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Results: 7

1.
Figure 6

Figure 6. From: Toward adaptive stereotactic robotic brachytherapy for prostate cancer: Demonstration of an adaptive workflow incorporating inverse planning and an MR stealth robot.

(a) The robot on the CBCT couch. Note the open architecture of the CBCT imaging device. This allowed for easy mechanical access and visual inspection at every step of the procedure. (b) The robot on the couch of the conebeam CT system with the needle inserted in the phantom.

J. ADAM CUNHA, et al. Minim Invasive Ther Allied Technol. ;19(4):189-202.
2.
Figure 2

Figure 2. From: Toward adaptive stereotactic robotic brachytherapy for prostate cancer: Demonstration of an adaptive workflow incorporating inverse planning and an MR stealth robot.

The MRBot robotic brachytherapy seed delivery system: (a) The robot is designed to fit inside a closed-bore MR system and is fully MR compatible, (b) the robot is attached to the control unit via air tubes and fiber optic cables.

J. ADAM CUNHA, et al. Minim Invasive Ther Allied Technol. ;19(4):189-202.
3.
Figure 3

Figure 3. From: Toward adaptive stereotactic robotic brachytherapy for prostate cancer: Demonstration of an adaptive workflow incorporating inverse planning and an MR stealth robot.

CT scan of the robot. Note the lack of artifacts that would be induced by materials with a high atomic number and which would show up as dense white streaks on the images. The end effector is positioned at the surface of a gel phantom (a,b). An ellipse, a line, and four balls are embedded on the end effector of the robot as registration markers. They can be seen clearly on the CBCT images (a,b,c); they are also visible under MR (d).

J. ADAM CUNHA, et al. Minim Invasive Ther Allied Technol. ;19(4):189-202.
4.
Figure 4

Figure 4. From: Toward adaptive stereotactic robotic brachytherapy for prostate cancer: Demonstration of an adaptive workflow incorporating inverse planning and an MR stealth robot.

Robot registration in the MR environment using a gel phantom; (a) the gold marker seed (left) to be implanted in the test media is 4 mm in length. It will show a stronger signal on the CBCT than the steel dummy seed (right); (b) the target and robot-placed seeds are indicated by the arrows in the center of the gel. The needle track is visible: the target track enters from the left and the dummy seed from the right; (c) gel phantom with ceramic target seed (on right, white) and robot-placed steel seed (left).

J. ADAM CUNHA, et al. Minim Invasive Ther Allied Technol. ;19(4):189-202.
5.
Figure 5

Figure 5. From: Toward adaptive stereotactic robotic brachytherapy for prostate cancer: Demonstration of an adaptive workflow incorporating inverse planning and an MR stealth robot.

Test of robot registration in a non-homogeneous (bovine muscle) environment and test of robot registration using MRS imaging to define the target in a gel phantom with MRS-imageable metabolite: (a) The target location is indicated by the arrow. (b) The robot’s needle has been inserted (orientated into the plane of the page) to the target location. (c) The seed has been dropped and the needle retracted. (d) The target as defined by the MRS analysis. (e) Robot needle is inserted to the location defined by the choline. The seed is laterally located 2 mm from the target location. The center of the seed is one slice in front of the slice shown. With a slice thickness of 2 mm, the seed was placed within 3 mm of the target.

J. ADAM CUNHA, et al. Minim Invasive Ther Allied Technol. ;19(4):189-202.
6.
Figure 7

Figure 7. From: Toward adaptive stereotactic robotic brachytherapy for prostate cancer: Demonstration of an adaptive workflow incorporating inverse planning and an MR stealth robot.

Intra-operative verification of the placement of PPI seeds. Panels a and b show the robot head with the needle extended along with the phantom. The contrast window level has been modified in panel b compared to panel a to show the internal structure of the phantom. The three round white dots above the needle (easily seen in panel b) were glued to the outside surface of the phantom – they can be seen in each figure and serve as a reference point. Panel c, d, e, f, and g were taken after two, four, six, eight, and all ten needles, respectively, were placed. These figures show the ease of which the seeds can be identified in the CT environment. In contrast, reliable seed identification is nearly impossible using ultrasound imaging techniques.

J. ADAM CUNHA, et al. Minim Invasive Ther Allied Technol. ;19(4):189-202.
7.
Figure 1

Figure 1. From: Toward adaptive stereotactic robotic brachytherapy for prostate cancer: Demonstration of an adaptive workflow incorporating inverse planning and an MR stealth robot.

An adaptive robotic brachytherapy image/plan/begin-delivery/image/plan/finish-delivery information workflow. This workflow begins with the acquisition of an MR or CT set of images of the patient. These images are then transferred via DICOM format to a treatment planning system where the anatomy is contoured and the needle and seed locations (i.e. a dose plan) are determined. The dose plan is transferred to the robot control unit which executes the instructions necessary to position the robot to insert the needles and deliver the seeds. Prior to placing all the seeds, an adaptive planning would entail returning to the beginning of the workflow to re-image the patient, determine the actual position of the already-placed seeds, and re-plan the remaining seeds if necessary to fine tune the dose distribution. Note, ultrasound is not included in the figure because adaptive brachytherapy requires the visualization of already-placed seeds. Identifying and locating seeds using ultrasound images is extremely difficult: Post-implant dosimetry is routinely done using CT imaging.

J. ADAM CUNHA, et al. Minim Invasive Ther Allied Technol. ;19(4):189-202.

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