November 10, 2015

Over the last 50 years medical imaging has repeatedly transformed medicine. X-Ray, MRI, DXA and CT Scans have changed how physicians measure, manage, diagnose, treat, and even think about medical illnesses and conditions. Technological innovations have also made imaging faster, more precise and less invasive to use. In fact, medical imaging is such an essential part of healthcare practice today that it often becomes the standard preliminary step for diagnosing virtually all major medical conditions and diseases. In some cases medical imaging itself is even being used to treat, manage and predict disease.

The Future of Surgery

Across the world doctors and researchers are pushing the boundaries of what’s possible with medical imaging. One of the most recent breakthroughs has come from researchers at Worcester Polytechnic Institute (WPI) who have created a system in which surgery can be performed from within an MRI scanner.

Now if you’ve ever been inside, operated or seen a closed bore MRI scanner, you know that the space inside the machine is severely limited. Typically there’s only enough room for the patient and not much else. The strong magnetic fields produced by the MRI machine make the use of metal or electronic tools impossible. In addition, any movement inside an MRI scanner can also throw off the results. So how could a doctor ever perform a highly delicate surgical operation within an MRI scanner?

Would you believe the answer is robots?

Robotic Surgery or Robot-Assisted Surgery

Robotic surgery or robot-assisted surgery is becoming more prevalent for many types of procedures because of its precision, flexibility, safety factors and control. Currently most robotic surgeries are minimally invasive and performed through tiny incisions. However, all surgeries of this type still require a surgeon present for operation and oversight.

The researchers at Worcester Polytechnic Institute (WPI) in conjunction with Johns Hopkins University have developed an MRI-compatible robotic surgery tool that can function within the space and technical limitations inside the bore of an MRI scanner.

About the size of a briefcase, and made from plastic and ceramic parts to avoid disrupting the electromagnetic field created by the MRI scanner, the tool is currently in the testing phase with human patients who are undergoing prostate biopsies at Boston’s Brigham and Women’s Hospital.

An Example: Improving the Prostate Biopsy

To truly illustrate how groundbreaking a robotic-assisted surgery tool can be we must first explain how a procedure is conducted without it. The process of obtaining a prostate biopsy is typically a highly invasive, painful and imprecise procedure for patients. Currently the most precise way to gain a tissue sample is a trial and error process that uses an ultrasound wand inserted into the patient’s rectum. A physician targets the prostate with needles to remove a tissue sample. However, since ultrasound does not provide a detailed enough image, doctors are not able to be certain of where the suspicious areas on the prostate are, and cannot make precision strikes with their needles. It can take 10 to 50 needles to get a core sample that is usable.

If you made it though that paragraph you’re probably thinking, “there’s got to be a better way,” and there is.

Using MRI and Robot-Assisted Surgery

Using highly precise and detailed MRI images that are streamed in real-time, the doctor can clearly identify the prostate as well as any parts of the prostate that look troublesome. The small robot tool is moved to the exact location and places a needle precisely on the skin’s surface. The machine informs the doctor exactly how deeply they need to insert the needle to hit their target. At this point a doctor physically takes the sample. Using this procedure the number of samples is reduced to about 4. Saving time, uncomfortable preparation and pain. Advanced versions of this are capable of autonomously steering and inserting the needles but testing has not begun with human patients.

As you can see, there is quite the difference.

Robotics and Medical Imaging

This is just one example of how robotics can be used in surgery and health care. Across the world research groups at universities and health care organizations are developing new tools that provide more automation, reliability and safety to medical procedures ranging from brain surgery to prostate exams. As these technologies advance the common factor will always be medical imaging. Without clear, accurate and detailed medical imaging from CT-Scanners, X-Ray and PET/CT/Nuclear scanners, robot-assisted surgery, or any important surgeries for that matter, just aren’t possible. When medical imaging and technology like robotics work together, it can change the face of medicine.


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