobuhiko Hata and Clare Tempany and Oliver Jonas and Adam S Kibel},

doi = {10.1097/JU.0000000000004269},

issn = {1527-3792},

year  = {2025},

date = {2025-02-01},

journal = {J Urol},

volume = {213},

number = {2},

pages = {173--182},

abstract = {PURPOSE: The purpose of this study was to assess safety and feasibility of percutaneous magnetic resonance-guided placement of an implantable microdevice (IMD) to evaluate in situ intratumor response to multiple pharmacologic agents in men with intermediate-risk and high-risk localized prostate cancer.nnMATERIALS AND METHODS: Biocompatible IMDs measuring 750 µm in diameter and 5 mm in length were prepared with 20 reservoirs containing candidate drug and drug combinations including second-generation androgen inhibitors, PARP inhibitors, PD-1 inhibitors, and conventional chemotherapy. Men with intermediate-risk or high-risk localized prostate cancer and MRI-visible lesions were enrolled. Up to 4 IMDs were placed using a transperineal approach into MRI-visible tumors 2 days before planned radical prostatectomy. After radical prostatectomy, the IMDs and a small segment of surrounding tumor tissue were removed and sectioned, stained, and analyzed for tissue drug response by a variety of pharmacodynamic markers.nnRESULTS: Fourteen patients were enrolled: 7 (50%) with intermediate-risk and 7 (50%) with high-risk localized prostate cancer. A total of 53 IMDs were implanted (mean 3.8 per patient), and 49 IMDs (92%) were successfully retrieved. All men underwent uncomplicated robotic-assisted radical prostatectomy and bilateral pelvic lymph node dissection 2 days after IMD placement. There were no severe adverse events. Pathological examination of the tissues adjacent to the IMDs demonstrated differential drug response within patients and between patients. Limitations include small sample size.nnCONCLUSIONS: A multidrug IMD can be safely placed percutaneously into MRI-visible lesions before radical prostatectomy, enabling assessment of tumor-specific local response to multiple agents simultaneously within the tumor's normal stromal environment to guide targeted systemic therapy.nnTRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04399876.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{bernardes_vivo_2024,

title = {In Vivo Feasibility Study: Evaluating Autonomous Data-Driven Robotic Needle Trajectory Correction in MRI-Guided Transperineal Procedures},

author = {Mariana C. Bernardes and Pedro Moreira and Dimitri Lezcano and Lori Foley and Kemal Tuncali and Clare Tempany and Jin Seob Kim and Nobuhiko Hata and Iulian Iordachita and Junichi Tokuda},

doi = {10.1109/LRA.2024.3455940},

issn = {2377-3766},

year  = {2024},

date = {2024-10-01},

journal = {IEEE ROBOTICS AND AUTOMATION LETTERS},

volume = {9},

number = {10},

pages = {8975–8982},

abstract = {This letter addresses the targeting challenges in MRI-guided transperineal needle placement for prostate cancer (PCa) diagnosis and treatment, a procedure where accuracy is crucial for effective outcomes. We introduce a parameter-agnostic trajectory correction approach incorporating a data-driven closed-loop strategy by radial displacement and an FBG-based shape sensing to enable autonomous needle steering. In an animal study designed to emulate clinical complexity and assess MRI compatibility through a PCa mock biopsy procedure, our approach demonstrated a significant improvement in targeting accuracy (p < 0.05), with mean target error of only 2.2 +/- 1.9 mm on first insertion attempts, without needle reinsertions. To the best of our knowledge, this work represents the first in vivo evaluation of robotic needle steering with FBG-sensor feedback, marking a significant step towards its clinical translation.},

note = {Num Pages: 8 

Place: Piscataway 

Publisher: Ieee-Inst Electrical Electronics Engineers Inc 

Web of Science ID: WOS:001316210300001},

keywords = {Accuracy, Fiber Bragg gratings, Force, In vivo, Magnetic Resonance Imaging, Medical robots and systems, needles, prostate biopsy, Robot sensing systems, robots, surgical robotics: steerable catheters/needles, TISSUE, Trajectory},

pubstate = {published},

tppubtype = {article}

}

@article{xu_pilot_2024,

title = {Pilot study of an implantable microdevice forin vivo evaluation of drug response in renal cell carcinoma (NCT05700461)},

author = {Wenxin Xu and Sharath Bhagavatula and Clara Steiner and Caiwei Zhong and Matthew Mossanen and Steven Chang and Michelle Hirsch and Sebastian Ahn and Destiny Matthew and Stephanie Berg and Michael Serzan and Bradley McGregor and Nobuhiko Hata and Srinivas Viswanathan and Stuart Silverman and Oliver Jonas and Toni Choueiri},

doi = {10.1093/oncolo/oyae181.021},

issn = {1083-7159, 1549-490X},

year  = {2024},

date = {2024-08-01},

journal = {ONCOLOGIST},

volume = {29},

pages = {S14–S15},

note = {Num Pages: 2 

Place: Oxford 

Publisher: Oxford Univ Press 

Web of Science ID: WOS:001289325400059},

keywords = {Biomarkers, drug response, microdevice, RCC, Tumor Microenvironment},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38328532,

title = {Supratrochlear Rim is Correlated with Isolated Patellar Chondromalacia on Magnetic Resonance Imaging of the Knee},

author = {Artur Banach and Nobuhiko Hata and Ross Crawford and Tomasz Piontek},

doi = {10.1016/j.asmr.2023.100855},

issn = {2666-061X},

year  = {2024},

date = {2024-04-01},

journal = {Arthrosc Sports Med Rehabil},

volume = {6},

number = {2},

pages = {100855},

abstract = {PURPOSE: To investigate the relationship between the supratrochlear rim and isolated patellar chondromalacia (PC) using magnetic resonance imaging (MRI) scans of the knee.nnMETHODS: Patients without patellofemoral pain (control group) and patients with patellofemoral pain and diagnosed with stage III or IV PC based on MRI (defect group) were retrospectively identified. Patients with a history of patellar subluxation were excluded. We used patient MRI scans to perform 20 anatomical measurements of the patellofemoral joint. We also performed 2 measurements of the anterior femoral curvature. A total of 30 patients (29 ± 8.7 years) were in the control group, and 20 patients were in the defect group (29.4 ± 9.7 years).nnRESULTS: The maximum curvature ( < 001) and mean curvature ( < .001) of the anterior femoral condyle were found statistically significantly different between the groups. Patellotrochlear index ( = .03) and Insall-Salvati index ( < .001) were also found statistically significantly different between the 2 groups. Patella type III and trochlear dysplasia grade B were found more common in the defect group.nnCONCLUSIONS: In this Level III prognostic, case-control study, we have shown through MRI knee measurements that the isolated patellar chondromalacia in patients without a history of patellar subluxation and dislocation is correlated with the increased anterior femoral curvature in combination with patella alta.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{kobayashi_feasibility_2023,

title = {Feasibility of multi-section continuum robotic ureteroscope in the kidney},

author = {Satoshi Kobayashi and Fumitaro Masaki and Franklin King and Daniel A. Wollin and Adam S. Kibel and Nobuhiko Hata},

doi = {10.1007/s11701-023-01530-0},

issn = {1863-2483, 1863-2491},

year  = {2023},

date = {2023-08-01},

journal = {JOURNAL OF ROBOTIC SURGERY},

volume = {17},

number = {4},

pages = {1411–1420},

abstract = {Our objective was to evaluate the feasibility of a multi-section continuum robotic ureteroscope to address the difficulties with access into certain renal calyces during flexible ureteroscopy. First, the robotic ureteroscope developed in previous research, which utilizes three actuated bendable sections controlled by wires, was modified for use in this project. Second, using phantom models created from five randomly selected computer tomography urograms, the flexible ureteroscope and robotic ureteroscope were evaluated, focusing on several factors: time taken to access each renal calyx, time taken to aim at three targets on each renal calyx, the force generated in the renal pelvic wall associated with ureteroscope manipulation, and the distance and standard deviation between the ureteroscope and the target. As a result, the robotic ureteroscope utilized significantly less force during lower pole calyx access (flexible ureteroscope vs. robotic ureteroscope; 2.0 vs. 0.98 N},

note = {Num Pages: 10 

Place: London 

Publisher: Springernature 

Web of Science ID: WOS:000922654100002},

keywords = {Anatomy, ERGONOMICS, FLEXIBLE URETEROSCOPY, Kidney stone, Lithotripsy, PERCUTANEOUS NEPHROLITHOTOMY, RENAL STONES, Robotic ureteroscope, Ureteroscopy},

pubstate = {published},

tppubtype = {article}

}

@article{bernardes_data-driven_2023,

title = {Data-driven adaptive needle insertion assist for transperineal prostate interventions},

author = {Mariana C. Bernardes and Pedro Moreira and Lisa Mareschal and Clare Tempany and Kemal Tuncali and Nobuhiko Hata and Junichi Tokuda},

doi = {10.1088/1361-6560/accefa},

issn = {0031-9155, 1361-6560},

year  = {2023},

date = {2023-05-01},

journal = {PHYSICS IN MEDICINE AND BIOLOGY},

volume = {68},

number = {10},

pages = {105016},

abstract = {Objective. Clinical outcomes of transperineal prostate interventions, such as biopsy, thermal ablations, and brachytherapy, depend on accurate needle placement for effectiveness. However, the accurate placement of a long needle, typically 150-200 mm in length, is challenging due to needle deviation induced by needle-tissue interaction. While several approaches for needle trajectory correction have been studied, many of them do not translate well to practical applications due to the use of specialized needles not yet approved for clinical use, or to relying on needle-tissue models that need to be tailored to individual patients. Approach. In this paper, we present a robot-assisted collaborative needle insertion method that only requires an actuated passive needle guide and a conventional needle. The method is designed to assist a physician inserting a needle manually through a needle guide. If the needle is deviated from the intended path, actuators shifts the needle radially in order to steer the needle trajectory and compensate for needle deviation adaptively. The needle guide is controlled by a new data-driven algorithm which does not require a priori information about needle or tissue properties. The method was evaluated in experiments with both in vitro and ex vivo phantoms. Main results. The experiments in ex vivo tissue reported a mean final placement error of 0.36 mm with a reduction of 96.25% of placement error when compared to insertions without the use of assistive correction. Significance. Presented results show that the proposed closed-loop formulation can be successfully used to correct needle deflection during collaborative manual insertion with potential to be easily translated into clinical application.},

note = {Num Pages: 14 

Place: Bristol 

Publisher: IoP Publishing Ltd 

Web of Science ID: WOS:000987076600001},

keywords = {biopsy, Brachytherapy, CANCER, Cryoablation, data-driven model, FEASIBILITY, Force, medical robotics, MOTION, needle insertion assist, Robot, TISSUE, transperineal prostate intervention, Ultrasound},

