Context Aware Catheter Navigation for Improved Stent Deployment (Creativity@Home Pilot)

Lead Research Organisation: Imperial College London
Department Name: Dept of Computing

Abstract

Cardiovascular disease is the major cause of deaths in the Western world, of which vascular disease is a main contributing factor. One particular form of vascular disease is Abdominal Aortic Aneurysm (AAA), which is one of the leading causes of death. The prevalence of AAA is 1.3% in men 45-54 years of age, rising to 12.5% in men over the age of 75. For women, although AAA is rare in younger age groups, it is found in 5.2% of those over 75. Aortic aneurysms, if left untreated, risk rupture, with only 25% of cases reaching to hospital alive, with operative mortality exceeding 40%. Endovascular repair offers several advantages over open surgery: faster recovery time, reduced need for general anaesthesia, no laparotomy, less blood loss, and decreased risk of erectile dysfunction. Endovascular repair procedures are likely to be a cost-effective alternative in cases for which open surgery is unsuitable. The aim of the project is to integrate real-time sensing, shape instantiation combined with modelling of in situ catheter-tissue interaction for context-aware catheter manipulation and stent deployment under dynamic active constraints. The project is timely in that the ageing population implies increasing prevalence of aortic aneurysm and for this patient group, traditional open surgery is unsuitable due to the major trauma involved. Technically, it is also timely to explore the latest developments in multi-modal intra-operative imaging, sensing and robotics for minimally invasive therapy. The proposed research on context-aware, robotically assisted catheter navigation addresses some of the major challenges faced by endovascular repair and the expected research results will guide future designs of control interfaces for flexible robotics, and exploration of models with quasi-physical behaviour and constraints are more conducive to rapid adaptation to intra-operative variation.

Planned Impact

Recent advances in robotic catheter guidance systems have offered significantly improved catheter manipulation for endovascular intervention with more degrees-of-freedom. Clinical benefit from robotic control and guidance systems is significant in that they assist and simplify navigation and localisation tasks in complex surgical settings, reducing operator fatigue and risk of error. The potential stakeholders that will benefit from this research include: Academia (both UK and international) in medical imaging, sensing, robotics and general biomedical engineering; Public and private sectors in healthcare provision; Medical devices industry; none-government organisations focussed on prevention and management of cardiovascular diseases; and more importantly patients and the general public. With demographic shift associated with ageing population, the proposed research can have a potentially significant impact on addressing the challenges faced by the current healthcare system and future improvement of minimally invasive therapies targeted for these patients. The main benefits of robotic-assisted endovascular intervention include minimised trauma, reduced complications, decreased hospital stay, improved anatomical and functional visualisation, and safer procedure by introducing active constraints. Patients also benefit from shorter procedures, lower exposure to contrast, and thus decreased nephrotoxic risk. Lowering the risk of endovascular repair procedures would enable more patients to qualify for elective intervention than otherwise would have been possible, which can lower overall treatment costs given that emergency repair incurs a much greater expense than elective surgical repair. This would also contribute to lower mortality from the condition. The benefit from this research includes potentially significant technological, social, commercial and economic impact. It not only enhances research capacity but also brings tangible knowledge transfer opportunities. The project addresses important research and development challenges, and the end results are likely to transform clinical research and practices in endovascular intervention, minimally invasive surgery, and interventional imaging. The project also provides opportunities in cross-scale morphological and functional integration of surgical information and the technical innovations described are introduced we are likely to generate opportunities in clinical applications that lead to personalisation of healthcare treatment.

