Mr. Eric Knull Profile

Eric Knull

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Proceedings Article | 4 April 2022 Poster + Paper

Robust registration and phantom validation of mechatronics-assisted MRI-guided needle delivery for prostate focal laser ablation therapy

Eric Knull, Claire Park, Jeffrey Bax, David Tessier, Aaron Fenster

Proceedings Volume 12034, 120342K (2022) https://doi.org/10.1117/12.2611282

KEYWORDS: Magnetic resonance imaging, Mechatronics, Image registration, Prostate, Error analysis, Laser therapeutics, Laser ablation, Image filtering, Prostate cancer

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Magnetic resonance imaging (MRI)-guided prostate focal laser ablation (FLA) therapy shows potential as a minimally invasive treatment method for localized prostate cancer, which minimizes overtreatment of surrounding structures, thereby improving quality of life. We previously developed an MRI-compatible mechatronic guidance system capable of needle positioning within an open-air and in-bore MRI environment. In comparison to open-air testing, an increased error was reported from in-bore experiments, suggesting the effects of image distortion, fiducial localization, and registration error may impact its accuracy. In this paper, we describe the design of an improved registration multi-fiducial for the robust registration of the mechatronic system to MRI, and comparison and validation of MRI-guided needle delivery to virtual targets (simulating localized focal zones) in tissue-mimicking prostate phantoms. The multi-fiducial structure is composed of thirty-six MR-spheres arranged across an extensive volume. Mechatronics-assisted MRI-guided needle delivery (N =10) to virtual targets were evaluated with tissue-mimicking phantoms. 3T MRI images were acquired for registration, the mechatronic system was remotely actuated and needle insertion was performed, then verification images were acquired. The needle tip and needle trajectory error were quantified between the planned and actual trajectories. Our preliminary results show significant improvements in needle targeting with the improved registration fiducial with an FLA ablation region radius of 2.0 mm within 95% confidence. Improvements in robust registration show potential to enable accurate mechatronics-assisted MRI-guided needle delivery for FLA therapy.

Proceedings Article | 15 February 2021 Presentation + Paper

MRI-compatible mechatronic needle guidance system for focal thermal laser ablation in localized prostate cancer

Eric Knull, Claire Park, Jeffrey Bax, David Tessier, Aaron Fenster

Proceedings Volume 11598, 1159804 (2021) https://doi.org/10.1117/12.2580783

KEYWORDS: Mechatronics, Prostate cancer, Laser ablation, Prostate, Cancer, Magnetic resonance imaging, Virtual reality, Tumors, Tissues, Radiotherapy

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Prostate cancer is the most frequently diagnosed non-cutaneous cancer and the second leading cause of cancer-related deaths in men. Whole gland surgical and radiation treatments for prostate cancer are highly effective for long-term cancer control. However, these are often associated with overtreatment, resulting in urinary complications and sexual dysfunction, adversely impacting the quality of life. Focal laser ablation (FLA) under magnetic resonance imaging (MRI)-guidance is an alternative minimally invasive treatment method for localized prostate tumors while preserving surrounding structures and healthy tissues. Accurate needle positioning and delivery are critical for the therapeutic success of MRI-guided FLA. We propose an MRI-compatible mechatronic system for in-bore transperineal FLA needle guidance to localized prostate lesions. This paper presents the mechatronic system design, including a remotely actuated, four degree-of-freedom transperineal positioning and needle guidance mechanism, and adaptable needle guide. We demonstrate its MR compatibility and evaluated its mechanical bias in free-space testing using an external optical tracking system with several measurement points (N=40) over its range-of-motion. Free-space testing resulted in a root-mean-square error of 0.71 ± 0.30 mm. Within an MR environment, in-bore testing to virtual targets (N=10) with projected needle trajectories resulted in a mean needle tip error of 1.81 ± 0.56 mm and needle trajectory error of 0.78 ± 0.75°. This suggests that localized ablation regions can be accurately targeted within 2.16 mm within 95% confidence. An extensive in-bore analysis and correction for systematic bias across the range-of-motion may improve this accuracy. This study shows that our proposed mechatronic needle guidance system may be a feasible alternative for accurate MR-guided FLA for localized prostate therapy.

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