Simulating Needle Insertion for Physician Training and Planning

3D simulation of needle insertion into the prostate for brachytherapy cancer treatment.

Medical procedures such as brachytherapy seed implantation, biopsies, and treatment injections require inserting a needle tip to a specific target location inside the human body. This is difficult because inserting needles into soft tissues causes the surrounding soft tissues to deform. Ignoring these deformations can result in substantial placement error, resulting in failure of the procedure or increased side effects.

To facilitate physician training and planning for medical procedures such as prostate brachytherapy, we are developing an interactive simulation of needle insertion and radioactive seed implantation in soft tissues. We are developing 2D and 3D simulations of needle insertion procedures by modeling tissue deformations using a finite element method, modeling needle frictional and cutting forces, and using novel re-meshing to ensure conformity of the mesh to the curvilinear needle path. Achieving a computationally efficient simulation is challenging; we parallelize the FEM computation over multiple cores and and used novel needle/tissue coupling algorithms to achieve a 25 Hz frame rate for a 3D prostate mesh composed of 13,375 tetrahedra on an 8-core 3.0 GHz PC.

Video of our interactive 3D simulator of needle insertion in the prostate for brachytherapy cancer treatment.

We are also developing a sensorless planning system for radioactive seed implantation that combines our simulation of needle insertion with numerical optimization to compute needle insertion offsets that compensate for tissue deformations. We applied the method using 2D simulation to seed implantation during permanent seed prostate brachytherapy to minimize seed placement error in simulation without relying on real-time imaging.

Without
planning

With
sensorless
planning

Simulation of needle insertion based on a 2D ultrasound image of a human prostate (green) to a target (cross). After needle retraction, the placement error, the distance between the target and implanted seed location, is 26% of the diameter of the prostate when no planning is used. Preoperative planning can anticipate and correct for the effects of tissue deformations, significantly reducing placement error, which improves treatment quality and reduces side effects.

Automatically guiding a traditional straight needle to a target by externally manipulating tissues to enable obstacle avoidance.

Publications/Presentations

  1. Kyle B. Reed, Ann Majewicz, Vinutha Kallem, Ron Alterovitz, Ken Goldberg, Noah J. Cowan, Allison M. Okamura, "Robot-Assisted Needle Steering," IEEE Robotics and Automation Magazine, vol. 18, pp. 35-46, Dec. 2011. (Download PDF)
  2. Nuttapong Chentanez, Ron Alterovitz, Daniel Ritchie, Jonha Cho, Kris Hauser, Ken Goldberg, Jonathan R. Shewchuk, and James F. O'Brien, "Interactive Simulation of Surgical Needle Insertion and Steering," ACM Transactions on Graphics (Proc. SIGGRAPH), vol. 28, no. 3, pp. 88:1-88:10, Aug. 2009. (Download PDF) (Video)
    (Image from article featured on back cover)
  3. Meysam Torabi, Kris K. Hauser, Ron Alterovitz, Vincent Duindam, and Ken Goldberg, "Guiding Medical Needles Using Single-Point Tissue Manipulation," in Proc. IEEE International Conference on Robotics and Automation (ICRA), May 2009, pp. 2705-2710. (Download PDF) (Video)
    (Best Medical Robotics Paper Award Finalist)
  4. Ron Alterovitz, Ken Goldberg, Jean Pouliot, and I-Chow Hsu, "Sensorless Motion Planning for Medical Needle Insertion in Deformable Tissues," IEEE Trans. Information Technology in Biomedicine, vol. 13, no. 2, pp. 217-225, Mar. 2009. (Download PDF)
  5. Ron Alterovitz, Jean Pouliot, Richard Taschereau, I-Chow Joe Hsu, and Ken Goldberg, "Sensorless Planning for Medical Needle Insertion Procedures," in Proceedings of the 2003 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS 2003), Oct. 2003, pp. 3337-3343. (Download PDF)
    (Best Paper Award Finalist)
  6. Ron Alterovitz, Jean Pouliot, Richard Taschereau, I-Chow Joe Hsu, and Ken Goldberg, "Needle Insertion and Radioactive Seed Implantation in Human Tissues: Simulation and Sensitivity Analysis," in Proceedings of the 2003 IEEE International Conference on Robotics and Automation (ICRA 2003), Sept. 2003, pp. 1793-1799. (Download PDF)
  7. Ron Alterovitz, Jean Pouliot, Richard Taschereau, I-Chow Joe Hsu, and Ken Goldberg, "Modeling Seed Misplacement by Simulating Tissue Deformations," American Brachytherapy Society (ABS) 24th Annual Meeting, New York, NY, May 2003.
  8. Ron Alterovitz, Jean Pouliot, Richard Taschereau, I-Chow Joe Hsu, and Ken Goldberg, "Simulating Needle Insertion and Radioactive Seed Implantation for Prostate Brachytherapy," in Medicine Meets Virtual Reality 11 (MMVR11), J.D. Westwood et al. (Eds.), IOS Press, Jan. 2003, pp. 19-25. (Download PDF)

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