MRI guided robot improves curved needle access to hippocampus for epilepsy
An MRI-Guided Robotic System to Improve Hippocampal Access for Epilepsy Interventions
Robotics
Summary
Treating epilepsy often requires reaching a part of the brain called the hippocampus. Current methods use straight needles, which sometimes miss parts of this area. The authors describe a robot that uses MRI images to guide a curved laser needle through a natural skull opening, reaching more of the hippocampus in one try. Tests with brain-like models showed this new system reached the target area better than common clinical methods.
What this means in practice
- •For neurosurgeons: Use the MRI-guided robotic system to improve precision and coverage of hippocampal laser ablation for epilepsy patients by navigating through the foramen ovale.
- •For medical device developers: Incorporate curved needle deployment guided by MRI within robotic platforms to enhance minimally invasive brain therapies beyond straight-line approaches.
Authors
John E. Peters, Abby M. Grillo, Mahshid Mansouri, Daniel S. Esser, Sarah Garrow, Nithin S. Kumar, Dario J. Englot, Joseph S. Neimat, William A. Grissom, Robert J. Webster, Eric J. Barth
Abstract
This paper presents an MRI-guided robotic system that improves hippocampal access by delivering a curved needle-like laser ablator through the foramen ovale, a natural opening in the base of the skull. Both the delivery path and the curved nature of the needle improve upon current clinical straight-line laser interstitial thermal therapy (LITT) as measured by hippocampal cannulation percentage. We describe the design of the robotic system which includes positioning, aiming, and curved needle deployment stages, followed by experimental results assessing cannulation percentages using MRI images in phantoms. In three curvilinear, single-insertion experiments, we achieved cannulation percentages of 93.5%, 96.5%, and 60.4%, exceeding reported clinical averages of 50-60%. Seizure control is believed by physicians to be a function of hippocampal volume treated, and our system provides a means of treating a greater volume of the hippocampus with LITT-based interventions.