Flexible, tip-steerable needles promise to enhance physicians' abilities to accurately reach targets and maneuver inside the human body while minimizing patient trauma. Here, we present a functional needle steering system that integrates two components: (1) a patient-specific 2D pre- and intra-operative planner that finds an achievable route to a target within a planar slice of tissue (Stochastic Motion Roadmap), and (2) a low-level image-guided feedback controller that keeps the needle tip within that slice. The planner generates a sequence of circular arcs that can be realized by interleaving pure insertions with 180° rotations of the needle shaft. This preplanned sequence is updated in realtime at regular intervals. Concurrently, the low-level image-based controller servos the needle to remain close to the desired plane between plan updates. Both planner and controller are predicated on a previously developed kinematic nonholonomic model of bevel-tip needle steering. We use slighly different needles here that have a small bend near the tip, so we extend the model to account for discontinuities of the tip position caused by 180° rotations. Further, during large rotations of the needle base, we maintain the desired tip angle by compensating for torsional compliance in the needle shaft, neglected in previous needle steering work. By integrating planning, control, and torsion compensation, we demonstrate both accurate targeting and obstacle avoidance.
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http://dx.doi.org/10.1109/BIOROB.2008.4762833 | DOI Listing |
Dig Dis Sci
January 2025
Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Background: Ulcerative colitis patients who undergo ileal pouch-anal anastomosis (IPAA) without mucosectomy may develop inflammation of the rectal cuff (cuffitis). Treatment of cuffitis typically includes mesalamine suppositories or corticosteroids, but refractory cuffitis may necessitate advanced therapies or procedural interventions. This review aims to summarize the existing literature regarding treatments options for cuffitis.
View Article and Find Full Text PDFNat Cancer
January 2025
Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK.
Human tumors are diverse in their natural history and response to treatment, which in part results from genetic and transcriptomic heterogeneity. In clinical practice, single-site needle biopsies are used to sample this diversity, but cancer biomarkers may be confounded by spatiogenomic heterogeneity within individual tumors. Here we investigate clonally expressed genes as a solution to the sampling bias problem by analyzing multiregion whole-exome and RNA sequencing data for 450 tumor regions from 184 patients with lung adenocarcinoma in the TRACERx study.
View Article and Find Full Text PDFRep U S
October 2024
Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, USA.
In diagnosing and treating prostate cancer the flexible bevel tip needle insertion surgical technique is commonly used. Bevel tip needles experience asymmetric loading on the needle's tip, inducing natural bending of the needle and enabling control mechanisms for precise placement of the needle during surgery. Several methods leverage the needles natural bending to provide autonomous control of needle insertion for accurate needle placement in an effort to reduce excess tissue damage and improve patient outcomes from needle insertion intraventions.
View Article and Find Full Text PDFJ Sch Health
January 2025
Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Background: This practice paper exemplifies a systematic approach used to learn about existing mental well-being programs for youth 11-14 years to inform curriculum development for after-school settings.
Methods: We reviewed 3389 mental well-being programs from publicly accessed databases and conducted a content analysis using inductive and deductive coding to explore the domains each program addressed.
Results: Through our content analysis of the final eight programs, we found strong alignment with the Collaborative for Academic, Social and Emotional Learning (CASEL) core social-emotional competencies: self-awareness, self-management, social awareness, relationship skills, and decision-making.
Ann Surg Oncol
January 2025
Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Background: Flat epithelial atypia (FEA), a rare breast proliferative lesion, is often diagnosed following core biopsy (CB) of mammographic microcalcifications. In the prospective multi-institution TBCRC 034 trial, we investigate the upgrade rate to ductal carcinoma in situ (DCIS) or invasive cancer following excision for patients diagnosed with FEA on CB.
Patients And Methods: Patients with a breast imaging reporting and data system (BI-RADS) ≤ 4 imaging abnormality and a concordant CB diagnosis of FEA were identified for excision.
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