Patrick J. Codd

Devi Yuliarti, Ravi Prakash, Hiu Ching Cheung et al.

The tactile properties of tissue, such as elasticity and stiffness, often play an important role in surgical oncology when identifying tumors and pathological tissue boundaries. Though extremely valuable, robot-assisted surgery comes at the cost of reduced sensory information to the surgeon, with vision being the primary. Sensors proposed to overcome this sensory desert are often bulky, complex, and incompatible with the surgical workflow. We present PalpAid, a multimodal pneumatic tactile sensor to restore touch in robot-assisted surgery. PalpAid is equipped with a microphone and pressure sensor, converting contact force into an internal pressure differential. The pressure sensor acts as an event detector, while the acoustic signature assists in tissue identification. We show the design, fabrication, and assembly of sensory units with characterization tests for robustness to use, repetition cycles, and integration with a robotic system. Finally, we demonstrate the sensor's ability to classify 3D-printed hard objects with varying infills and soft ex vivo tissues. We envision PalpAid to be easily retrofitted with existing surgical/general robotic systems, allowing soft tissue palpation.

Ashutosh Raman, Ren A. Odion, Kent K. Yamamoto et al.

Raman spectroscopy, a photonic modality based on the inelastic backscattering of coherent light, is a valuable asset to the intraoperative sensing space, offering non-ionizing potential and highly-specific molecular fingerprint-like spectroscopic signatures that can be used for diagnosis of pathological tissue in the dynamic surgical field. Though Raman suffers from weakness in intensity, Surface-Enhanced Raman Spectroscopy (SERS), which uses metal nanostructures to amplify Raman signals, can achieve detection sensitivities that rival traditional photonic modalities. In this study, we outline a robotic Raman system that can reliably pinpoint the location and boundaries of a tumor embedded in healthy tissue, modeled here as a tissue-mimicking phantom with selectively infused Gold Nanostar regions. Further, due to the relative dearth of collected biological SERS or Raman data, we implement transfer learning to achieve 100% validation classification accuracy for Gold Nanostars compared to Control Agarose, thus providing a proof-of-concept for Raman-based deep learning training pipelines. We reconstruct a surgical field of 30x60mm in 10.2 minutes, and achieve 98.2% accuracy, preserving relative measurements between features in the phantom. We also achieve an 84.3% Intersection-over-Union score, which is the extent of overlap between the ground truth and predicted reconstructions. Lastly, we also demonstrate that the Raman system and classification algorithm do not discern based on sample color, but instead on presence of SERS agents. This study provides a crucial step in the translation of intelligent Raman systems in intraoperative oncological spaces.

Guangshen Ma, Weston Ross, Patrick J. Codd

This paper focuses on a research problem of robotic controlled laser orientation to minimize errant overcutting of healthy tissue during the course of pathological tissue resection. Laser scalpels have been widely used in surgery to remove pathological tissue targets such as tumors or other lesions. However, different laser orientations can create various tissue ablation cavities, and incorrect incident angles can cause over-irradiation of healthy tissue that should not be ablated. This work aims to formulate an optimization problem to find the optimal laser orientation in order to minimize the possibility of excessive laser-induced tissue ablation. We first develop a 3D data-driven geometric model to predict the shape of the tissue cavity after a single laser ablation. Modelling the target and non-target tissue region by an obstacle boundary, the determination of an optimal orientation is converted to a collision-minimization problem. The goal of this optimization formulation is maintaining the ablated contour distance from the obstacle boundary, which is solved by Projected gradient descent. Simulation experiments were conducted and the results validated the proposed method with conditions of various obstacle shapes and different initial incident angles.

Jie Luo, Guangshen Ma, Sarah Frisken et al.

With the increasing availability of new image registration approaches, an unbiased evaluation is becoming more needed so that clinicians can choose the most suitable approaches for their applications. Current evaluations typically use landmarks in manually annotated datasets. As a result, the quality of annotations is crucial for unbiased comparisons. Even though most data providers claim to have quality control over their datasets, an objective third-party screening can be reassuring for intended users. In this study, we use the variogram to screen the manually annotated landmarks in two datasets used to benchmark registration in image-guided neurosurgeries. The variogram provides an intuitive 2D representation of the spatial characteristics of annotated landmarks. Using variograms, we identified potentially problematic cases and had them examined by experienced radiologists. We found that (1) a small number of annotations may have fiducial localization errors; (2) the landmark distribution for some cases is not ideal to offer fair comparisons. If unresolved, both findings could incur bias in registration evaluation.