WP4 Therapy Planning
OBJECTIVES
The primary purpose of WP4 is to identify freedoms and constraints associated with use of a twin-independent robot approach to deliver focused ultrasound therapy; thanks to these identified framework and constraints in association with a Focused Ultrasound Surgery (FUS) lesion patterning strategy it will be possible to develop a therapy planning strategy. Pre-operative imaging (Magnetic Resonance Imaging (MRI)/Computed Tomography (CT)) will be used to define motion pathways for the robotic treatment and robot- patient registration. Efforts will also be devoted to implementing a high precision robot positioning strategy.
In the framework of this WP, a pre-clinical test protocol will be devised to demonstrate the implementation of the therapy planning strategy, and to execute this test protocol under suitable conditions. Results from pre-clinical testing will be compared with data from the reference Magnetic Resonance guided FUS system to improve the therapy planning and FUS lesion patterning strategies.
DESCRIPTION OF WORK
T4.1 Methods for finding the optimal ultrasound window - Pre-operative imaging must be used for finding the optimal ultrasonic window, in order to avoid dangerous interactions (e.g., with bones or large blood vessels) and to complete the therapy. This will involve MRI and/or CT imaging of the patient in the same position as for the robotic surgery. Using CAMELOT’s capability in preparation of registered US images of MRI/CT data, the motion pathways for the robotic treatment will be simulated, in combination with constrains of the clinical requirements for the treatment. This will also take into account the strategy for FUS ablation in relation to the buildup of a complete treatment from individual FUS lesions which will be developed with IGT. UNIVDUN will acquire several MRI and US imaging data set and work out the optimal positioning window and provide these data for the specification of the FUTURA platform.
T4.2 Robot positioning for therapy and monitoring. A key requirement is that the patient must be registered with respect to the robotic platform using for instance fiducial markers. In this Task, the clinical aspects will be considered; optimal position for the imaging transducer will be established exploiting CAMELOT experience and know-how in learning and optimal design. It is possible that specific sensors will be used to register the robots but it may be better to use information from the US imaging transducer on each robot to achieve this, either as an alternative or an addition. Once registration has been achieved, the robot must be positioned in order to perform the optimal therapy defined in T4.1; continuous feedback will be possible again using registration between real-time US images and data from the pre-operative MRI/CT scans.
A highly precise robot positioning is an essential goal to be reached for deliver correctly and safely the therapy; this is clear since a small error in the robot position and/or orientation (even a few millimeters or degrees) leads to a much higher misalignment of the ultrasound beam in the target organ, leading to the damage of healthy regions. For this reason major efforts will be devoted to implement a high precision robot positioning strategy.
