Research On CT Fluoroscopy Real-time Robotic Navigation System For Percutaneous Puncture

With the development of imaging technology and the diversification of minimally invasive diagnostic and therapeutic methods, image-guided minimally invasive treatment has gradually revealed its advantages in clinical works. CT-guided percutaneous puncture technology as an important part in the field of image-guided minimally invasive treatment,has irreplaceable advantages in the diagnosis and treatment of pulmonary diseases, bone diseases and the other tumor diseases of its high spatial and density resolution. The key point of the successful implementation process of CT-guided percutaneous puncture technique depends on the accuracy of puncture. The "blind puncture" method was adopted in the early stage. The puncture accuracy can mainly depend on the doctors' experience.Especially in the multi needles cooperative minimally invasive surgery, the doctors' own experience and three-dimensional space imagination ability is more important. If the placement of the needle tip is not in the expected area, it often leads to a series of cases,such as the biopsy unsuccessful, tumor residual, the rate of the complications increased and so on. In order to improve the accuracy and the efficiency, kinds of CT-guided navigation systems come into being, but many shortcomings still remain. In order to solve these problems, we want to develop a real-time robotic navigation system by CT fluoroscopy guided, based on the previous research in the comparison with the clinical applications of different navigation systems and image guidance, combined with medical robotics and computer technology, to meet the requirements of percutaneous puncture surgery.The final purpose of the system is to be applied to the clinical works. The main service subjects are the doctors and patients. So, the system must have high accuracy,security and be easy to use. The key technologies include: (1) The image guidance and registration mode. They are key factors in system efficiency and design; (2) Reasonable layout and planning of the system. The space of the interventional operation room and the CT scanning aperture is limited. Reasonable layout solution directly affects the application of the system during the operation; (3) The design of software part. This part must include the functional modules: the import and processing of patients' information and images,preoperative planning, real-time output of images and the high precision remote control of the robot arm; (4) The design and manufacture of the hardware part. The stability of registration and accuracy of mechanical motion are directly related to the safety and stability of the whole system.According to plan, we completed the following tasks: (1) We did further analysis about the compare results in clinical application of electromagnetic, optical and mechanical navigation systems and analyzed the differences between CT fluoroscopy and scanning guided mode in clinical application. Combined with the clinical needs, we established the frame structure with the CT fluoroscopy-guided and mechanical registration mode; (2) A metal base was made as the bridge between the dimensional coordinate of robot arm and the image coordinate in the hardware part of navigation subsystem; In the software part we made there modules (readout of information, preoperative planning, intraoperative guidance) to meet clinical needs; (3) We use the master-slave heterogeneous operating mechanical mode in the mechanical operation subsystem, and makes a series of tests which show good results in accuracy and operability. The navigation subsystem is integrated with the mechanical operation subsystem to complete the whole system; (4) We made a puncture model with the characteristics of the human lung. And completed the model experiments. The accuracy, safety and usability of the system are verified by the results.In this research, we develop a set of CT fluoroscopy real-time robot navigation system and a puncture model, combined with the robot, computer control and other technologies,to meet the clinical requirements. We completed the mechanical tests and the model experiments which prove the high accuracy, safety and usability of the system. We are looking forward to improve and perfect the system to be better apply to clinical works.