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Description
In minimally invasive surgical procedures, there is often a challenge to visualize the procedure pathway inside the body in hard-to-reach locations in the lungs or abdomen. Therefore, harmful radiation is necessary especially for peripheral anatomical structures. Improved diagnosis can be achieved with navigation systems and precise automatic robotic devices which guide flexible medical instruments inside the body. The main objective of this proposal is to develop an advanced prototype of a medical software and robotic platform to improve cancer diagnostic using artificial intelligence and medical robotics to increase procedure success rate, decrease the patient’s radiation exposure, and reduce procedure cost for early detection and treatment of cancer.
The project strengthens the cooperation between Romanian and Norwegian universities, hospitals and industry partners: University of Craiova (RO), Politehnica University Bucharest (RO), Delta Health Care SRL (Ponderas Academic Hospital) (RO), SINTEF (NO), Norwegian University of Science and Technology (St. Olavs University Hospital) (NO) and Ceetron AS (NO) by further improving and advancing the technology initiated during the 2014-2017 EEA Program, Contract No. 3SEE/2014 to a clinical utility level , the highest level reached by our groups and possibly by any other groups in the EEA Program.
Summary of project results
In flexible endoscopy, there is often a challenge to visualize the procedure pathway to reach a suspect lesion in the lung periphery or lymph nodes via bronchoscopy or in the pancreas via endoscopy. In bronchoscopy, where only the central airways can be directly visualized, it is difficult to define and biopsy lesions outside the bronchial wall. Therefore, harmful radiation based fluoroscopic guidance is necessary especially for peripheral nodules. Improved diagnostic success rates can be achieved with navigation systems and precise automatic robotic devices which control steerable catheters and biopsy tools that can be extended outside the endoscope. The ideal medical imaging platform would allow concomitant visualization of the anatomical target(s), the neighboring anatomy (e.g., larger vessels), hybrid CT/MRI-video imaging, the best pathway to target, and the real-time precise position of the bronchoscope/endoscope and biopsy tool.
The most significant achievements obtained during the projects:
1. An advanced electromagnetic and optical guidance software was developed, for dynamic, automatic, continuous registration for flexible endoscopy diagnosis and surgical treatment. Using navigation technologies as electromagnetic tracking, this software platform includes the following, innovative features: automatic nodule detection and procedure planning, automatic organ/tumor segmentation, continuous registration of patient’s CT for endoscopy procedures, localization and tracing of the position of surgical tools, robot control for instrument navigation, augmented reality for virtual visualization of the patient’s anatomy over intraoperative video.
2. Three versions of a smart assisting robotic system ENDORO, for directing flexible instruments like catheters and flexible tip forceps inside the human body using electromagnetic navigation.
3. Multiple flexible instruments controlled manually or by a robotic system, that includes steering capabilities to follow a tortuous path to target and electromagnetic tracking capabilities.
4. A novel method to detect the catheter shape using Fiber-Bragg grating on a fiber optic running along the length of the catheter. This new guidance method improves the orientation for medical instruments using an advanced algorithm based on artificial intelligence.
5. Artificial intelligence algorithms for liver and pancreatic masses detection during endoscopy or ultrasound-endoscopy where developed, with excellent results during testing on a large patient imaging database.
The advanced electromagnetic and optical guidance software including innovative features like dynamic, automatic, continuous registration software for flexible endoscopy and robot control for instrument navigation is an important achievement for medical professionals and patients that will benefit from enhanced diagnostic accuracy, improved procedural planning, and safer, more effective surgical interventions.
The smart assisting robotic system (ENDORO), for directing flexible instruments like catheters and flexible tip forceps inside the human body is important for surgeons and interventional radiologists that gain improved control and precision during procedures, leading to better patient outcomes and reduced procedure times.
The flexible instruments with steering capabilities developed during the project, that can be controlled manually or by robotic systems, are important for medical professionals that will benefit from enhanced maneuverability and accuracy during complex procedures, improving the efficacy of treatments for patients.
The novel catheter shape detection method using Fiber-Bragg grating combined with an advanced AI-based algorithm, improves the orientation and guidance of medical instruments. Beneficiaries of this innovative technology are interventional radiologists and other specialists by increased precision and safety, leading to better patient outcomes and reduced risk of complications.
AI algorithms for liver and pancreatic mass detection during endoscopy or ultrasound-endoscopy, are important for oncologists and gastroenterologists that benefit from improved diagnostic tools, leading to earlier and more accurate detection of malignant tumors. Patients experience better diagnostic outcomes and potentially earlier interventions.
These achievements demonstrate the project''s success in advancing medical technology, improving healthcare outcomes, and benefiting a wide range of stakeholders involved in cancer diagnostics and treatment.
Summary of bilateral results
The IDEAR project has played a crucial role in strengthening bilateral cooperation between Romania and Norway through collaborative efforts and shared goals. The project brought together leading institutions from Romania and Norway, fostering a deep exchange of knowledge, expertise, and best practices. This collaboration not only enhanced the quality of the research but also built strong professional relationships. By working together on cutting-edge technologies in medical robotics and AI, the project harnessed the strengths of both countries, leading to innovative solutions that neither could have achieved alone. The project facilitated training sessions, meetings, and visits, promoting the transfer of skills and knowledge between Romanian and Norwegian researchers and medical professionals. This not only enhanced the capabilities of the participating institutions but also built a foundation for future collaborations.The success of the project has laid the groundwork for ongoing and future collaborations, ensuring that the bilateral relationships established will continue to thrive and contribute to further advancements in medical technology and healthcare.