pubstate = {published},

tppubtype = {article}

}

@article{banach_computer-based_2023,

title = {Computer-based airway stenosis quantification from bronchoscopic images: preliminary results from a feasibility trial},

author = {Artur Banach and Masahito Naito and Franklin King and Fumitaro Masaki and Hisashi Tsukada and Nobuhiko Hata},

doi = {10.1007/s11548-022-02808-8},

issn = {1861-6410, 1861-6429},

year  = {2023},

date = {2023-04-01},

journal = {INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY},

volume = {18},

number = {4},

pages = {707–713},

abstract = {Purpose Airway Stenosis (AS) is a condition of airway narrowing in the expiration phase. Bronchoscopy is a minimally invasive pulmonary procedure used to diagnose and/or treat AS. The AS quantification in a form of the Stenosis Index (SI), whether subjective or digital, is necessary for the physician to decide on the most appropriate form of treatment. The literature reports that the subjective SI estimation is inaccurate. In this paper, we propose an approach to quantify the SI defining the level of airway narrowing, using depth estimation from a bronchoscopic image. Methods In this approach we combined a generative depth estimation technique combined with depth thresholding to provide Computer-based AS quantification. We performed an interim clinical analysis by comparing AS quantification performance of three expert bronchoscopists against the proposed Computer-based method on seven patient datasets. Results The Mean Absolute Error of the subjective Human-based and the proposed Computer-based SI estimation was 24.0 +/- 13.9 [%] and 9.1 +/- 7.7 [%], respectively. The correlation coefficients between the CT measurements were used as the gold standard, and the Human-based and Computer-based SI estimation were-0.05 and 0.46, respectively. Conclusions We presented a new computer method to quantify the severity of AS in bronchoscopy using depth estimation and compared the performance of the method against a human-based approach. The obtained results suggest that the proposed Computer-based AS quantification is a feasible tool that has the potential to provide significant assistance to physicians in bronchoscopy.},

note = {Num Pages: 7 

Place: Heidelberg 

Publisher: Springer Heidelberg 

Web of Science ID: WOS:000900069100001},

keywords = {ADULTS, Airway stenosis quantification, Bronchoscopy, DEPTH, Image-guided surgery, OBSTRUCTION, RECONSTRUCTION, TRACHEOBRONCHOMALACIA},

pubstate = {published},

tppubtype = {article}

}

@article{kobayashi_automatic_2023,

title = {Automatic segmentation of prostate and extracapsular structures in MRI to predict needle deflection in percutaneous prostate intervention},

author = {Satoshi Kobayashi and Franklin King and Nobuhiko Hata},

doi = {10.1007/s11548-022-02757-2},

issn = {1861-6410, 1861-6429},

year  = {2023},

date = {2023-03-01},

journal = {INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY},

volume = {18},

number = {3},

pages = {449–460},

abstract = {Purpose Understanding the three-dimensional anatomy of percutaneous intervention in prostate cancer is essential to avoid complications. Recently, attempts have been made to use machine learning to automate the segmentation of functional structures such as the prostate gland, rectum, and bladder. However, a paucity of material is available to segment extracapsular structures that are known to cause needle deflection during percutaneous interventions. This research aims to explore the feasibility of the automatic segmentation of prostate and extracapsular structures to predict needle deflection. Methods Using pelvic magnetic resonance imagings (MRIs), 3D U-Net was trained and optimized for the prostate and extracapsular structures (bladder, rectum, pubic bone, pelvic diaphragm muscle, bulbospongiosus muscle, bull of the penis, ischiocavernosus muscle, crus of the penis, transverse perineal muscle, obturator internus muscle, and seminal vesicle). The segmentation accuracy was validated by putting intra-procedural MRIs into the 3D U-Net to segment the prostate and extracapsular structures in the image. Then, the segmented structures were used to predict deflected needle path in in-bore MRI-guided biopsy using a model-based approach. Results The 3D U-Net yielded Dice scores to parenchymal organs (0.61-0.83), such as prostate, bladder, rectum, bulb of the penis, crus of the penis, but lower in muscle structures (0.03-0.31), except and obturator internus muscle (0.71). The 3D U-Net showed higher Dice scores for functional structures (p <0.001) and complication-related structures (p <0.001). The segmentation of extracapsular anatomies helped to predict the deflected needle path in MRI-guided prostate interventions of the prostate with the accuracy of 0.9 to 4.9 mm. Conclusion Our segmentation method using 3D U-Net provided an accurate anatomical understanding of the prostate and extracapsular structures. In addition, our method was suitable for segmenting functional and complication-related structures. Finally, 3D images of the prostate and extracapsular structures could simulate the needle pathway to predict needle deflections.},

note = {Num Pages: 12 

Place: Heidelberg 

Publisher: Springer Heidelberg 

Web of Science ID: WOS:000857906200002},

keywords = {3-D, 3D U-Net, biopsy, CANCER, Deep learning, guidance, Percutaneous intervention, Prostate, RISK, Segmentation, Ultrasound},

pubstate = {published},

tppubtype = {article}

}

@article{naito_predicting_2023,

title = {Predicting reachability to peripheral lesions in transbronchial biopsies using CT-derived geometrical attributes of the bronchial route},

author = {Masahito Naito and Fumitaro Masaki and Rebecca Lisk and Hisashi Tsukada and Nobuhiko Hata},

doi = {10.1007/s11548-022-02723-y},

issn = {1861-6410, 1861-6429},

year  = {2023},

date = {2023-02-01},

journal = {INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY},

volume = {18},

number = {2},

pages = {247–255},

abstract = {Purpose The bronchoscopist's ability to locate the lesion with the bronchoscope is critical for a transbronchial biopsy. However, much less study has been done on the transbronchial biopsy route. This study aims to determine whether the geometrical attributes of the bronchial route can predict the difficulty of reaching tumors in bronchoscopic intervention. Methods This study included patients who underwent bronchoscopic diagnosis of lung tumors using electromagnetic navigation. The biopsy instrument was considered "reached" and recorded as such if the tip of the tracked bronchoscope or extended working channel was in the tumors. Four geometrical indices were defined: Local curvature (LC), plane rotation (PR), radius, and global relative angle. A Mann-Whitney U test and logistic regression analysis were performed to analyze the difference in geometrical indices between the reachable and unreachable groups. Receiver operating characteristic analysis (ROC) was performed to evaluate the geometrical indices to predict reachability. Results Of the 41 patients enrolled in the study, 16 patients were assigned to the unreachable group and 25 patients to the reachable group. LC, PR, and radius have significantly higher values in unreachable cases than in reachable cases (p < 0.001, p < 0.001},

note = {Num Pages: 9 

Place: Heidelberg 

Publisher: Springer Heidelberg 

Web of Science ID: WOS:000842139400003},

keywords = {Bronchoscopy, diagnosis, ENDOBRONCHIAL ULTRASOUND, FIBEROPTIC BRONCHOSCOPE, Geometrical index, LUNG LESIONS, Navigation, Reachability, SAFETY, ULTRATHIN BRONCHOSCOPY},

pubstate = {published},

tppubtype = {article}

}

@article{luo_guest_2022,

title = {Guest Editorial Special Section on Surgical Vision, Navigation, and Robotics},

author = {Xiongbiao Luo and Danail Stoyanov and Nobuhiko Hata and Alejandro F. Frangi and Russell H. Taylor and Terry M. Peters},

doi = {10.1109/TMRB.2022.3147605},

issn = {2576-3202},

year  = {2022},

date = {2022-02-01},

journal = {IEEE TRANSACTIONS ON MEDICAL ROBOTICS AND BIONICS},

volume = {4},

number = {1},

pages = {2–4},

note = {Num Pages: 3 

Place: Piscataway 

Publisher: Ieee-Inst Electrical Electronics Engineers Inc 

Web of Science ID: WOS:000896687000001},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{dominas_translational_2022,

title = {The Translational and Regulatory Development of an Implantable Microdevice for Multiple Drug Sensitivity Measurements in Cancer Patients},

author = {Christine Dominas and Sharath Bhagavatula and Elizabeth Stover and Kyle Deans and Cecilia Larocca and Yolanda Colson and Pierpaolo Peruzzi and Adam Kibel and Nobuhiko Hata and Lillian Tsai and Yin Hung and Robert Packard and Oliver Jonas},

doi = {10.1109/TBME.2021.3096126},

issn = {0018-9294, 1558-2531},

year  = {2022},

date = {2022-01-01},

journal = {IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING},

volume = {69},

number = {1},

pages = {412–421},

abstract = {Objective: The purpose of this article is to report the translational process of an implantable microdevice platform with an emphasis on the technical and engineering adaptations for patient use, regulatory advances, and successful integration into clinical workflow. Methods: We developed design adaptations for implantation and retrieval, established ongoing monitoring and testing, and facilitated regulatory advances that enabled the administration and examination of a large set of cancer therapies simultaneously in individual patients. Results: Six applications for oncology studies have successfully proceeded to patient trials, with future applications in progress. Conclusion: First-in-human translation required engineering design changes to enable implantation and retrieval that fit with existing clinical workflows, a regulatory strategy that enabled both delivery and response measurement of up to 20 agents in a single patient, and establishment of novel testing and quality control processes for a drug/device combination product without clear precedents. Significance: This manuscript provides a real-world account and roadmap on how to advance from animal proof-of-concept into the clinic, confronting the question of how to use research to benefit patients.},

note = {Num Pages: 10 

Place: Piscataway 

Publisher: Ieee-Inst Electrical Electronics Engineers Inc 

Web of Science ID: WOS:000733943200045},

keywords = {Animals, Biomarkers, biomaterials, Biomedical engineering, CANCER, clinical trials, drug delivery, drug discovery, Drugs, implants, In vivo, Medical treatment, Testing, Tumor Microenvironment, Tumors},

pubstate = {published},

tppubtype = {article}

}

@article{masaki_technical_2021,

title = {Technical Validation of Multi-Section Robotic Bronchoscope With First Person View Control for Transbronchial Biopsies of Peripheral Lung},

author = {Fumitaro Masaki and Franklin King and Takahisa Kato and Hisashi Tsukada and Yolonda Colson and Nobuhiko Hata},

