Bone marrow aspiration and bone marrow trephine
biopsy are essential for
the diagnosis of hematological malignancies
and nonmalignant diseases in children. In clinical practice, magnetic resonance
imaging (MRI) is used to locate the lesion/tumor prior to the biopsy or
However, there is a significant lack of tools which
are non-magnetic, or MRI-compatible, and that can apply the force needed for
bone biopsy procedures while maintaining surgical accuracy and safety.
Additionally, the lack of simultaneous imaging means that the procedures are non-line-of-sight,
offering limitations on intraoperative corroboration of sample capture which
results in a significant reduction in accuracy and safety.
Using the Pediatric Surgical Robot (PSR), a modular
and reconfigurable MRI-compatible robot for surgical use, we demonstrate the workspace
in clinical application of a Bone Biopsy tool (BBt) for use in simultaneous
imaging and treatment.
This work describes use of the PSR-BBt for MRI
guided, robotically actuated, bone biopsy for diagnosis and treatment. The
combination of imaging and surgical procedures offers a reduction in duration
of procedures and reduces the possibility of repeat procedures by providing simultaneous
imaging to confirm sample capture. Here we
present the workspace, drilling forces, dexterity, and accuracy of the PSR in its
BBt configuration under optical tracking in free-space, MRI-off, MRI-on, and with
imaging while operating on bone phantom.
Results from drill force indicate sufficient
drilling capability at ##.## N, optical readings verify an RMS accuracy at #.##
+/- #.## mm tip position and #.## +/- #.## o insertion angle under
operation of MRI, signal to noise ratios in the most extreme case (drilling
motor running during MRI scan) at ##.##%, and the reachable workspace volume of