IEEE Robotics & Automation Magazine - September 2023 - 81

probe are mounted inside the water bath. This is the case of
HAIFU JC (Haifu Medical Technology) and Surround
Sound Prototype (Kona Medical). Water guarantees correct
acoustic coupling-and, in turn, energy transmission-
between the transducer and human body.
However, this configuration results in a
bulky system with reduced flexibility in
terms of the range of motion of the HIFU
transducer. Thus, treatment planning and
the number of possible treatment sites
are limited.
The alternative design overcomes the
described limitations by mounting the
transducer on a manipulator,
top-down
approaching the patient, using a waterfilled
balloon between the transducer and
patient for ensuring the correct acoustic
coupling. Examples of this configuration
include the Alpius 900 (Alpinion Medical
Sytems) and EchoPulse (Theraclion).
These platforms take advantage of a passive
mechanical arm. Thus, the physician
has to manually position the transducer
with respect to the anatomical area to
treat, reducing the precision and repeatability
of the procedure as well as introducing high dependency
on the operator's experience. In addition, in both platform
designs, the HIFU treatment is limited to nonmoving organs,
that is, organs that are not subjected to motion induced by
physiological breathing and blood pressure.
357,587 Tumour Treatments Up to 2020
Pilot Trial
The introduction of a robotic arm with active control could
boost the application of HIFU for surgical treatments. Robotics
could represent the enabling technology for precise and
automatic targeting as well as the extension of HIFU treatment
to moving organs, while adding flexibility
to the therapy procedure [Figure 3(b)].
"
THE QUALITY OF HIFU
TREATMENTS IS STRICTLY
RELATED TO PRECISION
AND ACCURACY IN
TARGET IDENTIFICATION
AS WELL AS FOR THE
MONITORING OF
ENERGY DEPOSITION
THROUGHOUT THE
THERAPY.
„
RELATED RESEARCH
TO ROBOTIC HIFU
Although there are examples of works
combining robotics with US for diagnostic
purposes and for guiding the insertion
of surgical
tools (e.g., [7]-[9]), few
research groups have tried to combine
robotics and USgHIFU. Kheng et. al.
[10] and Pather et al. [11] proposed a
robotic device for HIFU treatment. However,
the robot was intended only as a
transducer holder for precise positioning.
No active and image-guided control of
the robotic arm was implemented. A sixdegrees-of-freedom
(DoF) robot coupled
with a HIFU transducer was reported in
[12]. In that work, an industrial robot
was used to position the HIFU transducer.
However, no coupling device was present, thus requiring
the transducer to be immersed in water for therapy delivery.
Yonetsuji et al., in [13], developed a 4-DoF robot-assisted
HIFU platform. Also in that case, no coupling device was
provided, and the robot was designed to work completely
Source:www.fusfoundation.org
Outside U.S. Approval CE Mark/FDA ApprovalU.S. Reimbursement
State of Research and Regulatory Approvals
69.99%
Women
and Men's Health
Breast Tumours
Cervical Tumours
Ovarian Tumours
Vaginal Tumours
Thyroid Tumours
Prostate Tumours
Uterine Fibroids
1.68%
Bone Metastases
Bone Tumours
Soft Tissue Tumours
Multiple Myeloma
0%
Esophageal Tumour
Lung Tumour
Lung Metastases
Head-Neck Tumours
0.07%
Bone and Tissue Area Cervical-Thoracic Area Neurological Area
Astrocytoma
Neuroblastoma
Giloblastoma
Brain Metastasis
27.52%
1.72%
Abdominal Area
Liver Tumours
Liver Metastases
Kidney Tumours
Pancreatic Tumours
Biliary Tract Tumours
Colorectal Tumours
Gastric Tumours
Bladder Tumours
Ophthalmological Area
Glaucoma
FIGURE 2. Tumor treatment with HIFU: an overview of the main applications. Percentages next to each area indicate how many tumor
treatments were conducted with HIFU out of the total procedures (i.e., 357,587). CE: Conformitè Europëenne; FDA: Food and Drug
Administration.
SEPTEMBER 2023 IEEE ROBOTICS & AUTOMATION MAGAZINE
81

IEEE Robotics & Automation Magazine - September 2023

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