url = {https://pubmed.ncbi.nlm.nih.gov/33945467/},

doi = {10.1109/TBME.2021.3077356},

issn = {1558-2531},

year  = {2021},

date = {2021-12-01},

journal = {IEEE transactions on bio-medical engineering},

volume = {68},

number = {12},

pages = {3534–3542},

abstract = {This study aims to validate the advantage of new engineering method to maneuver multi-section robotic bronchoscope with first person view control in transbronchial biopsy. Six physician operators were recruited and tasked to operate a manual and a robotic bronchoscope to the peripheral area placed in patient-derived lung phantoms. The metrics collected were the furthest generation count of the airway the bronchoscope reached, force incurred to the phantoms, and NASA-Task Load Index. The furthest generation count of the airway the physicians reached using the manual and the robotic bronchoscopes were 6.6 textbackslashpm 1.2ˆth and 6.7 textbackslashpm 0.8ˆth. Robotic bronchoscopes successfully reached the 5th generation count into the peripheral area of the airway, while the manual bronchoscope typically failed earlier in the 3 rd generation. More force was incurred to the airway when the manual bronchoscope was used (0.24 textbackslashpm 0.20 [N]) than the robotic bronchoscope was applied (0.18 textbackslashpm 0.22 [N], p< 0.05). The manual bronchoscope imposed more physical demand than the robotic bronchoscope by NASA-TLX score (55 textbackslashpm 24 vs 19 textbackslashpm 16, p< 0.05). These results indicate that a robotic bronchoscope facilitates the advancement of the bronchoscope to the peripheral area with less physical demand to physician operators. The metrics collected in this study would expect to be used as a benchmark for the future development of robotic bronchoscopes.},

note = {Publisher: IEEE Trans Biomed Eng},

keywords = {biopsy, Bronchoscopes*, Bronchoscopy, doi:10.1109/TBME.2021.3077356, Franklin King, Fumitaro Masaki, Humans, Lung, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Nobuhiko Hata, Non-U.S. Gov't, pmid:33945467, PubMed Abstract, Research Support, Robotic Surgical Procedures*},

pubstate = {published},

tppubtype = {article}

}

@article{lee_rapid_2021,

title = {Rapid Quality Assessment of Nonrigid Image Registration Based on Supervised Learning},

author = {Eung-Joo Lee and William Plishker and Nobuhiko Hata and Paul B. Shyn and Stuart G. Silverman and Shuvra S. Bhattacharyya and Raj Shekhar},

doi = {10.1007/s10278-021-00523-5},

issn = {0897-1889, 1618-727X},

year  = {2021},

date = {2021-12-01},

journal = {JOURNAL OF DIGITAL IMAGING},

volume = {34},

number = {6},

pages = {1376–1386},

abstract = {When preprocedural images are overlaid on intraprocedural images, interventional procedures benefit in that more structures are revealed in intraprocedural imaging. However, image artifacts, respiratory motion, and challenging scenarios could limit the accuracy of multimodality image registration necessary before image overlay. Ensuring the accuracy of registration during interventional procedures is therefore critically important. The goal of this study was to develop a novel framework that has the ability to assess the quality (i.e., accuracy) of nonrigid multimodality image registration accurately in near real time. We constructed a solution using registration quality metrics that can be computed rapidly and combined to form a single binary assessment of image registration quality as either successful or poor. Based on expert-generated quality metrics as ground truth, we used a supervised learning method to train and test this system on existing clinical data. Using the trained quality classifier, the proposed framework identified successful image registration cases with an accuracy of 81.5%. The current implementation produced the classification result in 5.5 s, fast enough for typical interventional radiology procedures. Using supervised learning, we have shown that the described framework could enable a clinician to obtain confirmation or caution of registration results during clinical procedures.},

note = {Num Pages: 11 

Place: New York 

Publisher: Springer 

Web of Science ID: WOS:000706904600001},

keywords = {HEPATECTOMY, HEPATOCELLULAR-CARCINOMA, METASTASES, Multimodality image registration, PERCUTANEOUS RADIOFREQUENCY ABLATION, PROGRESSION, Quality assessment, Registration quality metric, RESECTION, Supervised learning, VALIDATION},

pubstate = {published},

tppubtype = {article}

}

@article{kato_robotized_2021,

title = {Robotized Catheter With Enhanced Distal Targeting for Peripheral Pulmonary Biopsy},

author = {Takahisa Kato and Franklin King and Kiyoshi Takagi and Nobuhiko Hata},

doi = {10.1109/TMECH.2020.3040314},

issn = {1083-4435, 1941-014X},

year  = {2021},

date = {2021-10-01},

journal = {IEEE-ASME TRANSACTIONS ON MECHATRONICS},

volume = {26},

number = {5},

pages = {2451–2461},

abstract = {Transbronchial biopsy with a lung catheter is more appealing with lower complication risks for peripheral pulmonary biopsy. The distal tips of the current lung catheters lack targeting capabilities, however, which prevents a physician from guiding the biopsy tools to lesions, especially those in a peribronchial location. In this study, we investigated if a robotized catheter could enhance distal targeting after passing through tortuous bronchi. We experimentally evaluated targeting accuracy and the spatial dispersion of targeting with attention to catheter shape constraints by utilizing the bronchi of a patient-derived lung phantom. This newly developed robotized catheter has an outer diameter of 3 mm and a total length of 800 mm and comprises two bending sections at the distal 30 mm length. With these two bending sections, the distal tip can be steered to peribronchial lesions followed by the targeting of multiple locations inside the lesion with controlled dispersion to improve opportunities for tissue sampling. In the experimental results, the targeting position error for a peribronchial lesion ranged from 4.6 +/- 1.2 to 7.2 +/- 3.3 mm (mean +/- STD) among the different shape constraints. As for the targeting dispersion, the shape constraints reduced dispersion ability by a maximum of 50% compared to straight reference constraints, while the dispersion was still larger than the expected minimum requirement of 1 mm. One-way analysis of variance concluded that targeting accuracy and targeting dispersion included a significant dependence on shape constraints (p < .05). This study demonstrates the feasibility of enhancing distal targeting with the proposed robotized catheter and found that bronchi shape constraints significantly affect targeting capability.},

note = {Num Pages: 11 

Place: Piscataway 

Publisher: Ieee-Inst Electrical Electronics Engineers Inc 

Web of Science ID: WOS:000707442500022},

keywords = {ABLATION, Bending, biopsy, Bronchoscopy, Catheters, Continuum robots, Design, Dexterous manipulators, LESIONS, Lung, lung biopsy, medical robotics, PLATFORM, REMOTE MAGNETIC NAVIGATION, robotized catheter, robots, SHAPE ESTIMATION, Surgery, SYSTEM, Tools, TRACKING},

pubstate = {published},

tppubtype = {article}

}

@article{banach_visually_2021,

title = {Visually Navigated Bronchoscopy using three cycle-Consistent generative adversarial network for depth estimation},

author = {Artur Banach and Franklin King and Fumitaro Masaki and Hisashi Tsukada and Nobuhiko Hata},

doi = {10.1016/j.media.2021.102164},

issn = {1361-8415, 1361-8423},

year  = {2021},

date = {2021-10-01},

journal = {MEDICAL IMAGE ANALYSIS},

volume = {73},

pages = {102164},

abstract = {[Background] Electromagnetically Navigated Bronchoscopy (ENB) is currently the state-of-the art diagnostic and interventional bronchoscopy. CT-to-body divergence is a critical hurdle in ENB, causing navigation error and ultimately limiting the clinical efficacy of diagnosis and treatment. In this study, Visually Navigated Bronchoscopy (VNB) is proposed to address the aforementioned issue of CT-to-body divergence. [Materials and Methods] We extended and validated an unsupervised learning method to generate a depth map directly from bronchoscopic images using a Three Cycle-Consistent Generative Adversarial Network (3cGAN) and registering the depth map to preprocedural CTs. We tested the working hypothesis that the proposed VNB can be integrated to the navigated bronchoscopic system based on 3D Slicer, and accurately register bronchoscopic images to pre-procedural CTs to navigate transbronchial biopsies. The quantitative metrics to asses the hypothesis we set was Absolute Tracking Error (ATE) of the tracking and the Target Registration Error (TRE) of the total navigation system. We validated our method on phantoms produced from the pre-procedural CTs of five patients who underwent ENB and on two ex-vivo pig lung specimens. [Results] The ATE using 3cGAN was 6.2 +/-2.9 [mm]. The ATE of 3cGAN was statistically significantly lower than that of cGAN, particularly in the trachea and lobar bronchus (p < 0.001). The TRE of the proposed method had a range of 11.7 to 40.5 [mm]. The TRE computed by 3cGAN was statistically significantly smaller than those computed by cGAN in two of the five cases enrolled (p < 0.05). [Conclusion] VNB, using 3cGAN to generate the depth maps was technically and clinically feasible. While the accuracy of tracking by cGAN was acceptable, the TRE warrants further investigation and improvement. (c) 2021 Elsevier B.V. All rights reserved.},

note = {Num Pages: 12 

Place: Amsterdam 

Publisher: Elsevier 

Web of Science ID: WOS:000701725200004},

keywords = {Bronchoscopy, CANCER, CT Imaging, DIAGNOSTIC BRONCHOSCOPY, guidance, GUIDED BRONCHOSCOPY, Image-guided surgery, Lung cancer, Motion tracking, NODULES, PERIPHERAL LUNG LESIONS, RECONSTRUCTION, SYSTEM, VIDEO REGISTRATION},

pubstate = {published},

tppubtype = {article}

}

@article{shono_simulated_2020,

title = {Simulated accuracy assessment of small footprint body-mounted probe alignment device for MRI-guided cryotherapy of abdominal lesions},

author = {Naoyuki Shono and Brian Ninni and Franklin King and Takahisa Kato and Junichi Tokuda and Takahiro Fujimoto and Kemal Tuncali and Nobuhiko Hata},

doi = {10.1002/mp.14116},

issn = {0094-2405, 2473-4209},

year  = {2020},

date = {2020-06-01},

journal = {MEDICAL PHYSICS},

volume = {47},

number = {6},

pages = {2337–2349},

abstract = {Purpose Magnetic resonance imaging (MRI)-guided percutaneous cryotherapy of abdominal lesions, an established procedure, uses MRI to guide and monitor the cryoablation of lesions. Methods to precisely guide cryotherapy probes with a minimum amount of trial-and-error are yet to be established. To aid physicians in attaining precise probe alignment without trial-and-error, a body-mounted motorized cryotherapy-probe alignment device (BMCPAD) with motion compensation was clinically tested in this study. The study also compared the contribution of body motion and organ motion compensation to the guidance accuracy of a body-mounted probe alignment device. Methods The accuracy of guidance using the BMCPAD was prospectively measured during MRI-guided percutaneous cryotherapies before insertion of the probes. Clinical parameters including patient age, types of anesthesia, depths of the target, and organ sites of target were collected. By using MR images of the target organs and fiducial markers embedded in the BMCPAD, we retrospectively simulated the guidance accuracy with body motion compensation, organ motion compensation, and no compensation. The collected data were analyzed to test the impact of motion compensation on the guidance accuracy. Results Thirty-seven physical guidance of probes were prospectively recorded for sixteen completed cases. The accuracy of physical guidance using the BMCPAD was 13.4 +/- 11.1 mm. The simulated accuracy of guidance with body motion compensation, organ motion compensation, and no compensation was 2.4 +/- 2.9 mm, 2.2 +/- 1.6 mm, and 3.5 +/- 2.9 mm, respectively. Data analysis revealed that the body motion compensation and organ motion compensation individually impacted the improvement in the accuracy of simulated guidance. Moreover, the difference in the accuracy of guidance either by body motion compensation or organ motion compensation was not statistically significant. The major clinical parameters impacting the accuracy of guidance were the body and organ motions. Patient age, types of anesthesia, depths of the target, and organ sites of target did not influence the accuracy of guidance using BMCPAD. The magnitude of body surface movement and organ movement exhibited mutual statistical correlation. Conclusions The BMCPAD demonstrated guidance accuracy comparable to that of previously reported devices for CT-guided procedures. The analysis using simulated motion compensation revealed that body motion compensation and organ motion compensation individually impact the improvement in the accuracy of device-guided cryotherapy probe alignment. Considering the correlation between body and organ movements, we also determined that body motion compensation using the ring fiducial markers in the BMCPAD can be solely used to address both body and organ motions in MRI-guided cryotherapy.},

