Toward In-Scanner Transforamenal Epilepsy Interventions: A Compact MR-Safe Concentric Tube Actuation System
AUTHORS
ABSTRACT
Epilepsy affects more than 50 million people worldwide, afflicting patients with debilitating seizures. While antiepileptic drugs are available, 20-40% of patients remain medically refractory, leaving surgical intervention as the remaining option. Hippocampal resection is the gold standard surgical therapy while laser interstitial thermal therapy (LITT) offers a minimally invasive alternative. Current LITT interventions use a straight laser probe to deliver thermal energy through a burr hole in the back of the skull guided by magnetic resonance imaging (MRI). LITT has been associated with lower seizure freedom rates which we hypothesize is related to the use of straight-line trajectories in a naturally curved structure. Our previous work proposed a percutaneous approach whereby a helically pre-curved needle is deployed through the foramen ovale to ablate along the hippocampal midline maximizing tissue coverage. This minimally invasive approach demands a safe, compact, and accurate actuation system capable of operating within the MRI scanner. Concentric tube actuation units typically leverage transmission tube or lead screw-based designs which effectively double their overall length. A direct drive architecture can eliminate these components offering a more compact design. This paper presents a direct drive actuation system that minimizes overall device length using a novel pneumatic actuator for MR-guided, transforamenal epilepsy interventions.
Tags: Conference Papers 2024