MR-Conditional Robotic Cardiac Intervention: Design and Validation in Patient-Specific Phantoms

Manual hand-held catheterization by clinicians under Magnetic Resonance Imaging (MRI) has become popular for the treatment of cardiovascular diseases such as pulmonary edema and heart failure. However, the limited space of the MRI bore makes it challenging for clinicians to access the opening, and the prolonged operation can cause back injury. To implement MRI-guided robot-assisted catheterization, this paper presents an MR-conditional robotic system for right heart catheterization (MR-RHC). Our 2-degree-of-freedom (DoF) robotic manipulator is actuated by ultrasonic piezoelectric motors. The highly compact design (D× W× L=11 cm× 8 cm× 18 cm) allows the robot to be positioned in the MRI scanner bore, near the patient’s femoral vein opening. The contribution of this paper lies in the development of an MR-conditional robotic system that clinically required Swan-Ganz catheter movements, including (simultaneous) infinite continuous rotation and translation (i.e., the catheter can perform endless rotation and translation that are not restricted by cable tangling or limited operational motion of the actuators). The MR conditionality of the robotic system is demonstrated in a clinical MR environment. Additionally, the system has been characterized in terms of its force and torque capabilities and verified 100% success rate of tele-intervention within 7 patient specific phantoms. Lastly, the paper reports the intervention of an MRI-guided robot-operated catheter within the water-filled phantoms between the control room and MR scanner.