note = {Num Pages: 13 

Place: Hoboken 

Publisher: Wiley 

Web of Science ID: WOS:000521855600001},

keywords = {biopsy, Cryoablation, feasibility study, hepatic tumor, LIVER-TUMORS, MICROWAVE ABLATION, MOTION MANAGEMENT, MRI-guided intervention, needle guidance, RADIOFREQUENCY ABLATION, renal tumor, RENAL TUMORS, TRACKING},

pubstate = {published},

tppubtype = {article}

}

@article{gao_continuum_2020,

title = {Continuum Robot With Follow-the-Leader Motion for Endoscopic Third Ventriculostomy and Tumor Biopsy},

author = {Yuanqian Gao and Kiyoshi Takagi and Takahisa Kato and Naoyuki Shono and Nobuhiko Hata},

doi = {10.1109/TBME.2019.2913752},

issn = {0018-9294, 1558-2531},

year  = {2020},

date = {2020-02-01},

journal = {IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING},

volume = {67},

number = {2},

pages = {379–390},

abstract = {Background: In a combined endoscopic third ventriculostomy (ETV) and endoscopic tumor biopsy (ETB) procedure, an optimal tool trajectory is mandatory to minimize trauma to surrounding cerebral tissue. Objective: This paper presents wire-driven multi-section robot with push-pull wire. The robot is tested to attain follow-the-leader (FTL) motion to place surgical instruments through narrow passages while minimizing the trauma to tissues. Methods: A wire-driven continuum robot with six sub-sections was developed and its kinematic model was proposed to achieve FTL motion. An accuracy test to assess the robot's ability to attain FTL motion along a set of elementary curved trajectory was performed. We also used hydrocephalus ventricular model created from human subject data to generate five ETV/ETB trajectories and conducted a study assessing the accuracy of the FTL motion along these clinically desirable trajectories. Results: In the test with elementary curved paths, the maximal deviation of the robot was increased from 0.47 mm at 30 degrees turn to 1.78 mm at 180 degrees in a simple C-shaped curve. S-shaped FTL motion had lesser deviation ranging from 0.16 to 0.18 mm. In the phantom study, the greatest tip deviation was 1.45 mm, and the greatest path deviation was 1.23 mm. Conclusion: We present the application of a continuum robot with FTL motion to perform a combined ETV/ETB procedure. The validation study using human subject data indicated that the accuracy of FTL motion is relatively high. The study indicated that FTL motion may be useful tool for combined ETV and ETB.},

note = {Num Pages: 12 

Place: Piscataway 

Publisher: Ieee-Inst Electrical Electronics Engineers Inc 

Web of Science ID: WOS:000510903800006},

keywords = {continuum robot, Design, endoscopic biopsy, follow-the-leader motion, Kinematics, Neuroendoscopy, OPTIMIZATION, PINEAL REGION, POSTERIOR 3RD-VENTRICLE, Third ventriculostomy},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32782420,

title = {Ring-arrayed Forward-viewing Ultrasound Imaging System: A Feasibility Study},

author = {Ryosuke Tsumura and Doua P Vang and Nobuhiko Hata and Haichong K Zhang},

doi = {10.1117/12.2550042},

issn = {0277-786X},

year  = {2020},

date = {2020-02-01},

journal = {Proc SPIE Int Soc Opt Eng},

volume = {11319},

abstract = {Current standard workflows of ultrasound (US)-guided needle insertion require physicians to use their both hands: holding the US probe to locate interested areas with the non-dominant hand and the needle with the dominant hand. This is due to the separation of functionalities for localization and needle insertion. This requirement does not only make the procedure cumbersome, but also limits the reliability of guidance given that the positional relationship between the needle and US images is unknown and interpreted with their experience and assumption. Although the US-guided needle insertion may be assisted through navigation systems, recovery of the positional relationship between the needle and US images requires the usage of external tracking systems and image-based tracking algorisms that may involve the registration inaccuracy. Therefore, there is an unmet need for the solution that provides a simple and intuitive needle localization and insertion to improve the conventional US-guided procedure. In this work, we propose a new device concept solution based on the ring-arrayed forward-viewing (RAF) ultrasound imaging system. The proposed system is comprised with ring-arrayed transducers and an open whole inside the ring where the needle can be inserted. The ring array provides forward-viewing US images, where the needle path is always maintained at the center of the reconstructed image without requiring any registration. As the proof of concept, we designed single-circle ring-arrayed configurations with different radiuses and visualized point targets using the forward-viewing US imaging through simulations and phantom experiments. The results demonstrated the successful target visualization and indicates the ring-arrayed US imaging has a potential to improve the US-guided needle insertion procedure to be simpler and more intuitive.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{dupourque_transbronchial_2019,

title = {Transbronchial biopsy catheter enhanced by a multisection continuum robot with follow-the-leader motion},

author = {Lenny Dupourque and Fumitaro Masaki and Yolonda L. Colson and Takahisa Kato and Nobuhiko Hata},

doi = {10.1007/s11548-019-02017-w},

issn = {1861-6410, 1861-6429},

year  = {2019},

date = {2019-11-01},

journal = {INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY},

volume = {14},

number = {11},

pages = {2021–2029},

abstract = {Purpose Current manual catheters for transbronchial biopsy in the lung lack a steering ability, which hampers a physician's ability to reach nodules in the peripheral lung. The objective of this paper is to design and build a multisection robot with a follow-the-leader motion and compare the performance of the conventional catheter and our robotic catheter in the right main and right segmental lobar bronchus. Methods A three-section continuum robot with an outer diameter of 3 mm was developed. Each section includes one anchored wire and two driving wires made of stainless steel. Follow-the-leader control is implemented using a joystick for a physician to control the distal section of the robot, while the subsequent two sections follow the controlled distal section. Results The robotic catheter deviated from the preplanned approach path by less than the manual catheter did (robotic Conclusion This study demonstrated an improvement in the maneuverability for the robotic catheter. In addition to a greater aptitude for reaching a peripheral area of the lung, these findings suggest that the designated target in a peripheral area can be reached with less trauma to the bronchi wall.},

note = {Num Pages: 9 

Place: Heidelberg 

Publisher: Springer Heidelberg 

Web of Science ID: WOS:000496030000019},

keywords = {Bronchoscopy, CANCER, COMPUTED-TOMOGRAPHY, Continuum robots, diagnosis, lung biopsy, Multisection robot, NAVIGATION BRONCHOSCOPY, NODULE, Surgical robotics},

pubstate = {published},

tppubtype = {article}

}

@article{pmid31485544,

title = {System Integration and Preliminary Clinical Evaluation of a Robotic System for MRI-Guided Transperineal Prostate Biopsy},

author = {Niravkumar A Patel and Gang Li and Weijian Shang and Marek Wartenberg and Tamas Heffter and Everette C Burdette and Iulian Iordachita and Junichi Tokuda and Nobuhiko Hata and Clare M Tempany and Gregory S Fischer},

doi = {10.1142/S2424905X19500016},

issn = {2424-905X},

year  = {2019},

date = {2019-06-01},

journal = {J Med Robot Res},

volume = {4},

number = {2},

abstract = {This paper presents the development, preclinical evaluation, and preliminary clinical study of a robotic system for targeted transperineal prostate biopsy under direct interventional magnetic resonance imaging (MRI) guidance. The clinically integrated robotic system is developed based on a modular design approach, comprised of surgical navigation application, robot control software, MRI robot controller hardware, and robotic needle placement manipulator. The system provides enabling technologies for MRI-guided procedures. It can be easily transported and setup for supporting the clinical workflow of interventional procedures, and the system is readily extensible and reconfigurable to other clinical applications. Preclinical evaluation of the system is performed with phantom studies in a 3 Tesla MRI scanner, rehearsing the proposed clinical workflow, and demonstrating an in-plane targeting error of 1.5mm. The robotic system has been approved by the institutional review board (IRB) for clinical trials. A preliminary clinical study is conducted with the patient consent, demonstrating the targeting errors at two biopsy target sites to be 4.0 and 3.7, which is sufficient to target a clinically significant tumor foci. First-in-human trials to evaluate the system's effectiveness and accuracy for MR image-guide prostate biopsy are underway.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{wartenberg_closed-loop_2018,

title = {Closed-Loop Active Compensation for Needle Deflection and Target Shift During Cooperatively Controlled Robotic Needle Insertion},

author = {Marek Wartenberg and Joseph Schornak and Katie Gandomi and Paulo Carvalho and Chris Nycz and Niravkumar Patel and Iulian Iordachita and Clare Tempany and Nobuhiko Hata and Junichi Tokuda and Gregory S. Fischer},

doi = {10.1007/s10439-018-2070-2},

issn = {0090-6964, 1573-9686},

year  = {2018},

date = {2018-10-01},

journal = {ANNALS OF BIOMEDICAL ENGINEERING},

volume = {46},

number = {10},

pages = {1582–1594},

abstract = {Intra-operative imaging is sometimes available to assist needle biopsy, but typical open-loop insertion does not account for unmodeled needle deflection or target shift. Closed-loop image-guided compensation for deviation from an initial straight-line trajectory through rotational control of an asymmetric tip can reduce targeting error. Incorporating robotic closed-loop control often reduces physician interaction with the patient, but by pairing closed-loop trajectory compensation with hands-on cooperatively controlled insertion, a physician's control of the procedure can be maintained while incorporating benefits of robotic accuracy. A series of needle insertions were performed with a typical 18G needle using closed-loop active compensation under both fully autonomous and user-directed cooperative control. We demonstrated equivalent improvement in accuracy while maintaining physician-in-the-loop control with no statistically significant difference (p>0.05) in the targeting accuracy between any pair of autonomous or individual cooperative sets, with average targeting accuracy of 3.56mm(rms). With cooperatively controlled insertions and target shift between 1 and 10mm introduced upon needle contact, the system was able to effectively compensate up to the point where error approached a maximum curvature governed by bending mechanics. These results show closed-loop active compensation can enhance targeting accuracy, and that the improvement can be maintained under user directed cooperative insertion.},

