A Steerable Compact Robot for MRI-Guided Minimally-Invasive Interventions

1) Brief description of the context of the research including potential impact
Minimally-invasive image-guided interventions are at the forefront of cancer treatment in modern medicine. In this context, interventional MRI is opening new possibilities given the higher image quality and resolution when it comes to soft tissues. Furthermore, when compared with CT imaging, the absence of radiations enables continuous visual feedback during surgery without harming the patient or the clinicians. However, the use of interventional MRI machines poses new challenges: the narrower bore in comparison to their CT counterparts significantly reduces the workspace of clinicians and the tools used, which impacts both manual tools and robotic-assisted ones. Moreover, the demand for MRI-compatibility greatly impacts tool designs. Robotic solutions have been developed to assist surgeons in percutaneous procedures such as needle insertion of probes for cryoablation and RF-ablation of tumoral masses in the kidneys and in the liver. A number of robotic solutions to solve this problem have been proposed, however, there are still multiple challenges related to the size, the weight, the actuation and the design of the mechanisms for needle insertion. This PhD project will focus on the development of an MRI-compatible compact robot for percutaneous needle insertion and steering. Such guiding system can be used with needle-shaped probes for biopsies, cryo- or RF-ablations as well as for localised drugs delivery for cancer treatment. The proposed research will generate impactful results in the field of MRI-compatible needle insertion for oncology.

2) Aims and Objectives
In order to solve the aforementioned challenges, this PhD project will design a semi-autonomous MRI compatible compact robot for percutaneous needle insertion for the biopsy, cryo- or RF-ablations, and delivery of drugs to diagnose and treat cancer. The aim of this project is the development and validation of this novel mechatronic system as well as the control methods to manipulate the needle within the tissue to reach the pre-defined targets with shorter scan times and fewer steps to reduce patients' suffering.

3) Novelty of Research Methodology
To deploy the interventional robot in a real clinical scenario, clinical requirements such as biocompatibility must also be taken into consideration. Moreover, input from expert clinicians, specifically interventional radiologists and oncologists, will be key for the development of the proposed system. Regular observations in the surgical theatre will take place to understand the procedure workflow and work in close collaboration with the clinical project's partners.

For the envisioned system for percutaneous insertion the development of efficient mechanisms for probe clamping, inserting, and steering is of paramount importance. In insertions for different parts of the body, different insertion angles need to be considered to optimise the puncturing. Hence, the robot should have an angle-adjustable structure. Different mechanisms will be tested to assess the best actuation technology for this application. Combined mechanisms for clamping, inserting, and steering are going to be developed to downsize the actuator so that it can be used in the narrow bore of the MRI scanner. A method for driving the needle-shaped probe into the tissue, which could be similar to a syringe or hydraulic piston, and similar angle-adjustable structure will also be investigated.

4) Alignment to EPSRC's strategies and research areas
Interventional and surgical robotics is a current research hotspot, especially using robotic technology to treat tumours. The proposed project well aligns with the EPSRC grand challenge of the Frontiers of Physical Intervention by proposing a novel approach to treat tumours using MRI-guided robotic solutions to guide state-of-the-art needle-shaped probes.

5) Any companies involved? None

The critical mass of scientists and engineers that i4health will produce will ensure the UK's continued standing as a world-leader in medical imaging and healthcare technology research. In addition to continued academic excellence, they will further support a future culture of industry and entrepreneurship in healthcare technologies driven by highly trained engineers with deep understanding of the key factors involved in delivering effective translatable and marketable technology. They will achieve this through high quality engineering and imaging science, a broad view of other relevant technological areas, the ability to pinpoint clinical gaps and needs, consideration of clinical user requirements, and patient considerations. Our graduates will provide the drive, determination and enthusiasm to build future UK industry in this vital area via start-ups and spin-outs adding to the burgeoning community of healthcare-related SMEs in London and the rest of the UK. The training in entrepreneurship, coupled with the vibrant environment we are developing for this topic via unique linkage of Engineering and Medicine at UCL, is specifically designed to foster such outcomes. These same innovative leaders will bolster the UK's presence in medical multinationals - pharmaceutical companies, scanner manufacturers, etc. - and ensure the UK's competitiveness as a location for future R&D and medical engineering. They will also provide an invaluable source of expertise for the future NHS and other healthcare-delivery services enabling rapid translation and uptake of the latest imaging and healthcare technologies at the clinical front line. The ultimate impact will be on people and patients, both in the UK and internationally, who will benefit from the increased knowledge of health and disease, as well as better treatment and healthcare management provided by the future technologies our trainees will produce.

In addition to impact in healthcare research, development, and capability, the CDT will have major impact on the students we will attract and train. We will provide our talented cohorts of students with the skills required to lead academic research in this area, to lead industrial development and to make a significant impact as advocates of the science and engineering of their discipline. The i4health CDT's combination of the highest academic standards of research with excellent in-depth training in core skills will mean that our cohorts of students will be in great demand placing them in a powerful position to sculpt their own careers, have major impact within our discipline, while influencing the international mindset and direction. Strong evidence demonstrates this in our existing cohorts of students through high levels of conference podium talks in the most prestigious venues in our field, conference prizes, high impact publications in both engineering, clinical, and general science journals, as well as post-PhD fellowships and career progression. The content and training innovations we propose in i4health will ensure this continues and expands over the next decade.