Duke University bioengineers have developed a laboratory robot that can
locate the earliest traces of a mass in simulated breast tissue and
reach that mass with a biopsy needle – all without the need for human
assistance.

The results of proof-of-feasibility studies lead the researchers to
believe that routine medical procedures such as breast biopsies will be
performed in the future with minimal human guidance, and at greater
convenience and less cost to patients.

The researchers envision a scenario in the near future where women can
get an unassisted one-stop breast exam and biopsy, if needed. For
example, a woman would get a mammogram and if anything suspicious is
found, a robot could guide a needle to the spot and get a tissue sample.

For their experiments, the engineers started with a rudimentary
tabletop robot whose “eyes” used a novel 3-D ultrasound technology
developed at Duke. An artificial intelligence program served as the
robot’s “brain” by taking the real-time 3-D information, processing it,
and giving the robot specific commands to perform.

“After detecting the ‘lesion’ in a simulated breast, the robot was able
to calculate its position and then guide a biopsy to its exact
location,” said Ned Light, engineer in the laboratory of Stephen Smith,
director of the Duke University Ultrasound Transducer Group and senior
member of the research team.

Light presented the results of the Duke experiments, which were carried
out by Duke biomedical engineering student A.J. Rogers, at the Society
of Photo-Optical Instrumentation Engineers’ annual Medical Imaging
scientific sessions in Orlando.

Since the researchers achieved positive results using a rudimentary
robot and a basic artificial intelligence program, they are encouraged
that simple and reasonably safe procedures will become routine in the
near future as robot and artificial intelligence technology improves.

“The technology behind robotic surgery has grown dramatically, as
evidenced by the Da Vinci robot system, which is widely used in U.S.
hospitals,” Smith said. “The same is true of artificial intelligence,
which was unknown 20 years ago, and is now the standard in screening
pathology samples.

“Based on the results we’ve seen in our laboratory, I am confident that
within five to ten years, robots will be performing routine breast
biopsies,” Smith said.

Advances in ultrasound technology have made these latest experiments
possible, the researchers said, by generating detailed, 3-D moving
images in real-time. The Duke  team has a long track record of
modifying traditional 2-D ultrasound – like that used to image babies
in utero – into the more advanced 3-D scans. After inventing the
technique in 1991, the team also has shown its utility in developing
specialized catheters and endoscopes for real-time imaging of blood
vessels in the heart and brain.

In the latest experiments, the robot successfully performed its main
task: directing a needle on the end of the robotic arm to touch a tiny
piece of metal embedded inside simulated sponge breast, or phantom. The
tiny pieces of metal were sized to represent microcalcifications, tiny
deposits of calcium often found in the breast.

"Most of the time these deposits prove benign, but they can be a
precursor to cancer,” Light said. “If the mammogram and follow up
ultrasound show that the microcalcifications are suspicious, a biopsy
may be in order."

“Most of the time these deposits prove benign, but since they can be a
precursor to cancer, they are usually biopsied whenever they are found
during the mammogram study,” Light said.

The robot used the latest experiments is a tabletop version capable of
moving in three axes. For the next series of tests, the Duke
researchers plan to use a robotic arm with six-axis capability. The
ability of the new robot to find and direct a needle to the appropriate
site will next be tested in turkey breasts, which approximate human
breast tissue.

The research in Smith’s lab is supported by the National Institutes of
Health. Dr. Daniel von Allmen, University of North Carolina School of
Medicine  – Chapel Hill, was also a member of the research team.

Post Your Comment