IEEE Robotics & Automation Magazine - September 2023 - 91

USABILITY IN A CLINICAL ENVIRONMENT
In vivo tests were first performed to demonstrate the
compliance of the HIFUSK platform with the operating
room. The platform appeared to be easy to carry and
position in a reduced space. Its footprint enabled convenient
integration with the other instrumentation, which
was present by default [Figure 9(a)]. In addition, the GUI
proved to ensure that the physician
had intuitive control of the platform
and its functionalities throughout the
USgHIFU treatment.
TRACKING CAPABILITY ON
REAL MOVING ORGANS
EXPERIMENTAL PROTOCOL
During the in vivo experiment, the pig's
ventilation was in a controlled condition,
with a respiratory rate equal to
0.25 Hz. The compensation functionalities
of HIFUSK were assessed in vivo
by tracking and learning the motion of a
liver ROI defined by the physician [see
Figure 9(b)].
SAFETY AND EFFICACY
"
HIFU SURGERY
IS A PROMISING
NONINVASIVE
AND INTRINSICALLY
SAFE THERAPEUTIC
TECHNOLOGY THAT
COULD POTENTIALLY
EXPERIMENTAL PROTOCOL
Despite the similarity with humans from the anatomical and
pathophysiological point of view, some features of the porcine
model were not optimal for the preclinical validation of
FUS treatments. Indeed, pigs have a thick rind, covered with
rigid bristles, that is not comparable
with human skin, thus causing the FUS
beam to be potentially attenuated more
than in humans. To minimize this attenuation
effect, the pig rind was properly
prepared by removing the superficial
bristles. US gel was used for improving
the coupling between the water-filled
balloon of the HIFUSK and the rind of
the pig.
The physician initially placed the couCHANGE
THE TREATMENT
PARADIGM OF VARIOUS
MEDICAL CONDITIONS.
RESULTS
The estimated motion was assessed as
a sinusoid with a 0.24-Hz frequency and 5.29-mm amplitude.
These estimated parameters were in accordance with
the ventilation control frequency and motion amplitude
due to respiration that we could expect in an abdominal
organ [20].
„
Coupling
Balloon
Rind
Liver
pling balloon in contact with the pig's rind
by using the hand guidance functionality
until the liver was visible in the echographic
images on the GUI. Then, the physician
used the interface to select a desired internal
point of the liver (about 2 cm below the
liver's upper surface) as sonication target.
After the robot's automatic adjustment to
match the target, a single HIFU sonication
(thermal ablation with parameters as in ex vivo testing) was
executed. The sonication was carried out in static conditions by
temporarily suppressing the pig's breathing.
To check for the safety of the performed procedure, the rind
of the pig in the area where the coupling balloon was placed
Shaving Irritation
Coupling
Area
t1
t2
1.5 mm
2.63 mm
(a)
(b)
(c)
FIGURE 9. The HIFUSK in vivo testing. From left to right: the results associated with the platform usability, tracking capability, and
treatment safety and efficacy. (a) The HIFUSK footprint enables convenient integration in the operative room. (b) (top) The US image of
the target area: the HIFU transducer was coupled with the pig rind through the coupling balloon. The liver was identified as the target
organ. (bottom) The physician selected an ROI (the green square) on the US image. The selected ROI at two different time instants, t1
and t2, respectively, is reported. (c) (top) The visual inspection of the HIFU treated area. No rind burns at the coupling interface were
produced. (bottom) The digital microscope image of the lesion produced with the performed HIFU sonication.
SEPTEMBER 2023 IEEE ROBOTICS & AUTOMATION MAGAZINE
91

IEEE Robotics & Automation Magazine - September 2023

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