note = {Num Pages: 13 

Place: New York 

Publisher: Springer 

Web of Science ID: WOS:000445180100013},

keywords = {FEEDBACK, image-guided therapy, medical robotics, MOTION, Needle steering, Teleoperation},

pubstate = {published},

tppubtype = {article}

}

@article{moreira_evaluation_2018,

title = {Evaluation of robot-assisted MRI-guided prostate biopsy: needle path analysis during clinical trials},

author = {Pedro Moreira and Niravkumar Patel and Marek Wartenberg and Gang Li and Kemal Tuncali and Tamas Heffter and Everette C. Burdette and Iulian Iordachita and Gregory S. Fischer and Nobuhiko Hata and Clare M. Tempany and Junichi Tokuda},

doi = {10.1088/1361-6560/aae214},

issn = {0031-9155, 1361-6560},

year  = {2018},

date = {2018-10-01},

journal = {PHYSICS IN MEDICINE AND BIOLOGY},

volume = {63},

number = {20},

pages = {20NT02},

abstract = {While the interaction between a needle and the surrounding tissue is known to cause a significant targeting error in prostate biopsy leading to false-negative results, few studies have demonstrated how it impacts in the actual procedure. We performed a pilot study on robot-assisted MRI-guided prostate biopsy with an emphasis on the in-depth analysis of the needle-tissue interaction in vivo. The data were acquired during in-bore transperineal prostate biopsies in patients using a 4 degrees-of-freedom (DoF) MRI-compatible robot. The anatomical structures in the pelvic area and the needle path were reconstructed from MR images, and quantitatively analyzed. We analyzed each structure individually and also proposed a mathematical model to investigate the influence of those structures in the targeting error using the mixed-model regression. The median targeting error in 188 insertions (27 patients) was 6.3 mm. Both the individual anatomical structure analysis and the mixed-model analysis showed that the deviation resulted from the contact between the needle and the skin as the main source of error. On contrary, needle bending inside the tissue (expressed as needle curvature) did not vary among insertions with targeting errors above and below the average. The analysis indicated that insertions crossing the bulbospongiosus presented a targeting error lower than the average. The mixed-model analysis demonstrated that the distance between the needle guide and the patient skin, the deviation at the entry point, and the path length inside the pelvic diaphragm had a statistically significant contribution to the targeting error (p < 0.05). Our results indicate that the errors associated with the elastic contact between the needle and the skin were more prominent than the needle bending along the insertion. Our findings will help to improve the preoperative planning of transperineal prostate biopsies.},

note = {Num Pages: 9 

Place: Bristol 

Publisher: IoP Publishing Ltd 

Web of Science ID: WOS:000448103100002},

keywords = {Accuracy, bore prostate biopsy, CANCER, guidance, needle deflection, needle path analysis, robot-assisted biopsy, SYSTEM},

pubstate = {published},

tppubtype = {article}

}

@article{tokuda_motion_2018,

title = {Motion compensation for MRI-compatible patient-mounted needle guide device: estimation of targeting accuracy in MRI-guided kidney cryoablations},

author = {Junichi Tokuda and Laurent Chauvin and Brian Ninni and Takahisa Kato and Franklin King and Kemal Tuncali and Nobuhiko Hata},

doi = {10.1088/1361-6560/aab736},

issn = {0031-9155, 1361-6560},

year  = {2018},

date = {2018-04-01},

journal = {PHYSICS IN MEDICINE AND BIOLOGY},

volume = {63},

number = {8},

pages = {085010},

abstract = {Patient-mounted needle guide devices for percutaneous ablation are vulnerable to patient motion. The objective of this study is to develop and evaluate a software system for an MRI-compatible patient-mounted needle guide device that can adaptively compensate for displacement of the device due to patient motion using a novel image-based automatic device-to-image registration technique. We have developed a software system for an MRI-compatible patient-mounted needle guide device for percutaneous ablation. It features fully-automated image-based device-to-image registration to track the device position, and a device controller to adjust the needle trajectory to compensate for the displacement of the device. We performed: (a) a phantom study using a clinical MR scanner to evaluate registration performance; (b) simulations using intraoperative time-series MR data acquired in 20 clinical cases of MRI-guided renal cryoablations to assess its impact on motion compensation; and (c) a pilot clinical study in three patients to test its feasibility during the clinical procedure. FRE, TRE, and success rate of device-to-image registration were 2.71 +/- 2.29 mm,1.74 +/- 1.13 mm, and 98.3% for the phantom images. The simulation study showed that the motion compensation reduced the targeting error for needle placement from 8.2 mm to 5.4 mm (p < 0.0005) in patients under general anesthesia (GA), and from 14.4 mm to 10.0 mm (p < 1.0 x 10 -5 ) in patients under monitored anesthesia care (MAC). The pilot study showed that the software registered the device successfully in a clinical setting. Our simulation study demonstrated that the software system could significantly improve targeting accuracy in patients treated under both MAC and GA. Intraprocedural image-based device-to-image registration was feasible.},

note = {Num Pages: 16 

Place: Bristol 

Publisher: IoP Publishing Ltd 

Web of Science ID: WOS:000429950600005},

keywords = {ABLATION, CRYOTHERAPY, CT, guidance, LIVER-TUMORS, manipulator, MRI-compatible robot, MRI-guided interventions, PERCUTANEOUS CRYOABLATION, renal cryoablation, Robot, SYSTEM, THERAPY},

pubstate = {published},

tppubtype = {article}

}

@article{pmid29406411,

title = {Robotics in MRI-Guided Interventions},

author = {Nobuhiko Hata and Pedro Moreira and Gregory Fischer},

doi = {10.1097/RMR.0000000000000159},

issn = {1536-1004},

year  = {2018},

date = {2018-02-01},

journal = {Top Magn Reson Imaging},

volume = {27},

number = {1},

pages = {19--23},

abstract = {Robots have been found to be a useful tool in magnetic resonance imaging (MRI)-guided intervention. The utility of robots in MRI-guided therapy ranges from aid for precision targeting to high-dexterity surgical tools to improve or even enable new MRI-guided therapy options. The objective of this article is to review the technical aspects of robotics in MRI-guided interventions, highlight the role of MRI robots in prostate interventions, and finally discuss the future contribution of emerging robotics technology useful in MRI-guided intervention.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{abayazid_using_2018,

title = {Using needle orientation sensing as surrogate signal for respiratory motion estimation in percutaneous interventions},

author = {Momen Abayazid and Takahisa Kato and Stuart G. Silverman and Nobuhiko Hata},

doi = {10.1007/s11548-017-1644-z},

issn = {1861-6410, 1861-6429},

year  = {2018},

date = {2018-01-01},

journal = {INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY},

volume = {13},

number = {1},

pages = {125–133},

abstract = {Purpose To develop and evaluate an approach to estimate the respiratory-induced motion of lesions in the chest and abdomen. Materials and methods The proposed approach uses the motion of an initial reference needle inserted into a moving organ to estimate the lesion (target) displacement that is caused by respiration. The needles position is measured using an inertial measurement unit (IMU) sensor externally attached to the hub of an initially placed reference needle. Data obtained from the IMU sensor and the target motion are used to train a learning-based approach to estimate the position of the moving target. An experimental platform was designed to mimic respiratory motion of the liver. Liver motion profiles of human subjects provided inputs to the experimental platform. Variables including the insertion angle, target depth, target motion velocity and target proximity to the reference needle were evaluated by measuring the error of the estimated target position and processing time. Results The mean error of estimation of the target position ranged between 0.86 and 1.29mm. The processing maximum training and testing time was 5ms which is suitable for real-time target motion estimation using the needle position sensor. Conclusion The external motion of an initially placed reference needle inserted into a moving organ can be used as a surrogate, measurable and accessible signal to estimate in real-time the position of a moving target caused by respiration; this technique could then be used to guide the placement of subsequently inserted needles directly into the target.},

note = {Num Pages: 9 

Place: Heidelberg 

Publisher: Springer Heidelberg 

Web of Science ID: WOS:000419481300013},

keywords = {ABDOMINAL INTERVENTIONS, biopsy, INSERTION, Interventional radiology, Lung, Machine learning, Magnetic Resonance Imaging, MODEL, Motion compensation, percutaneous needle insertion, Radiotherapy, Respiratory motion, SYSTEM, TOMOGRAPHY, TRACKING, TUMOR MOTION},

pubstate = {published},

tppubtype = {article}

}

@article{pmid28652857,

title = {Fiber Optic Force Sensors for MRI-Guided Interventions and Rehabilitation: A Review},

author = {Hao Su and Iulian I Iordachita and Junichi Tokuda and Nobuhiko Hata and Xuan Liu and Reza Seifabadi and Sheng Xu and Bradford Wood and Gregory S Fischer},

doi = {10.1109/JSEN.2017.2654489},

issn = {1530-437X},

year  = {2017},

date = {2017-04-01},

journal = {IEEE Sens J},

volume = {17},

number = {7},

pages = {1952--1963},

abstract = {Magnetic Resonance Imaging (MRI) provides both anatomical imaging with excellent soft tissue contrast and functional MRI imaging (fMRI) of physiological parameters. The last two decades have witnessed the manifestation of increased interest in MRI-guided minimally invasive intervention procedures and fMRI for rehabilitation and neuroscience research. Accompanying the aspiration to utilize MRI to provide imaging feedback during interventions and brain activity for neuroscience study, there is an accumulated effort to utilize force sensors compatible with the MRI environment to meet the growing demand of these procedures, with the goal of enhanced interventional safety and accuracy, improved efficacy and rehabilitation outcome. This paper summarizes the fundamental principles, the state of the art development and challenges of fiber optic force sensors for MRI-guided interventions and rehabilitation. It provides an overview of MRI-compatible fiber optic force sensors based on different sensing principles, including light intensity modulation, wavelength modulation, and phase modulation. Extensive design prototypes are reviewed to illustrate the detailed implementation of these principles. Advantages and disadvantages of the sensor designs are compared and analyzed. A perspective on the future development of fiber optic sensors is also presented which may have additional broad clinical applications. Future surgical interventions or rehabilitation will rely on intelligent force sensors to provide situational awareness to augment or complement human perception in these procedures.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{shyn_breath-hold_2017,

title = {Breath-hold PET/CT-guided tumour ablation under general anaesthesia: accuracy of tumour image registration and projected ablation zone overlap},

author = {P. B. Shyn and S. Tremblay-Paquet and K. Palmer and S. Tatli and K. Tuncali and O. I. Olubiyi and N. Hata and S. G. Silverman},

