Mri-guided robotic systems and methods for biopsy

Abstract

To provide guided robotic systems.SOLUTION: A guided robotic system 200 includes a magnetic resonance imaging apparatus 220 for real-time imaging of a subject, a computer system 240 for analyzing images in real time, and a robotic system for guiding a robotic arm based on real-time analysis of the images. A method of using a guided robotic system is also disclosed. The method includes acquiring live magnetic resonance images of a subject, analyzing the live magnetic resonance images to continuously identify a target portion of the subject, guiding a robotic arm toward an identified target portion of the subject based on the live magnetic resonance images, and performing a procedure at the target portion of the subject. Non-limiting procedures using the guided robotic system may include, e.g., biopsy and stent insertion.SELECTED DRAWING: Figure 2

Description

[Background technology]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority under 35 U.S.C. § 119(e) to U.S. Provisional Patent Application No. 62 / 965,070, filed January 23, 2020, entitled "GUIDED ROBOTIC SYSTEM, METHODS AND APPARATUS FOR BIOPSY," the disclosure of which is incorporated herein by reference in its entirety.

[0002] Magnetic imaging, particularly magnetic resonance imaging (MRI), is ubiquitous in modern medicine. While MRI remains one of the best imaging modalities for conducting diagnostic scans for screening, biopsy planning, and treatment planning, or surgical intervention, using MRI systems for guidance during surgery or procedures can be challenging and, in some cases, has met with very limited success due to a variety of issues. Part of the problem stems, for example, from the strong magnetic fields required for imaging with MRI systems. In such cases, during magnetic resonance imaging, the powerful magnetic forces from the large magnets within the MRI system can damage surgical or diagnostic tools, including metal or any magnetically capable parts. In some cases, the strong magnetic fields can also endanger surgeons or medical personnel in their presence. For safety reasons, when using a robot or robotic system in place of a surgeon or medical personnel, the strong magnetic fields can interfere with various components of the robot, including, for example, the control system or mechanism, or the interconnecting joints that connect the robotic arms, potentially causing the robot to malfunction temporarily or permanently. Therefore, there is a need for a robotic system that can operate effectively and accurately in conjunction with medical imaging devices, such as MRI systems. Summary of the Invention

[0003] According to various embodiments, a guided robotic system is provided that includes a magnetic imaging device for continuously acquiring magnetic resonance images of a subject, a robotic arm, and a computer system for analyzing the magnetic resonance images and identifying portions of the subject, where the magnetic resonance images are analyzed in real time to guide the robotic arm to the portion of the subject.

[0004] According to various embodiments of the system, a robotic arm is attached to a component configured for drug delivery. According to various embodiments, the robotic arm is configured to insert a needle into the portion of the subject to extract a sample. According to various embodiments, the robotic arm is configured to place a stent in the portion of the subject. According to various embodiments, the robotic arm is attached to a needle configured to remove a sample from the portion. According to various embodiments, the robotic arm is configured to remove the identified portion by cutting the portion.

[0005] According to various embodiments, a robotic arm is attached to an end effector that includes a plurality of needles. According to various embodiments, a robotic arm is attached to an end effector that is configured to deliver one or more stents. According to various embodiments, a robotic arm is attached to an end effector that is configured to deliver one or more brachytherapy seeds.

[0006] According to various embodiments, the robotic arm is configured to extract a specimen for examination in a medical procedure from a list of medical procedures consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, brain stenting, and intensity modulated radiation therapy guidance.

[0007] According to various embodiments, a method of using a guided robotic system is provided, the method including acquiring live magnetic resonance images of a subject, performing image analysis of the live magnetic resonance images to continuously identify target portions of the subject, guiding a robotic arm toward the identified target portions of the subject based on the live magnetic resonance images, and performing a procedure at the target portions of the subject.

[0008] According to various embodiments of the method, the acquired live magnetic resonance images are displayed in a graphical user interface (GUI) that includes functional buttons for controlling the procedure. According to various embodiments, the acquired live magnetic resonance images include a high-resolution image portion near a needle that is inserted during the procedure and a low-resolution image portion farther away from the needle.

[0009] According to various embodiments, the method further includes correcting the acquired live magnetic resonance images for patient motion during performance of the procedure. According to various embodiments, the method further includes correcting the acquired live magnetic resonance images for motion artifacts during needle insertion. According to various embodiments, the method further includes overriding existing actions to manually correct for patient motion. According to various embodiments, the method further includes manually advancing the robotic arm by controlling a GUI using touch input, mouse input, or joystick input. According to various embodiments, the method further includes providing a needle attached to the robotic arm, performing automatic segmentation to capture the needle's position, withdrawing the needle, and advancing the needle to a next target location.

[0010] According to various embodiments of the method, the procedure comprises one from the list of medical procedures consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, brain stenting, and intensity modulated radiation therapy guidance.

[0011] According to various embodiments, a method of using a guided robotic system is provided, the method including continuously acquiring magnetic resonance images of a subject, continuously identifying a target portion of the subject within the magnetic resonance images, and guiding a needle attached to a robotic arm toward the identified target portion of the subject, wherein the magnetic resonance images are analyzed in real time to guide the needle to the target portion of the subject, insert the needle into the target portion of the subject, and extract a sample.

[0012] According to various embodiments of the method, continuously acquired live magnetic resonance images are displayed in a graphical user interface (GUI) that includes functional buttons for control during needle insertion. According to various embodiments, the continuously acquired live magnetic resonance images include a high-resolution image portion near the needle and a low-resolution image portion farther from the needle.

[0013] According to various embodiments, the method further includes automatically correcting the continuously acquired live magnetic resonance images to compensate for motion blur during needle insertion. According to various embodiments, the method further includes automatically correcting the needle trajectory during insertion based on the corrected acquired live magnetic resonance images. According to various embodiments, the method further includes overriding an existing guided trajectory to manually correct for motion blur. According to various embodiments, the method further includes manually advancing the robotic arm by controlling a GUI using touch, mouse, or joystick input. According to various embodiments, the method further includes performing automatic segmentation to capture the needle position, withdrawing the needle, and advancing the needle to a next target location.

[0014] According to various embodiments of the method, the extracted specimen is examined with a medical procedure from the list consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, cerebral stenting, and intensity-modulated radiation therapy guidance.

[0015] According to various embodiments, navigating further includes navigating through a central bore of a magnetic imaging device configured to continuously acquire magnetic resonance images.

[0016] According to various embodiments, a method of using a guidance system is provided, the method including acquiring a live magnetic resonance image of a subject, continuously identifying a target portion of the subject within the live magnetic resonance image, directing an end effector attached to a mechanical arm toward the identified target portion of the subject, the end effector transporting multiple needles, inserting the multiple needles one at a time into the target portion of the subject, and extracting multiple samples from the target portion of the subject.

[0017] According to various embodiments of the method, the acquired live magnetic resonance images are displayed in a graphical user interface (GUI) that includes functional buttons for control during insertion of multiple needles. According to various embodiments, the acquired live magnetic resonance images include a high-resolution image portion near the insertion needle and a low-resolution image portion farther away from the insertion needle.

[0018] According to various embodiments, the method further includes automatically correcting the acquired live magnetic resonance images to compensate for motion blur during insertion of the multiple needles. According to various embodiments, the method further includes automatically correcting the trajectories of the inserted needles during insertion based on the corrected acquired live magnetic resonance images. According to various embodiments, the method further includes overriding an existing guided trajectory to manually correct for motion blur. According to various embodiments, the method further includes manually advancing the mechanical arm by controlling the GUI using touch input, mouse input, or joystick input. According to various embodiments, the method further includes performing automatic segmentation to capture the positions of the inserted needles, withdrawing the inserted needles, and inserting additional needles at the next locations.

[0019] According to various embodiments of the method, the extracted specimen is examined with one or more medical procedures from the list consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, brain stenting, and intensity modulated radiation therapy guidance.

[0020] According to various embodiments of the method, guiding an end effector attached to a mechanical arm toward an identified target portion of the object includes guiding the end effector through a hole in the center of a single-sided magnetic imaging device configured to continuously acquire magnetic resonance images.

