This paper presents a new solution for 3D steering of flexible needles guided by 3D B-mode ultrasound imaging. It aims to realize a robust steering, by accounting for uncertainties, noise and tissue heterogeneities, while limiting tissue-related disturbances. The proposed solution features interconnected state observer, automatic needle tip segmentation and path planning algorithms. Measurement quality, state uncertainties and tissue heterogeneity are considered for robust needle steering with helical paths of variable curvature. Fast replanning allows for adaptability to unexpected disturbances. An experimental validation has been done through 62 insertions of 24 Gauge bevel-tip nitinol needles in various tissue. Results are promising, characterized by mean targeting errors of less than 1 mm in homogeneous phantoms, 1.5 ± 0.9 mm in heterogeneous phantoms and 1.7 ± 0.8 mm in ex-vivo tissue. This new approach is a step towards a precise and robust patient-specific gesture.
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http://dx.doi.org/10.1109/TBME.2020.3022619 | DOI Listing |
Ann Surg Oncol
January 2025
Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
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.
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