Steerable Needles to Save Lives in Lung Cancer
There are millions of people every year who face a life threatening dilemma. They have just had a chest X-ray or CT scan which turned up “suspicious nodules” that might, or might not, be cancer. But these nodules are too small to reliably biopsy. All these patients can do is go home and wait to see if cancer grows. Meanwhile every passing day makes their life expectancy lower.
We have a solution! A new kind of steerable needle deployed through a bronchsocpe can exit the airways and home in on the nodule, accurately taking a biopsy. In the longer term, such a needle has the potential to even directly deliver liquid or radioactive seeds to kill the tumor on site, without surgery.
We have designed the steerable needle system and created closed-loop controllers that automatically deliver it to the desired point in the lung. Our collaborators at the University of North Carolina at Chapel hill, led by Ron Alterovitz, have devised segmentation and motion planning algorithms that deliver the needle through the safest path to the target.
We have demonstrated this system in live animals and shown that it can dramatically out perform the accuracy of human surgeons. Our Science Robotics paper listed below summarizes many years of work on this project, as well as the animal and other experimental results mentioned above.
Related Publications:
A. Kuntz, M. Emerson, T. Ertop, I. Fried, M. Fu, J. Hoelscher, M. Rox, J. Akulian, E. A. Gillaspie, Y. Z. Lee, F. Maldonado, R. J. Webster III, and R. Alterovitz. Autonomous Medical Needle Steering In Vivo. Science Robotics, 8(82), 2023.
J. Hoelscher, M. Fu, I. Fried, M. Emerson, T. Ertop, M. Rox, A. Kuntz, J. Akulian, R. J. Webster III, and R. Alterovitz. Backward Planning for a Multi-Stage Steerable Needle Lung Robot. IEEE Robotics and Automation Letters, 6(2):3987-3994, 2021.
M. Rox, M. Emerson, T. E. Ertop, I. Fried, M. Fu, J. Hoelscher, A. Kuntz, J. Granna, J. Mitchell, M. Lester, F. Maldonado, E. A. Gillaspie, J. A. Akulian, R. Alterovitz, and R. J. Webster, III. Decoupling Steerability from Diameter: Helical Dovetail Laser Patterning for Steerable Needles. IEEE Access, 8:181411-181419, 2020.
P. J. Swaney, A. W. Mahoney, B. I. Hartley, A. A. Remirez, E. P. Lamers, R. H. Feins, R. Alterovitz, and R. J. Webster III. Toward Transoral Peripheral Lung Access: Combining Continuum Robots and Steerable Needles. Journal of Medical Robotics Research, 2(1):1750001, 2017.
T. E. Ertop, M. Emerson, M. Rox, J. Granna, F. Maldonado, E. Gillaspie, M. Lester, A. Kuntz, C. Rucker, M. Fu, J. Hoelscher, I. Fried, R. Alterovitz, and R. J. Webster, III, “Steerable Needle Trajectory Following In The Lung: Torsional Deadband Compensation And Full Pose Estimation With 5DOF Feedback For Needles Passing Through Flexible Endoscopes”, in ASME Dynamic Systems and Control Conference, 2020. Best Student Paper Finalist
P. J. Swaney, H. B. Gilbert, R. J. Hendrick, O. Commichau, R. Alterovitz, and R. J. Webster, III, “Transoral Steerable Needles in The Lung: How Non-Annular Concentric Tube Robots Can Improve Targeting”, in Hamlyn Symposium on Medical Robotics, 2015. Best Oral Presentation