doi = {10.1016/j.crad.2016.10.017},

issn = {0009-9260, 1365-229X},

year  = {2017},

date = {2017-03-01},

journal = {CLINICAL RADIOLOGY},

volume = {72},

number = {3},

pages = {223–229},

abstract = {AIM: To assess single-breath-hold combined positron-emission tomography/computed tomography (PET/CT) for accuracy of tumour image registration and projected ablation volume overlap in patients undergoing percutaneous PET/CT-guided tumour-ablation procedures under general anaesthesia. MATERIALS AND METHODS: Eight patients underwent 12 PET/CT-guided tumour-ablation procedures to treat 20 tumours in the lung, liver, or adrenal gland. Using breath-hold PET/CT, the centre of the tumour was marked on each PET and CT acquisition by four readers to assess two- (2D) and three-dimensional (3D) spatial misregistration. Overlap of PET and CT projected ablation volumes were compared using the Dice similarity coefficient (DSC). Interobserver differences were assessed with repeated measure analysis of variance (ANOVA). Technical success and local progression rates were noted. RESULTS: Mean tumour 2D PET/CT misregistrations were 1.02 mm (range 0.01e5.02), 1.89 (0.03-7.85), and 3.05 (0-10) in the x, y, and z planes. Mean 3D misregistration was 4.4 mm (0.36-10.74). Mean projected PET/CT ablation volume DSC was 0.72 (+/- 0.19). No significant interobserver differences in 3D misregistration (p = 0.73) or DSC (p = 0.54) were observed. Technical success of ablations was 100%; one (5.3%) of 19 tumours progressed. CONCLUSION: Accurate spatial registration of tumours and substantial overlap of projected ablation volumes are achievable when comparing PET and CT acquisitions from single-breathhold PET/CT. The results suggest that tumours visible only at PET could be accurately targeted and ablated using this technique. (C) 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.},

note = {Num Pages: 7 

Place: London 

Publisher: W B Saunders Co Ltd 

Web of Science ID: WOS:000397269000006},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid27038962,

title = {Three-dimensional quantitative assessment of ablation margins based on registration of pre- and post-procedural MRI and distance map},

author = {Soichiro Tani and Servet Tatli and Nobuhiko Hata and Xavier Garcia-Rojas and Olutayo I Olubiyi and Stuart G Silverman and Junichi Tokuda},

doi = {10.1007/s11548-016-1398-z},

issn = {1861-6429},

year  = {2016},

date = {2016-06-01},

journal = {Int J Comput Assist Radiol Surg},

volume = {11},

number = {6},

pages = {1133--1142},

abstract = {PURPOSE: Contrast-enhanced MR images are widely used to confirm the adequacy of ablation margin after liver ablation for early prediction of local recurrence. However, quantitative assessment of the ablation margin by comparing pre- and post-procedural images remains challenging. We developed and tested a novel method for three-dimensional quantitative assessment of ablation margin based on non-rigid image registration and 3D distance map.nnMETHODS: Our method was tested with pre- and post-procedural MR images acquired in 21 patients who underwent image-guided percutaneous liver ablation. The two images were co-registered using non-rigid intensity-based registration. After the tumor and ablation volumes were segmented, target volume coverage, percent of tumor coverage, and Dice similarity coefficient were calculated as metrics representing overall adequacy of ablation. In addition, 3D distance map around the tumor was computed and superimposed on the ablation volume to identify the area with insufficient margins. For patients with local recurrences, the follow-up images were registered to the post-procedural image. Three-dimensional minimum distance between the recurrence and the areas with insufficient margins was quantified.nnRESULTS: The percent tumor coverage for all nonrecurrent cases was 100 %. Five cases had tumor recurrences, and the 3D distance map revealed insufficient tumor coverage or a 0-mm margin. It also showed that two recurrences were remote to the insufficient margin.nnCONCLUSIONS: Non-rigid registration and 3D distance map allow us to quantitatively evaluate the adequacy of the ablation margin after percutaneous liver ablation. The method may be useful to predict local recurrences immediately following ablation procedure.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid26111458,

title = {In-bore prostate transperineal interventions with an MRI-guided parallel manipulator: system development and preliminary evaluation},

author = {Sohrab Eslami and Weijian Shang and Gang Li and Nirav Patel and Gregory S Fischer and Junichi Tokuda and Nobuhiko Hata and Clare M Tempany and Iulian Iordachita},

doi = {10.1002/rcs.1671},

issn = {1478-596X},

year  = {2016},

date = {2016-06-01},

journal = {Int J Med Robot},

volume = {12},

number = {2},

pages = {199--213},

abstract = {BACKGROUND: Robot-assisted minimally-invasive surgery is well recognized as a feasible solution for diagnosis and treatment of prostate cancer in humans.nnMETHODS: This paper discusses the kinematics of a parallel 4 Degrees-of-Freedom (DOF) surgical manipulator designed for minimally invasive in-bore prostate percutaneous interventions through the patient's perineum. The proposed manipulator takes advantage of four sliders actuated by MRI-compatible piezoelectric motors and incremental rotary encoders. Errors, mostly originating from the design and manufacturing process, need to be identified and reduced before the robot is deployed in clinical trials.nnRESULTS: The manipulator has undergone several experiments to evaluate the repeatability and accuracy (about 1 mm in air (in x or y direction) at the needle's reference point) of needle placement, which is an essential concern in percutaneous prostate interventions.nnCONCLUSION: The acquired results endorse the sustainability, precision and reliability of the manipulator. Copyright © 2015 John Wiley & Sons, Ltd.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hata2016,

title = {Nonrigid Registration of Pre-Procedural MRI and Intra-Procedural CT in CT-Guided Cryoablation of Lung Tumors to Improve Lung Tumor Conspicuity},

author = {Nobuhiko Hata and Servet Tatli and Atsushi Yamada and Olutayo Olubiyi and Stuart G. Silverman},

doi = {10.1142/s2424905x16500045},

issn = {2424-9068},

year  = {2016},

date = {2016-06-00},

journal = {J. Med. Robot. Res.},

volume = {01},

number = {02},

publisher = {World Scientific Pub Co Pte Ltd},

abstract = { To improve lung tumor conspicuity during CT-guided cryoablations, we used nonrigid image registrations to fuse pre-procedural MR images and intra-procedural CT images and determined which set of CT images taken at planning, targeting, and monitoring phases of the procedure provided the most accurate and fastest registrations. In 10 percutaneous CT-guided cryoablation procedures, MR images were registered with intra-procedural CT images using a nonrigid registration technique using an intensity-based approach with affine and B-Spline transformations. The time to complete the registration as well as the accuracy of the registration defined by Target Registration Error (TRE), Dice Similarity Coefficient (DSC), and Hausdorff Distance (HD) were measured to assess the performance of the registration. The least significant difference (LSD) method was used as a post-hoc analysis for comparing time and accuracy among planning, targeting, and monitoring phases. The mean TRE of the registration ranged from 6.26 (planning) to 10.31 (monitoring) mm. The mean DSC ranged from 83.86 (monitoring) to 89.22 (planning). The mean HD values ranged from 7.74 (targeting) to 12.20 (monitoring). Mean registration time ranged from 68.67 (monitoring) to 92.02 (planning) s. Using HD, registrations in either the planning or targeting phase were more accurate than in the monitoring phase. The registration was faster using monitoring images than using planning images. Nonrigid registration techniques can be used to fuse pre-procedural MR images with intra-procedural CT images with varying performance depending on the CT images taken at the different phases of the procedure. Therefore, caution should be taken in setting expectations on accuracies and speeds of registration depending on the phases of the CT-guided ablation procedures. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid26476639,

title = {Tendon-driven continuum robot for neuroendoscopy: validation of extended kinematic mapping for hysteresis operation},

author = {Takahisa Kato and Ichiro Okumura and Hidekazu Kose and Kiyoshi Takagi and Nobuhiko Hata},

doi = {10.1007/s11548-015-1310-2},

issn = {1861-6429},

year  = {2016},

date = {2016-04-01},

journal = {Int J Comput Assist Radiol Surg},

volume = {11},

number = {4},

pages = {589--602},

abstract = {PURPOSE: The hysteresis operation is an outstanding issue in tendon-driven actuation--which is used in robot-assisted surgery--as it is incompatible with kinematic mapping for control and trajectory planning. Here, a new tendon-driven continuum robot, designed to fit existing neuroendoscopes, is presented with kinematic mapping for hysteresis operation.nnMETHODS: With attention to tension in tendons as a salient factor of the hysteresis operation, extended forward kinematic mapping (FKM) has been developed. In the experiment, the significance of every component in the robot for the hysteresis operation has been investigated. Moreover, the prediction accuracy of postures by the extended FKM has been determined experimentally and compared with piecewise constant curvature assumption.nnRESULTS: The tendons were the most predominant factor affecting the hysteresis operation of the robot. The extended FKM including friction in tendons predicted the postures in the hysteresis operation with improved accuracy (2.89 and 3.87 mm for the single and the antagonistic-tendons layouts, respectively). The measured accuracy was within the target value of 5 mm for planning of neuroendoscopic resection of intraventricle tumors.nnCONCLUSION: The friction in tendons was the most predominant factor for the hysteresis operation in the robot. The extended FKM including this factor can improve prediction accuracy of the postures in the hysteresis operation. The trajectory of the new robot can be planned within target value for the neuroendoscopic procedure by using the extended FKM.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{hata_body-mounted_2016,

title = {Body-mounted robotic instrument guide for age-guided cryotherapy of renal cancer},

author = {Nobuhiko Hata and Sang-Eun Song and Olutayo Olubiyi and Yasumichi Arimitsu and Kosuke Fujimoto and Takahisa Kato and Kemal Tuncali and Soichiro Tani and Junichi Tokuda},

doi = {10.1118/1.4939875},

issn = {0094-2405, 2473-4209},

year  = {2016},

date = {2016-02-01},

journal = {MEDICAL PHYSICS},

volume = {43},

number = {2},

pages = {843–853},

abstract = {Purpose: Image-guided cryotherapy of renal cancer is an emerging alternative to surgical nephrectomy, particularly for those who cannot sustain the physical burden of surgery. It is well known that the outcome of this therapy depends on the accurate placement of the cryotherapy probe. Therefore, a robotic instrument guide may help physicians aim the cryotherapy probe precisely to maximize the efficacy of the treatment and avoid damage to critical surrounding structures. The objective of this paper was to propose a robotic instrument guide for orienting cryotherapy probes in image-guided cryotherapy of renal cancers. The authors propose a body-mounted robotic guide that is expected to be less susceptible to guidance errors caused by the patient's whole body motion. Methods: Keeping the device's minimal footprint in mind, the authors developed and validated a body-mounted, robotic instrument guide that can maintain the geometrical relationship between the device and the patient's body, even in the presence of the patient's frequent body motions. The guide can orient the cryotherapy probe with the skin incision point as the remote-center-of-motion. The authors' validation studies included an evaluation of the mechanical accuracy and position repeatability of the robotic instrument guide. The authors also performed a mock MRI-guided cryotherapy procedure with a phantom to compare the advantage of robotically assisted probe replacements over a free-hand approach, by introducing organ motions to investigate their effects on the accurate placement of the cryotherapy probe. Measurements collected for performance analysis included accuracy and time taken for probe placements. Multivariate analysis was performed to assess if either or both organ motion and the robotic guide impacted these measurements. Results: The mechanical accuracy and position repeatability of the probe placement using the robotic instrument guide were 0.3 and 0.1 mm, respectively, at a depth of 80 mm The phantom test indicated that the accuracy of probe placement was significantly better with the robotic instrument guide (4.1 mm) than without the guide (6.3 mm, p < 0.001), even in the presence of body motion. When independent organ motion was artificially added, in addition to body motion, the advantage of accurate probe placement using the robotic instrument guide disappeared statistically [i e, 6 0 mm with the robotic guide and 5.9 mm without the robotic guide (p = 0.906)]. When the robotic instrument guide was used, the total time required to complete the procedure was reduced from 19.6 to 12.7 min (p < 0.001). Multivariable analysis indicated that the robotic instrument guide, not the organ motion, was the cause of statistical significance. The statistical power the authors obtained was 88% in accuracy assessment and 99% higher in duration measurement. Conclusions: The body-mounted robotic instrument guide allows positioning of the probe during image-guided cryotherapy of renal cancer and was done in fewer attempts and in less time than the free-hand approach. The accuracy of the placement of the cryotherapy probe was better using the robotic instrument guide than without the guide when no organ motion was present. The accuracy between the robotic and free-hand approach becomes comparable when organ motion was present. 2016 American Association of Physicists in Medicine.},

