# US 10,368,850 B2 · System and method for real-time ultrasound guided prostate needle biopsies using a compliant robotic arm

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- Number: US 10,368,850 B2
- Document ID: US10368850B2
- Status: Granted
- Kind: B2
- Application number: 14/743,123
- Filed: 2015-06-18
- Published: 2015-12-24
- Granted: 2019-08-06
- Earliest claimed: 2014-06-18
- Assignees: Siemens Medical Solutions USA, Inc.
- Applicants: Siemens Medical Solutions USA, Inc.
- Inventors: Ali Kamen; John Benson; Richard Chiao; Dorin Comaniciu; Ankur Kapoor; Yuehaw Khoo; Andrzej Milkowski
- Web page: https://patentgrep.com/patent/US10368850B2

## CPC

- A61B 10/04: Endoscopic instruments, e.g. catheter-type instruments
- A61B 5/066: {Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging}
- A61B 5/067: {using accelerometers or gyroscopes}
- A61B 8/12: in body cavities or body tracts, e.g. by using catheters
- A61B 8/4218: {characterised by articulated arms}
- A61B 8/483: {involving the acquisition of a 3D volume of data}
- A61B 8/5261: {combining images from different diagnostic modalities, e.g. ultrasound and X-ray}
- A61B 10/0233: {Pointed or sharp biopsy instruments}
- A61B 34/30: Surgical robots
- A61B 90/11: with guides for needles or instruments, e.g. arcuate slides or ball joints
- A61B 8/429: {characterised by determining or monitoring the contact between the transducer and the tissue}
- A61B 8/4405: {Device being mounted on a trolley}
- A61B 8/4444: {related to the probe}
- A61B 2010/045: {Needles (pointed biopsy devices with vacuum aspiration A61B10/0283)}
- A61B 2017/00274: {Prostate operation, e.g. prostatectomy, turp, bhp treatment}
- A61B 2090/065: {for measuring contact or contact pressure}
- A61B 2090/378: {using ultrasound}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Systems and methods are provided for utilizing an MRI image and real-time an ultrasound images to guide and/or restrict the movement of an ultrasound probe in position for collecting a biopsy core. A real-time ultrasound image is acquired and fused with pre-operative imaging modalities, such as an MRI image, to provide a three-dimensional model of the prostate. A multi-link robotic arm is provided with an end-effector and an ultrasound probe mounted thereto. Sensor information is used to track the ultrasound probe position with respect to the 3D model. The robotic arm allows for the implementation of a virtual remote center of motion (VRCM) about the transrectal probe tip, an adjustable compliant mode for the physician triggered movement of probe, a restrictive trajectory of joints of the robotic arm and active locking for stationary imaging of the prostate.

## Claims

### Claim 1

A system for ultrasound guided prostate needle biopsies using a robotic arm, the system comprising:
a processor configured to receive a preoperative three-dimensional image of a prostate, wherein the processor is further configured to generate a three-dimensional model of the prostate based on the received image;
a multi-link robotic arm comprising:
a plurality of joints;
an end-effector attached to one of the plurality of joints;
an ultrasound probe attached to the end-effector, wherein the ultrasound probe is operably connected to the processor to capture an ultrasound image, wherein the preoperative three-dimensional image was captured using a different imaging modality from the ultrasound image, wherein the processor updates the three-dimensional model of the prostate based on the captured ultrasound image;
a position sensor for at least one of the plurality of joints, the position sensor operably connected to the processor to map the position of the ultrasound probe with the updated three-dimensional model; and
a force sensor operably connected to the processor, wherein the force sensor is configured to detect input forces to the end-effector,
wherein the processor, the position sensor and the force sensor comprise a control loop configured to control manipulation of the ultrasound probe based on updates to the three-dimensional model of the prostate, and
wherein the robotic arm is configured to operate in a first operating mode restricting movement of the ultrasound probe about a distal end of the ultrasound probe to maintain pressure on the prostate based on consecutively captured ultrasound images in automatic performance of a three-dimensional ultrasound sweep of the prostate.

### Claim 2 (depends on 1)

The system of claim 1 wherein the force sensor is attached to a handle of the ultrasound probe.

### Claim 3 (depends on 2)

The system of claim 2 wherein the robotic arm is configured to operate in a plurality of other operating modes to restrict movement of the ultrasound probe, the plurality of other operating modes comprising:
a second operating mode restricting movement of the ultrasound probe by mechanical limits of the robotic arm;
a third operating mode passively guiding movement of the ultrasound probe into a position to collect a biopsy core;
a fourth operating mode restricting all movement of the ultrasound probe; and
a fifth operating mode restricting movement of the ultrasound probe based on analysis of captured ultrasound images.

### Claim 4 (depends on 3)

The system of claim 3 wherein the processor is configured to identify the biopsy core based on the received three-dimensional image of the prostate and the captured ultrasound image of the prostate.

### Claim 5 (depends on 1)

The system of claim 1 wherein the pressure is maintained on the prostate based on de-correlation between the consecutively captured ultrasound images.

### Claim 6 (depends on 1)

The system of claim 1 wherein the pressure is maintained on the prostate based on a difference in a strain on prostate tissue between the consecutively captured ultrasound images.

### Claim 7 (depends on 1)

The system of claim 1 wherein the pressure is maintained on the prostate based on an image confidence map generated based on the consecutively captured ultrasound images.

### Claim 8 (depends on 1)

The system of claim 1 wherein the pressure is maintained on the prostate based de-correlation between the consecutively captured ultrasound images, strain on prostate tissue between the consecutively captured ultrasound images and an image confidence map generated based on the consecutively captured ultrasound images.

### Claim 9 (depends on 1)

The system of claim 1, wherein the control loop is configured to provide adjustable compliance of the multi-link robotic arm.

### Claim 10 (depends on 1)

The system of claim 1 wherein the control loop is configured to restrict motion of the ultrasound probe.

### Claim 11 (depends on 1)

The system of claim 1 wherein the preoperative three-dimensional model comprises a voxel representation of the prostate with prostate information.

### Claim 12 (depends on 11)

The system of claim 11 wherein the prostate information comprises tissue properties, biomechanical properties, or biomechanical relationships.

### Claim 13 (depends on 1)

The system of claim 1 wherein the processor is configured to identify a size of a biopsy core based on the received three-dimensional image of the prostate and the captured ultrasound image of the prostate.