[0021] According to various embodiments, a guided robotic system is provided that includes an imaging device for real-time imaging of an object, a computer system for analyzing the images in real-time, and a robotic system for guiding a robotic arm based on the real-time analysis of the images.

[0022] According to various embodiments of the system, a robotic arm is attached to a component configured for drug delivery. According to various embodiments, the robotic arm is configured to insert a needle into a subject to extract a sample. According to various embodiments, the robotic arm is configured to place a stent in a subject. According to various embodiments, the robotic arm is attached to a needle configured to remove a sample from a subject. According to various embodiments, the robotic arm is attached to a component or mechanism configured to provide ablation. According to various embodiments, the robotic arm is attached to an end effector including multiple needles. According to various embodiments, the robotic arm is attached to an end effector configured to deliver one or more stents. According to various embodiments, the robotic arm is attached to an end effector configured to deliver one or more brachytherapy seeds.

[0023] According to various embodiments of the system, the robotic arm is configured to extract a specimen for examination in a medical procedure from a list of medical procedures consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, brain stenting, and intensity modulated radiation therapy guidance.

[0024] According to various embodiments of the system, the imaging device is a single-sided magnetic resonance imaging device having a hole in its center.

[0025] These and other aspects and implementations are described in detail below. The foregoing information and the following detailed description, including illustrative examples of various aspects and implementations, provide an overview or framework for understanding the nature and characteristics of the claimed aspects and implementations. The drawings provide illustration and a further understanding of the various aspects and implementations, and are incorporated in and constitute a part of this specification. [Brief explanation of the drawings]

[0026] The novel features of the various aspects are set forth with particularity in the appended claims. However, the described aspects, both as to organization and method of operation, may best be understood by referring to the following description taken in conjunction with the accompanying drawings.

[0027] [Figure 1A] FIG. 1A is a schematic diagram of a guided robotic system according to various embodiments of the present disclosure.

[0028] [Figure 1B] FIG. 1B is a flowchart of a method of using a guided robotic system according to various aspects of the present disclosure.

[0029] [Figure 2] FIG. 2 illustrates another guided robotic system according to various aspects of the present disclosure.

[0030] [Figure 3A] FIG. 3A is a schematic diagram of a graphical user interface of a guided robotic system according to various embodiments of the present disclosure.

[0031] [Figure 3B] FIG. 3B is a schematic diagram of a live view during imaging of a guided robotic system according to various aspects of the present disclosure.

[0032] [Figure 4]FIG. 4A is a schematic diagram illustrating transverse images during a planning scan of a prostate sample, according to various aspects of the present disclosure.

[0033] FIG. 4B is a schematic diagram illustrating a sagittal image during a planning scan of a prostate sample, according to various aspects of the present disclosure.

[0034] FIG. 4C is a schematic diagram illustrating a transverse image of a biopsy plan based on the planning scan shown in FIG. 4A, according to various aspects of the present disclosure.

[0035] FIG. 4D is a schematic diagram illustrating a sagittal image of a biopsy plan based on the planning scan shown in FIG. 4B, according to various embodiments of the present disclosure.

[0036] [Figure 5] FIG. 5A is a schematic diagram showing a cross-sectional image of a biopsy plan providing the extent of malignancy in a prostate sample, according to various embodiments of the present disclosure.

[0037] FIG. 5B is a schematic diagram illustrating a sagittal image of a biopsy plan providing the extent of malignancy in a prostate sample, according to various embodiments of the present disclosure.

[0038] FIG. 5C is a schematic diagram illustrating a transverse image for low-dose brachytherapy planning of a prostate sample, according to various embodiments of the present disclosure.

[0039] FIG. 5D is a schematic diagram illustrating a sagittal image for low-dose brachytherapy planning of a prostate sample, according to various embodiments of the present disclosure.

[0040] [Figure 6] FIG. 6A is a schematic diagram illustrating a transverse image without a virtual grid for biopsy planning of a prostate sample, according to various embodiments of the present disclosure.

[0041] FIG. 6B is a schematic diagram illustrating a sagittal image without a virtual grid for biopsy planning of a prostate sample, according to various aspects of the present disclosure.

[0042] [Figure 7] FIG. 7 is a flowchart of a method of using a guided robotic system according to various aspects of the present disclosure.

[0043] [Figure 8] FIG. 8 is another flowchart of a method of using a guided robotic system according to various aspects of the present disclosure.

[0044] [Figure 9] FIG. 9 is another flowchart of a method of using a guided robotic system according to various aspects of the present disclosure.

[0045] [Figure 10] FIG. 10 is a schematic diagram of a magnetic resonance imaging system according to various aspects of the present disclosure.

[0046] [Figure 11] FIG. 11 is an exploded perspective view of the magnetic resonance imaging system shown in FIG. 10 according to various aspects of the present disclosure.

[0047] [Figure 12] FIG. 12 is an elevational view of the magnetic resonance imaging system shown in FIG. 10 according to various aspects of the present disclosure.

[0048] [Figure 13] FIG. 13 is an elevational view of the magnetic resonance imaging system shown in FIG. 10 according to various aspects of the present disclosure.

[0049] [Figure 14] FIG. 14 illustrates exemplary positioning of a patient for imaging by a magnetic resonance imaging system for certain surgical procedures and interventions, according to various aspects of the present disclosure.

[0050] The accompanying drawings are not intended to be drawn to scale. Corresponding reference characters indicate corresponding parts throughout the several views. For clarity, not every component may be labeled in every drawing. The examples described herein illustrate certain embodiments of the invention in one form, and such examples should not be construed as limiting the scope of the invention in any way. DETAILED DESCRIPTION OF THE INVENTION

[0051] The following international patent applications are also incorporated herein by reference in their entireties: · International Patent Application No. PCT / US2020 / 018352, filed February 14, 2020, entitled "SYSTEMS AND METHODS FOR ULTRALOW FIELD RELAXATION DISPERSION," now International Publication No. WO2020 / 168233. · International Patent Application No. PCT / US2020 / 019530, now International Publication No. WO2020 / 172673, filed February 24, 2020, entitled "SYSTEMS AND METHODS FOR PERFORMING MAGNETIC RESONANCE IMAGING." · International Patent Application No. PCT / US2020 / 019524, now International Publication No. WO2020 / 172672, filed February 24, 2020, entitled "PSEUDO-BIRDCAGE COIL WITH VARIABLE TUNING AND APPLICATIONS THEREOF." · International Patent Application No. PCT / US2020 / 024776, filed March 25, 2020, entitled "SINGLE-SIDED FAST MRI GRADIENT FIELD COILS AND APPLICATIONS THEREOF," now International Publication No. WO2020 / 198395. International Patent Application No. PCT / US2020 / 024778, filed March 25, 2020, entitled "SYSTEMS AND METHODS FOR VOLUMETRIC ACQUISITION IN A SINGLE-SIDED MRI SYSTEM," now International Publication No. WO2020 / 198396; and · International Patent Application No. PCT / US2020 / 039667, filed June 25, 2020, entitled "SYSTEMS AND METHODS FOR IMAGE RECONSTRUCTIONS IN MAGNETIC RESONANCE IMAGING," now International Publication No. WO2020 / 264194.

[0052] U.S. Patent Application No. 16 / 003,585, filed June 8, 2018, and entitled "UNILATERAL MAGNETIC RESONANCE IMAGING SYSTEM WITH APERTURE FOR INTERVENTIONS AND METHODOLOGIES FOR OPERATING SAME," is hereby incorporated by reference in its entirety.

[0053] The following US provisional patent applications are incorporated herein by reference in their entireties: · U.S. Provisional Patent Application No. 62 / 979,332, filed February 20, 2020, entitled "SYSTEMS AND METHODS FOR UTILIZING A RADIO FREQUENCY RECEIVE NETWORK FOR SINGLE-SIDED MAGNETIC RESONANCE IMAGING." U.S. Provisional Patent Application No. 62 / 987,286, filed March 9, 2020, entitled "SYSTEMS AND METHODS FOR ADAPTING DRIVEN EQUILIBRIUM FOURIER TRANSFORM FOR SINGLE-SIDED MRI"; and · U.S. Provisional Patent Application No. 62 / 987,292, filed March 9, 2020, entitled "SYSTEMS AND METHODS FOR LIMITING K-SPACE TRUNCATION IN A SINGLE-SIDED MRI SCANNER."