Publications

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Lee SL (2011) An instantiability index for intra-operative tracking of 3D anatomy and interventional devices. in Medical image computing and computer-assisted intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Intervention

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Merrifield R (2015) Surgical Robot Challenge 2015 [Competitions] in IEEE Robotics & Automation Magazine

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Rafii-Taril H (2012) Assessment of navigation cues with proximal force sensing during endovascular catheterization. in Medical image computing and computer-assisted intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Intervention

 
Description The research aims to develop a context aware catheter navigation scheme that integrates proximal sensing for better understanding of the manipulation required and dynamic motion compensation through subject-specific shape modelling. Detailed user studies of catheter manipulation, dynamic motion modelling and navigation strategies have been performed to assist with the design of a novel catheter robot. This is a feasibility study, which has also led to further research for path planning and tactile feedback for endovascular intervention with reduced X-ray and contrast exposure.
Exploitation Route The work is served as the basis for a new hands on robot for catheter manipulation currently being developed at the Hamlyn Centre for Robotic Surgery at Imperial College, with a view for potential commercial exploitation. Part of this work has led to an EU grant entitled: CASCADE (Cognitive AutonomouS CAtheter operating in Dynamic Environments).

Further funding from the EPSRC has been sought to maximise the impact of the research outputs from this grant; this is via the EPSRC Healthcare Impact Partnerships 2015/2016.
Sectors Digital/Communication/Information Technologies (including Software),Electronics,Healthcare

URL http://www.imperial.ac.uk/hamlyn
 
Description The project has allowed the exploitation of new ideas through the Creativity@Home framework. These ideas have been subsequently turned into tangible projects (both EU and UK) and clinical collaboration for catheter navigation.
Sector Digital/Communication/Information Technologies (including Software),Healthcare
Impact Types Societal,Economic

 
Description CASCADE
Amount € 56,902,100 (EUR)
Funding ID FP7 601021 
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 02/2013 
End 01/2016
 
Description Robot Assisted Endovascular Intervention: Device Design and Innovation
Amount £1,112,059 (GBP)
Funding ID EP/N024877/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 01/2017 
End 12/2020
 
Title A device 
Description A system comprising a platform assembly comprising a master platform and a slave platform, both the master platform and the slave platform being moveable, the platform assembly further comprising a force feedback control arrangement for applying a force to the master platform in response to a force exerted on a slave device mounted on the platform. 
IP Reference WO2014053859 
Protection Patent granted
Year Protection Granted 2014
Licensed No
Impact New publications based on force sensing device.
 
Description Former Prime Minister Tony Blair Visit 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The former Prime Minister Tony Blair visited Imperial College and toured the Hamlyn Centre for Robotics, viewing demonstrations of surgical robots, 3D printed microrobotic tools and augmented reality technology for medical imaging.
Year(s) Of Engagement Activity 2018
URL https://www.imperial.ac.uk/news/187036/former-pm-supports-lord-darzi-report/
 
Description Friends of Imperial Visit 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Supporters
Results and Impact The Hamlyn Centre participated in the programme of "Friends of Imperial Visit" as one of visit destinations. Our research teams demonstrated the latest research result to the "Friends of Imperial Visit" participants and answered their questions regarding the works.
Year(s) Of Engagement Activity 2018
URL https://www.friendsofimperial.org.uk/Media/Documents/Current_Programme.pdf
 
Description Hamlyn Centre Official Twitter 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact The Hamlyn Centre Official Twitter account aims to reach out all types of audiences for demonstrating our research progress and result, promoting our events and sharing relevant information.
Year(s) Of Engagement Activity 2014,2015,2016,2017,2018,2019
URL https://twitter.com/ICLHamlynRobots
 
Description Invited Talk- Prof Itaru Kitahara: 3D-CG Virtual Surgical Operation in University of Tsukuba 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Our senior research fellow Dr Matina Giannarou invited Prof. Itaru Kitahara to share the experience about "3D-CG Virtual Surgical Operation in University of Tsukuba" with our researchers in the Hamlyn Centre. Prof. Itaru Kitahara is leading the Virtual Surgery research project at the University of Tsukuba, Japan and his research focuses on Computer Vision and Mixed Reality. During the talk, he not only introduced "3D CG Virtual Surgery", which aims to realise a navigation system of surgical operation using Computer Vision and AR/VR techniques, but also presented the collaboration between their research team and the medical doctors in our university regarding 3D CG Virtual Surgery.
Year(s) Of Engagement Activity 2019
URL https://twitter.com/ICLHamlynRobots/status/1102943972790542336
 