note = {Num Pages: 11 

Place: Hoboken 

Publisher: Wiley 

Web of Science ID: WOS:000372030000023},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{peacock_assessment_2015,

title = {Assessment of the OsteoMark-Navigation System for Oral and Maxillofacial Surgery},

author = {Zachary S. Peacock and John C. Magill and Brad J. Tricomi and Brian A. Murphy and Vladimir Nikonovskiy and Nobuhiko Hata and Laurent Chauvin and Maria J. Troulis},

doi = {10.1016/j.joms.2015.03.017},

issn = {0278-2391, 1531-5053},

year  = {2015},

date = {2015-10-01},

journal = {JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY},

volume = {73},

number = {10},

pages = {2005–2016},

abstract = {Purpose: To assess the accuracy of a novel navigation system for maxillofacial surgery using human cadavers and a live minipig model. Materials and Methods: We tested an electromagnetic tracking system (OsteoMark-Navigation) that uses simple sensors to determine the position and orientation of a hand-held pencil-like marking device. The device can translate 3-dimensional computed tomographic data intraoperatively to allow the surgeon to localize and draw a proposed osteotomy or the resection margins of a tumor on bone. The accuracy of the OsteoMark-Navigation system in locating and marking osteotomies and screw positions in human cadaver heads was assessed. In group 1 (n = 3, 6 sides), OsteoMark-Navigation marked osteotomies and screw positions were compared to virtual treatment plans. In group 2 (n = 3, 6 sides), marked osteotomies and screw positions for distraction osteogenesis devices were compared with those performed using fabricated guide stents. Three metrics were used to document the precision and accuracy. In group 3 (n = 1), the system was tested in a standard operating room environment. Results: For group 1, the mean error between the points was 0.7 mm (horizontal) and 1.7 mm (vertical). Compared with the posterior and inferior mandibular border, the mean error was 1.2 and 1.7 mm, respectively. For group 2, the mean discrepancy between the points marked using the OsteoMark-Navigation system and the surgical guideswas 1.9 mm (range 0 to 4.1). The system maintained accuracy on a live minipig in a standard operating room environment. Conclusion: Based on this research OsteoMark-Navigation is a potentially powerful tool for clinical use in maxillofacial surgery. It has accuracy and precision comparable to that of existing clinical applications. (C) 2015 American Association of Oral and Maxillofacial Surgeons},

note = {Num Pages: 12 

Place: Philadelphia 

Publisher: W B Saunders Co-Elsevier Inc 

Web of Science ID: WOS:000361237300028},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{barillot_media_2015,

title = {MEDIA special issue on MICCAI 2014},

author = {Christian Barillot and Polina Golland and Nobuhiko Hata and Joachim Hornegger and Robert Howe},

doi = {10.1016/j.media.2015.04.017},

issn = {1361-8415, 1361-8423},

year  = {2015},

date = {2015-10-01},

journal = {MEDICAL IMAGE ANALYSIS},

volume = {25},

number = {1},

pages = {1–1},

note = {Num Pages: 1 

Place: Amsterdam 

Publisher: Elsevier Science Bv 

Web of Science ID: WOS:000360864700001},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{kato_tendon-driven_2015,

title = {Tendon-Driven Continuum Robot for Endoscopic Surgery: Preclinical Development and Validation of a Tension Propagation Model},

author = {Takahisa Kato and Ichiro Okumura and Sang-Eun Song and Alexandra J. Golby and Nobuhiko Hata},

doi = {10.1109/TMECH.2014.2372635},

issn = {1083-4435, 1941-014X},

year  = {2015},

date = {2015-10-01},

journal = {IEEE-ASME TRANSACTIONS ON MECHATRONICS},

volume = {20},

number = {5},

pages = {2252–2263},

abstract = {In this paper, we present a tendon-driven continuum robot for endoscopic surgery. The robot has two sections for articulation actuated by tendon wires. By actuating the two sections independently, the robot can generate a variety of tip positions while maintaining the tip direction. This feature offers more flexibility in positioning the tip for large viewing angles of up to 180. than does a conventional endoscope. To accurately estimate the tip position at large viewing angles, we employed kinematic mapping with a tension propagation model including friction between the tendon wires and the robot body. In a simulation study using this kinematic mapping, the two-section robot at a target scale (outer diameter 1.7 mm and length 60 mm) produced a variety of tip positions within 50-mm ranges at the 180. angle view. In the experimental validation, a 10: 1 scale prototype performed three salient postures with different tip positions at the 180. angle view. The proposed forward kinematic mapping (FKM) predicted the tip position within a tip-to-tip error of 6 mm over the 208-mm articulating length. The tip-to-tip error by FKM was significantly less than the one by conventional piecewise-constant-curvature approximation (FKM: 5.9 +/- 2.9 mm versus PCCA: 23.7 +/- 3.6 mm},

note = {Num Pages: 12 

Place: Piscataway 

Publisher: Ieee-Inst Electrical Electronics Engineers Inc 

Web of Science ID: WOS:000360831900024},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid26412962,

title = {Piezoelectrically Actuated Robotic System for MRI-Guided Prostate Percutaneous Therapy},

author = {Hao Su and Weijian Shang and Gregory Cole and Gang Li and Kevin Harrington and Alexander Camilo and Junichi Tokuda and Clare M Tempany and Nobuhiko Hata and Gregory S Fischer},

doi = {10.1109/TMECH.2014.2359413},

issn = {1083-4435},

year  = {2015},

date = {2015-08-01},

journal = {IEEE ASME Trans Mechatron},

volume = {20},

number = {4},

pages = {1920--1932},

abstract = {This paper presents a fully-actuated robotic system for percutaneous prostate therapy under continuously acquired live magnetic resonance imaging (MRI) guidance. The system is composed of modular hardware and software to support the surgical workflow of intra-operative MRI-guided surgical procedures. We present the development of a 6-degree-of-freedom (DOF) needle placement robot for transperineal prostate interventions. The robot consists of a 3-DOF needle driver module and a 3-DOF Cartesian motion module. The needle driver provides needle cannula translation and rotation (2-DOF) and stylet translation (1-DOF). A custom robot controller consisting of multiple piezoelectric motor drivers provides precision closed-loop control of piezoelectric motors and enables simultaneous robot motion and MR imaging. The developed modular robot control interface software performs image-based registration, kinematics calculation, and exchanges robot commands and coordinates between the navigation software and the robot controller with a new implementation of the open network communication protocol OpenIGTLink. Comprehensive compatibility of the robot is evaluated inside a 3-Tesla MRI scanner using standard imaging sequences and the signal-to-noise ratio (SNR) loss is limited to 15%. The image deterioration due to the present and motion of robot demonstrates unobservable image interference. Twenty-five targeted needle placements inside gelatin phantoms utilizing an 18-gauge ceramic needle demonstrated 0.87 mm root mean square (RMS) error in 3D Euclidean distance based on MRI volume segmentation of the image-guided robotic needle placement procedure.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{hata_miccai_2015,

title = {MICCAI 2014 special issue},

author = {Nobuhiko Hata and Joachim Hornegger},

doi = {10.1007/s11548-015-1270-6},

issn = {1861-6410, 1861-6429},

year  = {2015},

date = {2015-08-01},

journal = {INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY},

volume = {10},

number = {8},

pages = {1179–1179},

note = {Num Pages: 1 

Place: Heidelberg 

Publisher: Springer Heidelberg 

Web of Science ID: WOS:000358938200001},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{tilak_3t_2015,

title = {3T MR-guided in-bore transperineal prostate biopsy: A comparison of robotic and manual needle-guidance templates},

author = {Gaurie Tilak and Kemal Tuncali and Sang-Eun Song and Junichi Tokuda and Olutayo Olubiyi and Fiona Fennessy and Andriy Fedorov and Tobias Penzkofer and Clare Tempany and Nobuhiko Hata},

doi = {10.1002/jmri.24770},

issn = {1053-1807, 1522-2586},

year  = {2015},

date = {2015-07-01},

journal = {JOURNAL OF MAGNETIC RESONANCE IMAGING},

volume = {42},

number = {1},

pages = {63–71},

abstract = {PurposeTo demonstrate the utility of a robotic needle-guidance template device as compared to a manual template for in-bore 3T transperineal magnetic resonance imaging (MRI)-guided prostate biopsy. Materials and MethodsThis two-arm mixed retrospective-prospective study included 99 cases of targeted transperineal prostate biopsies. The biopsy needles were aimed at suspicious foci noted on multiparametric 3T MRI using manual template (historical control) as compared with a robotic template. The following data were obtained: the accuracy of average and closest needle placement to the focus, histologic yield, percentage of cancer volume in positive core samples, complication rate, and time to complete the procedure. ResultsIn all, 56 cases were performed using the manual template and 43 cases were performed using the robotic template. The mean accuracy of the best needle placement attempt was higher in the robotic group (2.39 mm) than the manual group (3.71 mm, P<0.027). The mean core procedure time was shorter in the robotic (90.82 min) than the manual group (100.63 min, P<0.030). Percentage of cancer volume in positive core samples was higher in the robotic group (P<0.001). Cancer yields and complication rates were not statistically different between the two subgroups (P=0.557 and P=0.172, respectively). ConclusionThe robotic needle-guidance template helps accurate placement of biopsy needles in MRI-guided core biopsy of prostate cancer. J. Magn. Reson. Imaging 2015;42:63-71. (c) 2014 Wiley Periodicals, Inc.},

note = {Num Pages: 9 

Place: Hoboken 

Publisher: Wiley 

Web of Science ID: WOS:000356625500007},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid25784325,

