Kent K. Yamamoto

Pejman Kheradmand, Kent K. Yamamoto, Emma Webster et al.

Cervical cancer accounts for a significant portion of the global cancer burden among women. Interstitial brachytherapy (ISBT) is a standard procedure for treating cervical cancer; it involves placing a radioactive source through a straight hollow needle within or in close proximity to the tumor and surrounding tissue. However, the use of straight needles limits surgical planning to a linear needle path. We present the OncoReach stylet, a handheld, tendon-driven steerable stylet designed for compatibility with standard ISBT 15- and 13-gauge needles. Building upon our prior work, we evaluated design parameters like needle gauge, spherical joint count and spherical joint placement, including an asymmetric disk design to identify a configuration that maximizes bending compliance while retaining axial stiffness. Free space experiments quantified tip deflection across configurations, and a two-tube Cosserat rod model accurately predicted the centerline shape of the needle for most trials. The best performing configuration was integrated into a reusable handheld prototype that enables manual actuation. A patient-derived, multi-composite phantom model of the uterus and pelvis was developed to conduct a pilot study of the OncoReach steerable stylet with one expert user. Results showed the ability to steer from less-invasive, medial entry points to reach the lateral-most targets, underscoring the significance of steerable stylets.

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.