[0054] Before describing various aspects of the MRI-guided robotic systems and methods in detail, it should be noted that the illustrative embodiments are not limited to the details of construction and arrangement of parts illustrated in the accompanying drawings and description. The illustrative embodiments may be implemented or incorporated in other embodiments, variations, and modifications, and may be practiced or carried out in various ways. Furthermore, unless otherwise indicated, the terms and phrases used herein have been chosen for the convenience of the reader and for the purpose of describing illustrative examples, not for the purpose of limitation thereof. It will also be understood that one or more of the following described embodiments, manifestations of embodiments, and / or examples may be combined with any one or more of the other described embodiments, manifestations of embodiments, and / or examples.

[0055] In some medical procedures, such as prostate biopsy, patients typically endure lengthy procedures in an uncomfortable prone position, involving immobilization in one specific body position during the entire procedure. During such long procedures, if a metal ferromagnetic needle is used for biopsy with guidance from an MRI system, the needle may experience attractive forces from the MRI system's powerful magnet, causing it to deviate from its path during the length of the procedure. Even when using a non-magnetic needle, local electric field distortions can cause distortions in the magnetic resonance images, resulting in poor image quality surrounding the needle. To avoid such distortions, pneumatic robots with complex compressed air mechanisms are designed to interface with conventional MRI systems. Nevertheless, access to the target anatomical structure remains challenging due to the form factor of currently available MRI systems.

[0056] Various embodiments presented herein include improved MRI systems configured for use in guidance in medical procedures, including, for example, robot-assisted invasive medical procedures. The techniques, methods, and devices disclosed herein relate to guided robotic systems that use magnetic resonance imaging as guidance to automatically guide a robot (generally referred to herein as a robotic system) through a medical procedure. According to various embodiments, the disclosed techniques combine a robotic system with magnetic resonance imaging for guidance. According to various embodiments, the robotic systems disclosed herein are combined with other suitable imaging techniques, such as, for example, optical, ultrasound, x-ray, laser, or any other suitable diagnostic or imaging technique.

[0057] According to various embodiments, a guided robotic system includes a magnetic resonance imaging device for real-time imaging of a subject, a computer system for analyzing the images in real time, and a robotic system for guiding a robotic arm based on the real-time analysis of the images. According to various embodiments, a method of using the guided robotic system may include acquiring live magnetic resonance images of a subject, analyzing the live magnetic resonance images to continuously identify target portions of the subject, guiding the robotic arm toward the identified target portions of the subject based on the live magnetic resonance images, and performing a procedure at the target portions of the subject. The procedure, including any invasive procedure, may include, for example, but is not limited to, a biopsy or a stent insertion.

[0058] 1A is a schematic diagram of a guided robotic system 100, according to various embodiments. The guided robotic system 100 includes an imaging device 120, a computer system 140, and a robotic system 160. According to various embodiments, the guided robotic system 100 optionally includes an operator 180.

[0059] According to various embodiments described herein, the imaging device 120 is a magnetic resonance imaging device. According to various embodiments described herein, the imaging device 120 is a single-plane magnetic resonance imaging device. According to various embodiments, the imaging device 120 can be any imaging device based on ultrasound, X-ray, gamma ray, ultraviolet, infrared, visible, laser, or any other suitable diagnostic or imaging modality, including, but not limited to, visual guidance based on previously acquired scans, mixed or augmented reality-based navigation systems, etc. According to various embodiments, a robot is used to replace the stereotactic frame used for brain procedures outside of magnetic resonance imaging (MRI). In such cases, the magnetic resonance scan is used to plan the procedure, the frame is registered to the magnetic resonance image, and the frame is used to perform the intervention, with or without any image guidance.

[0060] According to various embodiments described herein, the imaging device 120 is a low-field magnetic resonance imaging system that allows for the placement of robotic devices with appropriate shielding in its vicinity. According to various embodiments, the imaging device 120 is configured to have limited fringe fields, thereby allowing a robot or robotic arm to be placed in its vicinity without damaging the robot or robotic arm. According to various embodiments, the imaging device 120 is configured to be a single-sided magnetic resonance imaging system. According to various embodiments, the single-sided magnetic resonance imaging system of the imaging device 120 has an imaging region (e.g., a target anatomical portion of a patient) that is outside of a magnet assembly. According to various embodiments, the magnet assembly includes a single-sided gradient coil set including several gradient field spiral coils configured to function in a single-sided MRI system. According to various embodiments, the single-sided MRI system of the imaging device 120 is configured such that the patient is covered on one side, but not completely surrounded, by magnetic field-generating materials and imaging system components. The single-sided configuration reduces unnecessary strain during patient positioning and / or removal from the imaging device 120 while limiting patient movement. In this way, the patient will not feel trapped within the imaging device 120 with the placement of a single-sided gradient coil set on only one side of the patient.

[0061] According to various embodiments described herein, the imaging device 120 is configured to continuously acquire images of a patient (or generally referred to herein as a "subject"). According to various embodiments described herein, the imaging device 120 is configured for continuous acquisition of magnetic resonance images of the subject. According to various embodiments, the imaging device 120 is configured for real-time or near real-time imaging of the subject. According to various embodiments, the imaging device 120 is configured to acquire live images, magnetic resonance images, or otherwise of the subject.

[0062] According to various embodiments described herein, computer system 140 is coupled to imaging device 120. According to various embodiments, computer system 140 is configured to automatically or in real time analyze images and identify portions of the subject from the images. According to various embodiments, computer system 140 is configured to analyze magnetic resonance images from imaging device 120 and identify portions of the subject from the magnetic resonance images. According to various embodiments, computer system 140 is configured to continuously identify target portions of the subject from live images, magnetic resonance images, or other methods received from imaging device 120. According to various embodiments, computer system 140 is configured to analyze images from imaging device 120 in real time or near real time and provide guidance to robotic system 160.

[0063] According to various embodiments, computer system 140 is configured to automatically analyze one or more images manually input by a physician or operator (and not obtained from imaging device 120) and then identify portions of interest from the analyzed images. According to various embodiments, computer system 140 is configured to identify portions of interest from one or more images analyzed by a physician or operator.

[0064] According to various embodiments described herein, robotic system 160 is coupled to computer system 140. According to various embodiments, robotic system 160 is configured to guide a robotic arm (or generally referred to herein as a "robotic system") based on guidance from computer system 140. According to various embodiments, the guidance includes, for example, executable instructions for the robotic arm. According to various embodiments, the executable instructions include a series of sequential actions for manipulating the robotic arm. According to various embodiments, the executable instructions result in guiding the robotic arm toward an identified target portion of an object. According to various embodiments, the robotic arm is configured to move based on instructions from computer system 140.

[0065] According to various embodiments, the robotic system 160 includes a motion controller and a robotic arm. According to various embodiments, executable instructions from the computer system 140 are received by the motion controller to execute the instructions, which result in a series of sequential actions for manipulating the robotic arm. According to various embodiments, the executable instructions result in guiding the robotic arm toward an identified target portion of an object. According to various embodiments, the robotic arm is configured to move based on instructions from the motion controller. According to various embodiments, the motion controller of the robotic system 160 resides on the computer system 140.

[0066] According to various embodiments, the robotic system 160 is configured to guide the robotic arm (also referred to herein as a "mechanical arm" or "mechanical member") toward and guide the mechanical arm to an identified target portion of the object based on real-time analysis of the acquired images. According to various embodiments, the robotic system 160 is configured to automatically guide the robotic arm toward the identified target portion of the object based on analysis of the acquired images of the target portion of the object by the imaging device 120. According to various embodiments, the real-time or near real-time operation of the guided robotic system 100 occurs automatically without further input from the operator 180.

