RESUMEN
Cerebral aneurysms are potentially life threatening and nowadays treated by a catheter-guided coiling or by a neurosurgical clipping intervention. Here, we propose a helically shaped magnetic micro-robot, which can be steered by magnetic fields in an untethered manner and could be applied for a novel coiling procedure. This is shown by navigating the micro-robot through an additively manufactured phantom of a human cerebral aneurysm. The magnetic fields are applied with a magnetic particle imaging (MPI) scanner, which allows for the navigation and tomographic visualization by the same machine. With MPI the actuation process can be visualized with a localization accuracy of 0.68 mm and an angiogram can be acquired both without any radiation exposure. First in-vitro phantom experiments are presented, showing an idea of a robot conducted treatment of cerebral aneurysms.
Asunto(s)
Diagnóstico por Imagen/métodos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Fantasmas de Imagen , Procedimientos Quirúrgicos Robotizados , Humanos , Hipertermia Inducida , Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional , Procedimientos Quirúrgicos Robotizados/métodos , Cirugía Asistida por Computador , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
BACKGROUND AND AIMS: To evaluate the diagnostic accuracy of magnetic resonance colonography (MRC) without bowel cleansing in a screening population and compare the results to colonoscopy as a standard of reference. METHODS: 315 screening patients, older than 50 years with a normal risk profile for colorectal cancer, were included in this study. For MRC, a tagging agent (5.0% Gastrografin, 1.0% barium sulphate, 0.2% locust bean gum) was ingested with each main meal within 2 days prior to MRC. No bowel cleansing was applied. For the magnetic resonance examination, a rectal water enema was administered. Data collection was based on contrast enhanced T1 weighted images and TrueFISP images. Magnetic resonance data were analysed for image quality and the presence of colorectal lesions. Conventional colonoscopy and histopathological samples served as reference. RESULTS: In 4% of all colonic segments, magnetic resonance image quality was insufficient because of untagged faecal material. Adenomatous polyps >5 mm were detected by means of MRC, with a sensitivity of 83.0%. Overall specificity was 90.2% (false positive findings in 19 patients). However, only 16 of 153 lesions <5 mm and 9 of 127 hyperplastic polyps could be visualised on magnetic resonance images. CONCLUSIONS: Faecal tagging MRC is applicable for screening purposes. It provides good accuracy for the detection of relevant (ie, adenomatous) colorectal lesions >5 mm in a screening population. However, refinements to optimise image quality of faecal tagging are needed.