An MRI-Guided Robotic System to Improve Hippocampal Access for Epilepsy Interventions

RESUMO

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.