[0067] 1A , guided robotic system 100, according to various embodiments, optionally includes operator 180. According to various embodiments, operator 180 intervenes during operation of guided robotic system 100 when input or intervention is required. According to various embodiments, intervention by operator 180 occurs, for example, during image acquisition by imaging device 120, during analysis of acquired images by computer system 140, and / or during guidance of robotic system 160. According to various embodiments, operator 180 intervenes when an error occurs during operation of guided robotic system 100 or when correction is warranted during robotic operation.

[0068] FIG. 1B is a flowchart of a method S100 of using the guided robotic system 100, according to various embodiments. As shown in FIG. 1B, method S100 includes, in step S110, acquiring an image of the object. According to various embodiments, acquiring the image of the object includes acquiring one or more target anatomical portions of the object or patient. According to various embodiments, the image is acquired from an imaging device or an external source. The acquisition may be performed by any suitable imaging device or technique, including, but not limited to, magnetic imaging, magnetic resonance imaging, ultrasound, x-ray, gamma ray, ultraviolet, infrared, visible, laser, or visual guidance based on previously acquired scans, mixed or augmented reality-based navigation systems, etc. According to various embodiments, the image is acquired from an external source, such as a physician, patient, user, or operator.

[0069] 1B, method S100 includes automatically analyzing the images to identify target portions of the subject in step S120. According to various embodiments, the acquired images are automatically uploaded to a computer system, such as computer system 140, for analysis via one or more processes, including, but not limited to, artificial intelligence (AI), machine learning, image or signal denoising, segmentation algorithms, object and boundary identification, image registration, adaptive intensity correction, and pattern recognition. According to various embodiments, the acquired images are manually analyzed and input by a physician or operator into a computer system, such as computer system 140, which is used to automatically identify portions of the subject from the analyzed images.

[0070] In step S130, method S100 includes automatically guiding (via automatic guidance) the robotic arm to the identified target portion of the object based on image analysis. According to various embodiments, the automatic guidance includes guiding the robotic arm in real time or near real time based on analysis of continuously acquired images of the target portion of the object. According to various embodiments, the automatic guidance includes self-correction via image analysis. According to various embodiments, the automatic guidance includes occasional intervention by a physician or operator to modify the trajectory of the robotic arm based on the acquired images. According to various embodiments, the automatic guidance includes occasional intervention by a physician or operator to modify the trajectory of the robotic arm based on the acquired images to perform an alternative or additional medical procedure.

[0071] According to various embodiments of method S100, the robotic arm is configured for movement with at least six degrees of freedom (DoF). According to various embodiments, the robotic arm includes one or more mechanical arm segments connected in a configuration that allows the robotic arm to move, rotate, or pivot with six DoF. According to various embodiments, the robotic arm is configured to access various anatomical parts of a subject.

[0072] According to various embodiments, the robotic arm may have fewer than six DoFs, and three DoFs may be sufficient for some scenarios, such as transperineal biopsy, where the robot only needs to move in and out of a plane (two DoFs) and along a parallel trajectory (one DoF). According to various embodiments, one of two more DoFs may be added to provide small rotations about the x and y axes of the plane, allowing access to areas occluded or blocked by anatomical structures, such as the pubic arch when accessing the prostate.

[0073] In step S140, method S100 includes performing a procedure at the target portion of the subject. According to various embodiments, method S100 includes performing an appropriate medical procedure, including, but not limited to, transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, cerebral stenting, and intensity-modulated radiation therapy guidance.

[0074] 2 is an illustration of an exemplary guided robotic system 200, according to various embodiments. As shown in FIG. 2, the guided robotic system 200 includes a magnetic imaging device 220, a computer system 240, and a robotic system 260. The guided robotic system 200 is similar to the robotic system 100 in many aspects.

[0075] The exemplary magnetic imaging device 220 shown in FIG. 2 may include a hole 222 (also referred to herein as an "access port") in the center of a single-sided magnetic coil set 224 to provide access to one or more anatomical portions of a patient being imaged during a medical procedure. According to various embodiments, the magnetic imaging device 220 has a fixed field of view (FOV) relative to its mechanical structure. According to various embodiments, the fixed FOV is defined as a cylindrical volume approximately 4 inches in diameter and approximately 4 inches long, or a cubic volume with approximately 4-inch sides. According to various embodiments, the fixed FOV ranges from approximately 2 inches in diameter / side to approximately 12 inches in diameter / side. In some other implementations, the FOV may be larger, such as for breast imaging applications, where a receive coil array (e.g., dual receive coils) may cover a total cube / cylinder of approximately 18-24 inches in side.

[0076] Within the defined fixed FOV, the robotic system 260 can be calibrated to determine a fixed frame of reference between the robotic system 260 and the imaging FOV of the magnetic imaging device 220, according to some embodiments. This calibration can ensure that the robotic system 260 is operably coupled to the magnetic imaging device 220 via the computer system 240.

[0077] The setup and calibration process can include setting up the robotic system 260 and the magnetic imaging device 220 for use together. In various instances, the setup involves building an MR imaging phantom having at least four non-coplanar markers that are readily identifiable on MR imaging.

[0078] To calibrate the system after setup, the following steps can be performed. First, the phantom can be rigidly fixed within the scanner's field of view, and an image can be acquired. Second, the positions of the marks can be recorded by visually identifying them one at a time on the image. This set of all points visible on the image can be referred to as point set A0 (having dimensions Nx3, where N is the number of identified points). In certain instances, identification can be performed automatically through segmentation and / or classification. Third, the robot can be operated in free-drive mode and navigated to each point set A0. The position of the robot when the needle tip reaches each point in the set can be recorded. This set of all points recorded in robot coordinates can be referred to as point set B0 (having dimensions Nx3). Fourth, a rigid linear least-squares transformation can be estimated that transforms B0 to A0 (T:B0-->A0). This is the robot-to-image transformation. The inverse of this transformation is the image-to-robot transformation.

[0079] To test the calibration based on the transformation T, the phantom can be repositioned to a new position in the field of view (e.g., a 1-2 cm shift in the X and Y directions). The four calibration steps above can be repeated to generate point sets A1 and B1. The previously estimated transformation T can then be applied to B1 to obtain T(B1), and the root mean square error (RMSE) between T(B1) and A1 can be calculated. Finally, the RMSE can be verified to determine that it is within an acceptable threshold and / or value.

[0080] As depicted in FIG. 2, magnetic imaging device 220 includes a single bore through which a robotic arm can extend to reach a patient or target site. In other examples, magnetic imaging device 220 may include two or more access ports. Each access port may provide access to the patient and / or surgical site. For example, in multiple access port examples, the multiple access ports may allow access from different directions and / or proximal locations.

[0081] 2 shows an exemplary magnetic imaging device 220 having a hole 222 in the center of a single-sided magnetic coil set, this magnetic imaging device is used for illustrative purposes only. The robotic arm 262 can be configured to operate with any magnetic imaging device or imaging device, as discussed herein (e.g., see above regarding imaging device 120), regardless of device design (e.g., a standard MRI system, a single-sided MRI, or any other contemplated magnetic imaging device or imaging device in general).

[0082] Using a robot instead of a human to guide tools for robotic-assisted medical procedures may, in certain instances, be a safer and more accurate approach, even with some of the limitations of currently available imaging systems. These limitations may arise, for example, from the structural design and geometric architecture of current MRI systems. For example, most, if not all, current MRI systems in patient care centers utilize a magnet configuration in which the patient lies within the gantry (scaffolding) of the MRI machine during imaging. This arrangement of the magnet surrounding the patient limits direct access to most anatomical parts of the patient, most often prohibitively. Therefore, MRI systems (or imaging systems in general) that do not limit access to various anatomical parts of a patient can further utilize the benefits of robots, according to various embodiments, to be used as guidance tools in medical procedures in particular. Such systems may therefore be additionally beneficial, particularly in robotic or robotic-assisted invasive medical procedures, for targeting any anatomical part of a patient without the constraints or limitations resulting from the confining geometry of a gantry, for example.