Description MICCAI Workshop on CVII and STENT 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Su-Lin Lee was a co-organiser for this international workshop focused on technological advances in intravascular imaging. This imaging offers increasingly useful information regarding vascular anatomy and function and are poised to have dramatic impact on the diagnosis, analysis, modeling, and treatment of vascular diseases.
Year(s) Of Engagement Activity 2011,2012,2013,2014,2016,2017
URL http://vpa.sabanciuniv.edu/sites/cvii2011/
 
Description Minister of State for Immigration Caroline Nokes MP and Cancer Research UK Visit 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Caroline Nokes MP, Minister of State for Immigration, visited Imperial in October 2018 and took a tour of the Hamlyn Centre for Robotic Surgery. She was joined by representatives of Cancer Research UK and our college president Alice Gast. During the visit, Caroline Nokes was shown some of our latest robot technology in medicine, developments which have enabled healthcare professionals to conduct smarter operations with higher precision.
Year(s) Of Engagement Activity 2018
URL http://www.imperial.ac.uk/news/188691/immigration-minister-sees-benefits-internationalism-imperial/
 
Description Professor Daniel Elson: Lighting Up The Operating Theatre 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Professor Daniel Elson, our Hamlyn Centre Director of Studies, talked through a career that has mirrored the typical innovation translation pathway - from a PhD in laser physics, and time spent in the Faculty of Engineering developing imaging tools for key hole surgery, a move to the Division of Surgery saw him work directly with surgeons to begin translating those technologies into image guidance tools. He discussed progress made developing diagnostic methods and technologies, and the value of adopting a clinical, rather than purely technological driven, approach to innovation and problem solving, working with surgeons to identify challenges today and tomorrow.
Year(s) Of Engagement Activity 2018
URL https://www.youtube.com/watch?v=DOQz7HufVaQ&feature=youtu.be
 
Description Robotic Endovascular Interventions Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A dedicated workshop on Robotic Endovascular Interventions, in conjunction with the 5th Hamlyn Symposium on Medical Robotics, was held in London on Saturday, 30 June 2012. This forum brought together researchers in academia and industry to exchange ideas on the current state-of-the-art and on the future trends in endovascular procedures and technologies.
Year(s) Of Engagement Activity 2012,2013,2014,2015
URL http://ubimon.doc.ic.ac.uk/Hamlyn2012/m1587.html
 
Description The Hamlyn Centre Christmas Showcase 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Supporters
Results and Impact The Hamlyn Christmas Showcase is an event that showcased the latest research outputs form our research teams at the Hamlyn Centre. Every year we invite our collaborators and affiliates to participate this event in order to demonstrate our research findings and to discuss potential further collaboration.
Year(s) Of Engagement Activity 2016,2017,2018,2019
URL https://twitter.com/ICLHamlynRobots/status/1073577685488754688
 
Description The Hamlyn Centre Official Website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact The Hamlyn Centre Official website aims to engage with all types of audiences for introducing our centre purpose and structure as well as our research areas and environment. On the website, we also constantly update job opportunities, event information and News from our research teams as well as the Imperial College.
Year(s) Of Engagement Activity 2010,2011,2012,2013,2014,2015,2016,2017,2018,2019
URL https://www.imperial.ac.uk/hamlyn-centre/
 
Description The Hamlyn Symposium 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Hamlyn Symposium on Medical Robotics (HSMR) provides an annual forum for surgeons and engineers from across the globe, to network and explore the latest developments in medical robotics. The Symposium has been successfully conducted for the past 11 years and has become a leading international conference on medical robotics, current clinical practice and emerging technologies in robotic surgery. Every year researchers, clinicians and engineers are invited to submit papers on a range of topics covering clinical specialities in Urology, Cardiac Surgery, Neuro Surgery, Thoracic Surgery, General Surgery, Gynaecology, ENT, Orthopaedic and Paediatric Surgery. The Hamlyn Symposium is composed of a series of workshops on various clinical and technical topics and the main conference with the participants from leading medical, science and technology institutions.
Year(s) Of Engagement Activity 2006,2007,2008,2009,2010,2011,2012,2013,2014,2015,2016,2017,2018,2019
URL https://www.ukras.org/hamlyn/