title = {Graphics Processing Unit-Accelerated Nonrigid Registration of MR Images to CT Images During CT-Guided Percutaneous Liver Tumor Ablations},

author = {Junichi Tokuda and William Plishker and Meysam Torabi and Olutayo I Olubiyi and George Zaki and Servet Tatli and Stuart G Silverman and Raj Shekher and Nobuhiko Hata},

doi = {10.1016/j.acra.2015.01.007},

issn = {1878-4046},

year  = {2015},

date = {2015-06-01},

journal = {Acad Radiol},

volume = {22},

number = {6},

pages = {722--733},

abstract = {RATIONALE AND OBJECTIVES: Accuracy and speed are essential for the intraprocedural nonrigid magnetic resonance (MR) to computed tomography (CT) image registration in the assessment of tumor margins during CT-guided liver tumor ablations. Although both accuracy and speed can be improved by limiting the registration to a region of interest (ROI), manual contouring of the ROI prolongs the registration process substantially. To achieve accurate and fast registration without the use of an ROI, we combined a nonrigid registration technique on the basis of volume subdivision with hardware acceleration using a graphics processing unit (GPU). We compared the registration accuracy and processing time of GPU-accelerated volume subdivision-based nonrigid registration technique to the conventional nonrigid B-spline registration technique.nnMATERIALS AND METHODS: Fourteen image data sets of preprocedural MR and intraprocedural CT images for percutaneous CT-guided liver tumor ablations were obtained. Each set of images was registered using the GPU-accelerated volume subdivision technique and the B-spline technique. Manual contouring of ROI was used only for the B-spline technique. Registration accuracies (Dice similarity coefficient [DSC] and 95% Hausdorff distance [HD]) and total processing time including contouring of ROIs and computation were compared using a paired Student t test.nnRESULTS: Accuracies of the GPU-accelerated registrations and B-spline registrations, respectively, were 88.3 ± 3.7% versus 89.3 ± 4.9% (P = .41) for DSC and 13.1 ± 5.2 versus 11.4 ± 6.3 mm (P = .15) for HD. Total processing time of the GPU-accelerated registration and B-spline registration techniques was 88 ± 14 versus 557 ± 116 seconds (P < .000000002), respectively; there was no significant difference in computation time despite the difference in the complexity of the algorithms (P = .71).nnCONCLUSIONS: The GPU-accelerated volume subdivision technique was as accurate as the B-spline technique and required significantly less processing time. The GPU-accelerated volume subdivision technique may enable the implementation of nonrigid registration into routine clinical practice.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid24923473,

title = {OpenIGTLink interface for state control and visualisation of a robot for image-guided therapy systems},

author = {Sebastian Tauscher and Junichi Tokuda and Günter Schreiber and Thomas Neff and Nobuhiko Hata and Tobias Ortmaier},

doi = {10.1007/s11548-014-1081-1},

issn = {1861-6429},

year  = {2015},

date = {2015-03-01},

journal = {Int J Comput Assist Radiol Surg},

volume = {10},

number = {3},

pages = {285--292},

abstract = {PURPOSE: The integration of a robot into an image-guided therapy system is still a time consuming process, due to the lack of a well-accepted standard for interdevice communication. The aim of this project is to simplify this procedure by developing an open interface based on three interface classes: state control, visualisation, and sensor. A state machine on the robot control is added to the concept because the robot has its own workflow during surgical procedures, which differs from the workflow of the surgeon.nnMETHODS: A KUKA Light Weight Robot is integrated into the medical technology environment of the Institute of Mechatronic Systems as a proof of concept. Therefore, 3D Slicer was used as visualisation and state control software. For the network communication the OpenIGTLink protocol was implemented. In order to achieve high rate control of the robot the "KUKA Sunrise. Connectivity SmartServo" package was used. An exemplary state machine providing states typically used by image-guided therapy interventions, was implemented. Two interface classes, which allow for a direct use of OpenIGTLink for robot control on the one hand and visualisation on the other hand were developed. Additionally, a 3D Slicer module was written to operate the state control.nnRESULTS: Utilising the described software concept the state machine could be operated by the 3D Slicer module with 20 Hz cycle rate and no data loss was detected during a test phase of approximately 270s (13,640 packages). Furthermore, the current robot pose could be sent with more than 60 Hz. No influence on the performance of the state machine by the communication thread could be measured.nnCONCLUSION: Simplified integration was achieved by using only one programming context for the implementation of the state machine, the interfaces, and the robot control. Eventually, the exemplary state machine can be easily expanded by adding new states.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{penzkofer_transperineal_2015,

title = {Transperineal In-Bore 3-T MR Imaging-guided Prostate Biopsy: A Prospective Clinical Observational Study},

author = {Tobias Penzkofer and Kemal Tuncali and Andriy Fedorov and Sang-Eun Song and Junichi Tokuda and Fiona M. Fennessy and Mark G. Vangel and Adam S. Kibel and Robert V. Mulkern and William M. Wells and Nobuhiko Hata and Clare M. C. Tempany},

doi = {10.1148/radiol.14140221},

issn = {0033-8419},

year  = {2015},

date = {2015-01-01},

journal = {RADIOLOGY},

volume = {274},

number = {1},

pages = {170–180},

abstract = {Purpose: To determine the detection rate, clinical relevance, Gleason grade, and location of prostate cancer (PCa) diagnosed with and the safety of an in-bore transperineal 3-T magnetic resonance (MR) imaging-guided prostate biopsy in a clinically heterogeneous patient population. Materials and Methods: This prospective retrospectively analyzed study was HIPAA compliant and institutional review board approved, and informed consent was obtained. Eighty-seven men (mean age, 66.2 years +/- 6.9) underwent multiparametric endorectal prostate MR imaging at 3 T and transperineal MR imaging-guided biopsy. Three subgroups of patients with at least one lesion suspicious for cancer were included: men with no prior PCa diagnosis, men with PCa who were undergoing active surveillance, and men with treated PCa and suspected recurrence. Exclusion criteria were prior prostatectomy and/or contraindication to 3-T MR imaging. The transperineal MR imaging-guided biopsy was performed in a 70-cm wide-bore 3-T device. Overall patient biopsy outcomes, cancer detection rates, Gleason grade, and location for each subgroup were evaluated and statistically compared by using x(2) and one-way analysis of variance followed by Tukey honestly significant difference post hoc comparisons. Results: Ninety biopsy procedures were performed with no serious adverse events, with a mean of 3.7 targets sampled per gland. Cancer was detected in 51 (56.7%) men: 48.1% (25 of 52) with no prior PCa, 61.5% (eight of 13) under active surveillance, and 72.0% (18 of 25) in whom recurrence was suspected. Gleason pattern 4 or higher was diagnosed in 78.1% (25 of 32) in the no prior PCa and active surveillance groups. Gleason scores were not assigned in the suspected recurrence group. MR targets located in the anterior prostate had the highest cancer yield (40 of 64, 62.5%) compared with those for the other parts of the prostate (P < .001). Conclusion: In-bore 3-T transperineal MR imaging-guided biopsy, with a mean of 3.7 targets per gland, allowed detection of many clinically relevant cancers, many of which were located anteriorly. (C) RSNA, 2014},

note = {Num Pages: 11 

Place: Oak Brook 

Publisher: Radiological Soc North America (rsna) 

Web of Science ID: WOS:000348699400021},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{yoshimitsu_novel_2014,

title = {A novel four-wire-driven robotic catheter for radio-frequency ablation treatment},

author = {Kitaro Yoshimitsu and Takahisa Kato and Sang-Eun Song and Nobuhiko Hata},

doi = {10.1007/s11548-014-0982-3},

issn = {1861-6410, 1861-6429},

year  = {2014},

date = {2014-09-01},

journal = {INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY},

volume = {9},

number = {5},

pages = {867–874},

abstract = {Robotic catheters have been proposed to increase the efficacy and safety of the radio-frequency ablation treatment. The robotized motion of current robotic catheters mimics the motion of manual ones-namely, deflection in one direction and rotation around the catheter. With the expectation that the higher dexterity may achieve further efficacy and safety of the robotically driven treatment, we prototyped a four-wire-driven robotic catheter with the ability to deflect in two- degree-of-freedom motions in addition to rotation. A novel quad-directional structure with two wires was designed and developed to attain yaw and pitch motion in the robotic catheter. We performed a mechanical evaluation of the bendability and maneuverability of the robotic catheter and compared it with current manual catheters. We found that the four-wire-driven robotic catheter can achieve a pitching angle of 184.7 at a pulling distance of wire for 11 mm, while the yawing angle was 170.4 at 11 mm. The robotic catheter could attain the simultaneous two- degree-of-freedom motions in a simulated cardiac chamber. The results indicate that the four-wire-driven robotic catheter may offer physicians the opportunity to intuitively control a catheter and smoothly approach the focus position that they aim to ablate.},

note = {Conference Name: 4th IPCAI Conference 

Num Pages: 8 

Place: Heidelberg 

Publisher: Springer Heidelberg 

Web of Science ID: WOS:000343130300012},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{ren_treatment_2014,

title = {Treatment Planning and Image Guidance for Radiofrequency Ablation of Large Tumors},

author = {Hongliang Ren and Enrique Campos-Nanez and Ziv Yaniv and Filip Banovac and Hernan Abeledo and Nobuhiko Hata and Kevin Cleary},

doi = {10.1109/JBHI.2013.2287202},

issn = {2168-2194, 2168-2208},

year  = {2014},

date = {2014-05-01},

journal = {IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS},

volume = {18},

number = {3},

pages = {920–928},

abstract = {This article addresses the two key challenges in computer-assisted percutaneous tumor ablation: planning multiple overlapping ablations for large tumors while avoiding critical structures, and executing the prescribed plan. Toward semiautomatic treatment planning for image-guided surgical interventions, we develop a systematic approach to the needle-based ablation placement task, ranging from preoperative planning algorithms to an intraoperative execution platform. The planning system incorporates clinical constraints on ablations and trajectories using a multiple objective optimization formulation, which consists of optimal path selection and ablation coverage optimization based on integer programming. The system implementation is presented and validated in both phantom and animal studies. The presented system can potentially be further extended for other ablation techniques such as cryotherapy.},

note = {Num Pages: 9 

Place: Piscataway 

Publisher: Ieee-Inst Electrical Electronics Engineers Inc 

Web of Science ID: WOS:000336050400023},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid25489644,

title = {17th International Conference on Medical Image Computing and Computer-Assisted Intervention},

author = {Polina Golland and Nobuhiko Hata and Christian Barillot and Joachim Hornegger and Robert Howe},

year  = {2014},

date = {2014-01-01},

journal = {Med Image Comput Comput Assist Interv},

volume = {17},

number = {Pt 2},

pages = {V--VI},

keywords = {},

pubstate = {published},

tppubtype = {article}

}