[0083] For example, as shown in FIG. 2, a computer system 240 may be coupled to a magnetic imaging device 220 and a robotic system 260 according to various embodiments. Similar to FIG. 1, the computer system 240 may be configured to analyze images acquired from the magnetic imaging device 220 in real time and identify an anatomical portion of a patient (or subject) from the acquired images. For example, during the operation of a medical procedure, the magnetic imaging device 220 may be configured to acquire live (real-time) or near-live (near real-time) images, which may also include a needle, stent, or surgical device, such as one attached to the end of the robotic system 260, that is moved to the target anatomical portion of the patient for the medical procedure. The imaging of the needle or stent provides relative positioning of the needle or stent with respect to the target portion of the patient's anatomy. For example, during guidance of the robotic system 260 to insert a needle or stent within its FOV, the plane of the acquired image containing the needle or stent is continuously monitored rather than manually identified. This provides the advantage of knowing the imaging plane containing the needle, for example. According to various embodiments, if the acquired images are not of sufficient quality to determine the relative positioning of the needle with respect to the target portion of the anatomy, higher resolution images can be acquired. According to various embodiments, if the acquired images are of sufficient quality to determine the relative positioning of the needle with respect to the target portion of the anatomy, lower resolution images may be taken at a higher acquisition rate, which provides real-time or near real-time imaging capability during the operation of the medical procedure. According to various embodiments, the image acquisition rate of the magnetic imaging device 220 ranges from approximately 3-10 images to approximately 1 image per 5 minutes, depending on the resolution. According to various embodiments, the image acquisition rate of the magnetic imaging device 220 ranges up to approximately 60 or 120 images per second.

[0084] According to various embodiments, the robotic system 260 is configured to be disposed outside the magnetic imaging device 220. As shown in FIG. 2 , the robotic system 260 may include a robotic arm 262 configured for movement in six degrees of freedom. According to various embodiments, the robotic arm 262 includes one or more mechanical arm portions (also referred to herein as one or more components), including a hollow shaft 264 and an end effector 266, connected in a configuration that allows the robotic arm 262 to move, rotate, or pivot in six degrees of freedom via one or more motion controllers 270. A double-headed curved arrow indicates rotational motion generated by the motion controller 270. According to various embodiments, the one or more motion controllers 270 are actuators, such as mechanical actuators, including, but not limited to, servo motors. According to various embodiments, the one or more motion controllers 270 are actuators, such as pneumatic, spring, mechanical, or electric motors, piezoelectric actuators, or combinations thereof.

[0085] According to various embodiments, the robotic arm 262 of the robotic system 260 is configured to access various anatomical portions of interest through or around the magnetic imaging device 220. According to various embodiments, the bore 222 in the center of the magnetic imaging device 220 is specially designed to provide access for the robotic arm 262 of the robotic system 260 to operate on various anatomical portions of interest of a patient during a medical procedure. According to various embodiments, the bore 222 in the center of the magnetic imaging device 220 is designed with the size of the robotic arm 262 in mind. For example, the bore 222 defines a perimeter configured to accommodate a robotic arm therethrough, such as the various robotic arms described herein. According to various embodiments, the robotic arm 262 of the robotic system 260 is configured to access various anatomical portions of a patient from around the side of the magnetic imaging device 220. The magnetic imaging device is further described in U.S. Patent Application No. 16 / 003,585, filed June 8, 2018, and entitled "UNILATERAL MAGNETIC RESONANCE IMAGING SYSTEM WITH APERTURE FOR INTERVENTIONS AND METHODOLOGIES FOR OPERATING SAME," which is incorporated herein by reference in its entirety.

[0086] According to various embodiments, the hollow shaft 264 provides a housing for the mechanism that actuates the end effector and may include a long screw drive, shaft, or another mechanism that provides the quick end effector action necessary to take a biopsy sample. Additionally, the hollow shaft may be capable of storing multiple needles and / or sampled cores.

[0087] According to various embodiments, as shown in FIG. 2 , the end effector 266 is attached to one end of the robotic arm 262. According to various embodiments, the end effector 266 includes a mechanism, actuator, housing, or configuration for storing or transporting one or more needles 280 and / or inserting one or more needles 280, or a housing or configuration for storing, transporting, and / or inserting one or more stents or brachytherapy seeds. According to various embodiments, the end effector 266 includes a mechanism for inserting a needle 280 to obtain a biopsy sample, a component or mechanism for providing ablation, or a component or mechanism for performing brachytherapy, among many other suitable medical procedures (also referred to herein as interventions). According to various embodiments, the needle 280 is used to extract a sample, which may be attached to the needle 280, retracted into the needle 280, or via any other mechanism capable of extracting a sample using the needle 280. According to various embodiments, the end effector 266 has minimal mechanical or pneumatic control for selecting the needle 280 to be inserted. According to various embodiments, the movement or motion of the robotic arm 262 inserts or withdraws the needle 280 .

[0088] According to various embodiments, one or more mechanical arm portions of the robotic arm 262, including the hollow shaft 264 and the end effector 266, are made of a non-magnetic material and do not include any electrical components, such as servo motors, for motion control. In such a configuration, all motion, such as servo motors, for the robotic system 260 can remain outside the bore 222 on one side of the magnetic imaging device 220, facing away from the patient. This configuration allows the robotic system 260 to be safely stored away from the magnet of the magnetic imaging device 220. In this configuration, according to various embodiments, the robotic system 260 can extend using one or more mechanical arm portions of the robotic arm 262 to reach a target portion of the patient through the bore 222. According to various embodiments, the robotic system 260 can extend using one or more mechanical arm portions of the robotic arm 262 to reach a target portion of the patient around the magnetic imaging device 220, instead of passing through the bore 222. The circumferential reaching configuration is suitable for limb or breast biopsies, where the needle (mounted on the end effector of the robotic arm 262) can be inserted orthogonally from the side of the patient. According to various embodiments, the needle is inserted into the imaging plane and the needle trajectory is calibrated to lie within the imaging plane.

[0089] According to various embodiments, needle 280 comprises any non-magnetic material, such as titanium, non-magnetic stainless steel, ceramic, etc. In certain instances, needle 280 may be completely non-magnetic to reduce interference with magnetic imaging devices.

[0090] According to various embodiments, image distortion may occur locally when a magnetic stainless steel needle is used, although this is common practice in certain cases. If there is distortion due to the use of a magnetic needle or other magnetic surgical device, the distortion can be removed by image processing. The advantage of using a non-magnetic needle is that it does not cause distortion in the image. According to various embodiments, as shown in FIG. 2, a needle 280, such as a biopsy needle, includes an outer cylindrical sleeve 282 and an inner core 284. The inner sleeve has a recessed area to accommodate sampled tissue. For example, during a medical procedure or intervention, the inner sleeve first cuts the tissue, allowing the tissue to enter the recessed area. In such a case, the outer sleeve immediately follows, cutting the tissue so that the tissue sample remains in the recessed area.

[0091] According to various embodiments, a hollow needle is used to place a stent or brachytherapy seed. According to various embodiments, the hollow needle includes an outer sleeve and an inner needle that pushes the stent / seed into position.

[0092] According to various embodiments, needle 280 includes gauge sizes ranging from 12 G to 18 G, including 10 G, 12 G, 14 G, 16 G, and 18 G. According to various embodiments, needle 280 is sized from 16 G to 18 G for biopsy and 10 G for brachytherapy or ablation. According to various embodiments, needle 280 has a range of lengths for prostate treatment of approximately 15 cm to 25 cm.

[0093] According to various embodiments, the magnetic imaging device 220 is a low-field magnetic imaging system with a fixed geometry. During operation of such a low-field magnetic imaging system, sufficiently low-field magnets may not interfere with shielded robot servo motors. However, the presence and movement of these components may interfere with the magnetic fields generated by the magnetic imaging device 220 during operation. To eliminate or reduce potential interference during magnetic imaging, the robotic system 260 is configured with a robot arm 262 that can extend through the bore 222 of the magnetic imaging device 220 via one or more mechanical arm sections, including a hollow shaft 264 and an end effector 266. In such an example, the entire robot tool can be distal to the bore 220 and external to the magnetic imaging device 220 during a surgical procedure. According to various embodiments, the magnetic imaging device is designed to have a cylindrical region aligned with the bore 222 and having lower magnetic interference than other regions within the imaging zone. For example, the robotic tool can be positioned sufficiently far from the coils and within the region of the imaging zone having the weakest magnetic, gradient, and / or RF fields. This cylindrical region can be where the robotic arm 262 extends and operates in various ways. To further reduce or avoid potential magnetic interference from the robotic system 260, all or most of the components of the robotic arm 262 can be constructed from non-magnetic materials. According to various embodiments, the magnetic imaging device 220 is kept close to the patient and away from sources of magnetic interference. For example, motors for the robotic arm and / or robotic tools can be positioned outside the bore 222. In such an example, referring to FIG. 14 , the patient is proximate to the magnetic imaging device 220, and the magnetic imaging device is between the patient and the robotic system. The distal portion of the robotic arm can reach through the magnetic imaging device 220 to reach the patient. According to various embodiments, active noise cancellation techniques can be used to sense and then remove noise generated by the motor from the acquired MRI signal. According to various embodiments, signal processing can be used to remove any noise generated by the motor.For example, to remove noise generated by a motor, the MRI signal can be combined with an actively generated motor noise removal signal to produce a noiseless MRI signal. Low field magnetic imaging systems are further described in International Patent Application No. PCT / US2020 / 018352, now International Publication No. WO2020 / 172673,168233, filed February 14, 2020, and entitled "SYSTEMS AND METHODS FOR ULTRALOW FIELD RELAXATION DISPERSION," which is incorporated herein by reference in its entirety.

[0094] 3A is a schematic diagram of a graphical user interface (GUI) 300 for an exemplary guided robotic system, according to various embodiments. As shown in FIG. 3A, GUI 300 includes a left panel 310, a middle panel 320, and a right panel 340. GUI 300 shown in FIG. 3A is for illustrative purposes and is therefore a non-limiting exemplary user interface. As a non-limiting example, GUI 300 is configured for use in an invasive surgical procedure, robotic transperineal prostate biopsy.

[0095] As shown in FIG. 3A , the left panel 310 displays multiple buttons for robotic control. According to various embodiments, the buttons are operated or activated by capacitive touch, mouse input, or joystick input by the operator. According to various embodiments, the left panel 310 includes touchscreen controls for controlling the robot and for various imaging adjustments. According to various embodiments, the left panel 310 includes controls for overriding previous inputs, including certain user actions, such as, but not limited to, changing the previous trajectory of needle movement. According to various embodiments, the left panel 310 may include buttons for motion correction during a live scan of a subject.

[0096] The middle panel 320 includes a live guidance view showing a live image 320 (the term "live" is also used herein as "continuously captured" or "continuously acquired") of a portion of a target 330 (e.g., prostate gland 330), a current needle position 324, a current needle trajectory 326, and a target sample location 328 within the prostate gland 330. Live images are acquired intraoperatively during a surgical procedure and / or intervention. According to various embodiments, the middle panel 320 shows an acquired live scan image, including the current needle position 324, the needle trajectory 326, and a target 330 automatically identified from the scan. As the needle advances within the field of view shown in the live guidance view of the middle panel 320, the live image 320 continuously displays the current needle position, i.e., the updated current needle position 324. In the background (e.g., behind-the-scenes processing), this view is continuously registered to a corresponding view from a pre-procedure image to correct for motion, according to some embodiments. For example, with each scan, a new image is generated and re-registered with the corresponding view from the pre-treatment image to correct for any motion.

[0097] As shown in FIG. 3A , the right panel 340 includes various views of the planning scan, including, for example, a cross-sectional view 342, a sagittal view 344, and a three-dimensional (3D) view 346. The cross-sectional view 342 shows a slice from the planning scan that includes the target 330. According to various embodiments, a virtual grid 345 is used to indicate evenly spaced potential needle positions, shown in the cross-sectional view 342 as hollow circles. The sagittal view 344 shows a sagittal image containing the target 330. According to various embodiments, the virtual grid 345 is used to indicate evenly spaced potential needle positions, shown in the sagittal view 344 as horizontal lines. According to some embodiments, the lines represent potential needle trajectories via a transperineal approach along the lateral direction. The 3D view 346 displays cross-sectional views from the planning image based on the current needle position 324 and updates graphics on the GUI (e.g., GUI 300) as the needle advances distally.

[0098] FIG. 3B is a schematic diagram of a live view 350 during imaging of a guided robotic system, according to various embodiments. As shown in FIG. 3B, the live view 350 is in an xyz coordinate system, indicated by a dotted cube along the x-, y-, and z-axes. Imaging need only be acquired in the plane where the needle is expected, represented by the imaging plane 370 in the center of the field of view 360 in FIG. 3B. According to various embodiments, the live view 350 incorporates a z-gradient to excite one or more slabs of varying thickness within the field of view 360. Alternative embodiments do not incorporate a z-axis gradient. According to various embodiments, x and y gradients are embedded as phase encodes for imaging in the imaging plane 370, which includes the needle. The spatial localization of a point within the field of view 360 is determined by a combination of the x and y phase encodes and the transmit frequency band corresponding to the z-gradient. These slabs can be divided into multiple slices, which differs from traditional image slicing and through-image reconstruction.

[0099] According to various embodiments, slice interleaving is utilized, whereby the system excites the entire field of view 360 by multiplexing the excitation of different slabs within the field of view 360, and by transmitting and receiving at different bandwidths at different time intervals within the pulse sequence, complete coverage of the entire field of view 360 is achieved. Rapid, needle-containing, two-dimensional cross-sectional images can be generated based solely on y-phase encoding (due to the z-phase built into the system). For example, utilizing slice interleaving in a single dimension (e.g., needle trajectory) can be performed at high resolution and speed. According to various embodiments, the acquisition and computational costs associated with acquiring thick slabs are virtually nonexistent while using only y-phase encoding using a slice interleaving approach, where sampling is performed in only one dimension.

[0100] As shown in FIG. 3B , the live view 350 is configured to display a needle trajectory 380 projected within the imaging plane 370. According to some implementations, the needle is advanced in the positive z direction in an xyz coordinate system, as shown in FIG. 3B . According to various embodiments, the entire volume is imaged with lower detail, and then the area around the needle trajectory 380 is imaged with greater detail during live guidance to indicate the precise positioning of the needle. According to various embodiments, a hybrid image, which includes a higher-resolution portion of the image near the needle and a lower-resolution image portion elsewhere in the image, may be sufficient. The hybrid imaging approach can provide further improvements in image acquisition time, i.e., faster imaging, while maintaining sufficient detail in the area needed to determine the precise positioning of the needle relative to the location of the target 330.

[0101] Additional trade-offs between image acquisition speed and resolution of acquired images can be achieved through appropriate optimization techniques using hardware and / or software approaches, such as k-space undersampling, parallel imaging, and compressed sensing using multi-slice image acquisition. These techniques aim to speed up image acquisition at the cost of a general image signal-to-noise ratio. Data symmetry and data compression techniques are utilized to acquire the minimum amount of data necessary to reconstruct an image.

[0102] Some target anatomical structures, such as the prostate, present unique challenges for needle-guided interventions. For example, the prostate is surrounded by soft tissue and is prone to movement as a result of any pressure from a transrectal transducer or needle entering the prostate. For example, when a needle is inserted into the prostate, the prostate is pushed away, and upon insertion, the gland can return to its original position or some other position. Similarly, when the needle is removed, the gland can be pushed back and continue to change its position. This is particularly problematic when attempting to use a rigid reference frame with a robot, as registration between the anatomy and imaging can be incorrect.

[0103] According to various embodiments, a motion correction method is used to dynamically estimate motion using image similarity metrics between live images and corresponding cross-sections from planning images. According to various embodiments, this is further enhanced by motion detection and correction in k-space itself. Correction in k-space ensures that reconstructed images are free of motion artifacts, while image-based registration minimizes motion-induced errors in the robot's precise positioning. For example, the patient's gross motion and local glandular deformation can be isolated and corrected separately using visible fiducial markers in magnetic resonance imaging. Motion can be determined, for example, from a comparison of MRI image frames. The measured motion is applied to a robot frame of reference known by the robot, so that the target anatomy and the robot maintain their correspondence. For example, the measured motion updates the reference frames of the target anatomy and the robot, allowing the robot to move along the correct path relative to the target anatomy. Fiducial markers can also be used to determine correspondence.

[0104] For guided robotic procedures or interventions, magnetic imaging scans are taken of the target anatomical structure for planning the procedure. These scans (planning scans) may include magnetic (e.g., magnetic resonance) imaging scans using one or more contrast types. Images may be manually or automatically classified into suspected malignancies for biopsy and into areas of malignancy for image-guided therapy. According to various embodiments, the image-guided procedure may be performed immediately after the planning images are acquired, i.e., live imaging, or at a later time. According to various embodiments for procedures performed at a later time, a pre-procedure anatomical scan is performed to map the planning images to the current reference frame. The following figures illustrate various embodiments of procedures utilizing guided robotic procedures.

[0105] 4A, 4B, 4C, 4D, 5A, 5B, 5C, 5D show different views (e.g., transverse and sagittal views) for the virtual template-based or grid-based approach.

[0106] FIG. 4A is a schematic diagram illustrating a cross-sectional view 400a during a planning scan of a prostate sample 430, according to various embodiments. FIG. 4B is a schematic diagram illustrating a sagittal view 400b of the prostate sample 430, according to various embodiments. As shown in FIGS. 4A and 4B, the planning image of the prostate sample 430 can be marked to indicate suspicious regions 435 (e.g., possible malignancy or confirmed malignancy) in both the cross-sectional view 400a and the sagittal view 400b. As shown in FIGS. 4A and 4B, a virtual template grid 445 is depicted as evenly spaced hollow dots for potential needle positions in FIG. 4A and straight lines for potential needle trajectories in FIG. 4B. According to various embodiments, the spacing of the hollow dots can vary based on the desired needle position or trajectory.

[0107] FIG. 4C is a schematic diagram illustrating a cross-sectional view 400c of a biopsy plan based on the planning scan shown in FIG. 4A, according to various embodiments. FIG. 4D is a schematic diagram illustrating a sagittal view 400d of a biopsy plan based on the planning scan of the prostate sample 430 shown in FIG. 4B. As shown in FIG. 4C, four positions (e.g., four filled dots) of a grid 445 where biopsy samples can be obtained from the suspicious region 435 are indicated as sample positions 455. Similarly, FIG. 4D shows two straight trajectory lines of the grid 445 of the sagittal view 400d corresponding to the sample positions 455 that encompass the suspicious region 435. The biopsy plan, represented by circles and straight lines, covers the entire targeted suspicious region 435.

[0108] 5A and 5B respectively show a cross-sectional view 500a and a sagittal view 500b of a prognosis plan for determining the extent of malignancy by positioning a bounding box of a prostate sample 530, according to various embodiments. In FIGS. 5A and 5B, the prognosis plan for the prostate sample 530 is marked to indicate suspicious regions 535 (e.g., possible malignancy or confirmed malignancy) in both the cross-sectional view 500a and the sagittal view 500b. As shown in FIGS. 5A and 5B, a virtual template grid 545 is shown as evenly spaced hollow dots for potential needle locations in FIG. 5B and straight lines for potential needle trajectories in FIG. 5A. As shown in FIGS. 5A and 5B, the prognosis plan for the prostate sample 530 provides a bounding box indicated by sample locations 555, shown as sixteen solid dots in FIG. 5A and four solid lines in FIG. 5B. Sample locations 555 encompass suspected or known malignancies in suspicious region 535 to determine a range of prognoses, which can be used to determine disease management pathways such as active surveillance or type and extent of treatment.

[0109] FIG. 5C is a schematic diagram illustrating an axial view 500c for a low-dose brachytherapy plan of a prostate sample 560, according to various embodiments. FIG. 5D shows a schematic diagram of a sagittal view 500d, according to various embodiments. The low-dose proximal brachytherapy plan of the prostate sample 560 shown in FIGS. 5C and 5D is indicated by the sample location 565, which is shown as a solid dot within the entire prostate sample 560 in FIG. 5C and as a dashed line within the entire prostate sample 560 in FIG. 5D. According to various embodiments, low-dose brachytherapy may be used to treat the prostate sample 560 as shown in FIGS. 5C and 5D. In some other embodiments, low-dose brachytherapy may be used to treat portions of the prostate sample 560.

[0110] FIG. 6A is a schematic diagram illustrating a cross-sectional view 600a of a biopsy plan for a prostate sample 630 without a virtual grid, according to various embodiments. FIG. 6B is a schematic diagram illustrating a sagittal view 600b of a biopsy plan for a prostate sample 630, according to various embodiments. As shown in FIGS. 6A and 6B, the biopsy plan for the prostate sample 630 is marked to indicate suspicious regions 635 (e.g., possible malignancy or confirmed malignancy) in both the cross-sectional view 600a and the sagittal view 600b. As shown, the biopsy plan for the prostate sample 630 shown in FIGS. 6A and 6B is not limited by a grid for needle insertion. As shown in FIGS. 6A and 6B, the biopsy plan for the prostate sample 630 includes several selected sample locations 655 within the suspicious region 635. The sample locations 655 are shown as three solid dots in FIG. 6B and as solid lines in FIG. 6B.

[0111] According to various embodiments described herein, the robotic system 260 of FIG. 2 can be used for any of the procedures or interventions shown and described with respect to FIGS. 4A, 4B, 4C, 4D, 5A, 5B, 5C, 5D, 6A, and 6D. As shown in FIG. 2, the robotic system 260 includes a robotic arm 262 configured for movement in six degrees of freedom. After calibration at a base point within the imaging field of view, e.g., in FIG. 3A or 3B, the robotic arm 262 can move the needle tip to any point in the x-y plane, e.g., as shown in FIG. 3B. According to various embodiments, the robotic arm 262 can be aligned to any point within the grid pattern of an overlaid virtual template, e.g., as shown in FIG. 4A, 4C, 5A, or 5C, or to any other location within the field of view using a template-free approach, e.g., as shown in FIG. 6A. According to various embodiments, needle insertion is performed by advancing the robotic arm 262 along the z-direction as shown in FIG. 3B, or from left to right or vice versa as shown in FIGS. 4B, 4D, 5B, 5D, or 6B.

[0112] As described above, according to various embodiments, the robotic arm 262 is configured to include one or more motion controllers 270, such as an actuator or end effector 266 at the end of the arm that can hold one or more short needles. According to various embodiments, the actuator 270 is entirely mechanical and is triggered by a servo motor near the base of the robotic system 260. According to various embodiments, the actuator is a pneumatic actuator for positioning the needle in a plane. According to various embodiments, the actuator is pneumatically controlled, while other components throughout the robotic system 260 are mechanically controlled by one or more servo motors. According to various embodiments, nearly all components of the robotic system 260, including the actuators, are mechanically controlled by one or more servo motors.

[0113] According to various embodiments, the robotic arm 262 of the robotic system 260 is constrained to move along a parallel line, for example, in a transperineal prostate procedure. According to various embodiments, an additional degree of freedom (in addition to the six degrees of freedom) includes angular motion, such that a needle attached to the robotic arm 262 can be manipulated through the pubic arch region, such as in the case of benign prostatic hyperplasia. According to various embodiments, the robotic system 260 is constrained to move to maintain an external remote center of motion (RCM) so that the same location within the body can be approached through various trajectories. In the RCM model, the robotic mechanism moves such that the tools acted upon by it have trajectories that always pass through a fixed point relative to the robotic mechanism. For example, for a minimally invasive single-port intervention, the RCM may remain fixed at the entry port to the body, and the robotic mechanism can advance tools to different locations within the body through different angles. According to various embodiments, the RCM center can be on the surface of the patient's body to facilitate sampling / treating multiple locations through only one access puncture / port.

[0114] According to various embodiments, an operator may preload multiple needles 280 into the actuator if a biopsy plan has already been determined. In such cases, the biopsy plan includes obtaining sample specimens from all planned locations, as described, for example, with respect to FIGS. 4C, 4D, 5A, 5B, 6A, and 6B. In such implementations, the robotic arm 262 is configured to obtain multiple samples at once using multiple needles 280. In such cases, the prostate sample may need to be held in place using a transurethral tube (not shown). Because the prostate motion is only along the needle insertion direction and is equal for all simultaneously inserted needles, it may be sufficient to track only one of the needles 280. In this way, correcting the motion of the center needle may be sufficient to correct the motion of all needles 280.

[0115] According to various embodiments, the needles 280 can be inserted one at a time. In such a configuration, a predetermined order of needle insertion is used along with an optimized sampling scheme to minimize the effect of needle insertion on imaging of the next target location. In this implementation, the actuator does not hold all the needles for insertion simultaneously, but holds multiple needles within the cartridge or end effector 266 and inserts and withdraws one needle at a time. This is done to avoid withdrawing the entire robotic arm 262 over the bore 222.

[0116] According to various embodiments, needle 280 has an RF coil or metamaterial attached to it. According to various embodiments, the RF coil or metamaterial is configured to couple to a receive coil chain of magnetic imaging device 220. This implementation allows for wireless coupling and transfer of information to the receive coil network, which is digitized by a computer. According to various embodiments, the attached RF coil or metamaterial may increase signal transduction from tissue surrounding the needle during insertion, which improves the quality of images acquired during a scan by magnetic imaging device 220.

[0117] According to various embodiments, the guided robotic system 200 used in guided robotic procedures, such as those described with respect to FIGS. 4A, 4B, 4C, 4D, 5A, 5B, 5C, 5D, 6A, and 6D, includes additional configurations that utilize a nuclear magnetic resonance (NMR) analysis network. According to various embodiments, the NMR analysis network on the robotic system 260 is configured to utilize the higher magnetic field within the bore 222 to perform spectral analysis on the collected biopsy specimens. Because different tissue types are known to have different NMR spectra, the type and amount of tissue in each specimen can be quickly characterized immediately after the specimen is obtained. According to various embodiments, the additional NMR information collected and analyzed from the specimens can be used for real-time feedback on the tissue type and provide additional information that may be related to the pathology of the biopsy core.

[0118] According to various embodiments, a guided robotic system 200 used in a guided robotic procedure, such as those described with respect to FIGS. 4A, 4B, 4C, 4D, 5A, 5B, 5C, 5D, 6A, and 6D, includes an additional configuration that utilizes ultrasound for guidance. According to various embodiments, the device for acquiring ultrasound is external to the guided robotic system 200. According to various embodiments, the device for acquiring ultrasound is integrated into the guided robotic system 200, for example, integrated into the robotic arm 262 near the end effector 266. According to various embodiments, the guided robotic system 200 supplemented with ultrasound can provide faster imaging updates or improve magnetic guidance for localizing veins and arteries within a subject during surgery or intervention.

[0119] Additional medical procedures, operations, or interventions in which the guided robotic system 100 or the guided robotic system 200 uses magnetic imaging technology may include, but are not limited to, for example, transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, and transrectal HIFU.

[0120] For transrectal HIFU, according to various embodiments, a robotic system 260 is used to rotate the transrectal HIFU transducer around its axis. According to various embodiments, an operator or physician first inserts the transducer and then moves the patient into the magnetic imaging field of view. In these implementations, the robotic arm 262 is configured to enter through the hole 222 in the magnetic imaging device 220 and latch into the transducer or its holder.

[0121] Additional medical procedures, operations, or interventions in which guided robotic system 100 or guided robotic system 200 may use magnetic imaging technology include breast biopsy. In a breast biopsy, the procedure is similar to a prostate biopsy, but the direction of insertion is different. For example, a robotic system 260 used for a breast biopsy may be configured to use one or more mechanical arm portions of robotic arm 262 to extend and reach a target portion of the breast around magnetic imaging device 220 instead of through bore 222. This configuration is particularly suited for breast biopsy, in which needle 280 is inserted from the side of the breast.

[0122] Additional medical procedures, operations, or interventions for which the guided robotic system 100 or the guided robotic system 200 may use magnetic imaging technology include deep brain stimulation (DBS). For DBS, for example, pre-planning may be performed prior to the procedure or intervention to ensure the needle trajectory does not pass through any critical structures. According to various embodiments, critical structures are automatically or manually pre-segmented, identified, or marked. These structures can then be overlaid on live images during the procedure. During live guidance, images are acquired to ensure the needle 280 is inserted in the correct location under direct visualization so that critical structures are not damaged or violated. According to various embodiments, an RCM model may be used once an entry point is selected for entry into the brain to minimize complexity.

[0123] Additional medical procedures, operations, or interventions in which guided robotic system 100 or guided robotic system 200 uses magnetic imaging technology include brain biopsies. According to various embodiments, brain biopsies are performed using a projected needle trajectory that is displayed to the operator on a live guidance panel, as shown in FIG. 3A, for example. After reviewing the information on the live guidance panel on middle panel 320, the operator can decide to begin needle insertion. According to various embodiments, guided robotic system 200 is configured to record target locations in the brain. According to various embodiments, the operator reviews acquired images of the target locations in the brain and inputs pathology findings for each finding along with their respective locations in the images.

[0124] Additional medical procedures, operations, or interventions in which guided robotic system 100 or guided robotic system 200 may use magnetic imaging techniques include liver and kidney biopsies. According to various embodiments, liver and kidney biopsies involve inserting and obtaining specimens at a single entry point. According to various embodiments, to minimize complexity, a remote center of motion (RCM) model may be used once an entry point is selected for entry into the brain.

[0125] Additional medical procedures, operations, or interventions for which guided robotic system 100 or guided robotic system 200 may use magnetic imaging techniques include lung biopsy, which, according to various embodiments, involves the insertion of a tube through the trachea with the aid of the robotic system.

[0126] According to various embodiments described herein, the guided robotic system 100 or the guided robotic system 200 may be utilized in a medical procedure, operation, or intervention, for example, for the insertion of a stent, such as a coronary stent or a cerebral stent. According to various embodiments described herein, the guided robotic system 100 or the guided robotic system 200 may be used for intensity-modulated radiation therapy guidance.

[0127] 7 is a flowchart of an exemplary method S200 of using the guided robot system 200, according to various embodiments. As shown in FIG. 7, the method S200 includes, in step S210, acquiring a magnetic resonance image of a subject. According to various embodiments, acquiring the image of the subject includes acquiring one or more target anatomical portions of the subject or patient. According to various embodiments, the magnetic resonance image is acquired from a magnetic resonance imaging device, such as the magnetic imaging device 200 or an external source. According to various embodiments, the magnetic resonance image is acquired from an external source, such as a physician, a patient, a user, or an operator.

[0128] 7, method S200 includes, in step S220, performing image analysis of live magnetic resonance images to continuously identify target portions of interest. According to various embodiments, acquired magnetic resonance images are automatically uploaded to a computer system, such as computer system 240, for analysis via one or more processes, including, but not limited to, artificial intelligence (AI), machine learning, image or signal denoising, segmentation algorithms, object and boundary identification, image registration, adaptive intensity correction, and pattern recognition. According to various embodiments, acquired magnetic resonance images are manually analyzed and input by a physician or operator into a computer system, such as computer system 240, which is used to automatically identify portions of interest from the analyzed images.

[0129] In step S230, method S200 includes automatically guiding (via automatic guidance) a robotic arm, such as robotic arm 262, to the identified target portion of the subject based on live magnetic resonance images. According to various embodiments, the automatic guidance includes guiding the robotic arm in real time or near real time based on analysis of continuously acquired magnetic resonance images of the target portion of the subject. According to various embodiments, the automatic guidance includes self-correction via image analysis. According to various embodiments, the automatic guidance includes occasional intervention by a physician or operator to correct the trajectory of the robotic arm based on the acquired magnetic resonance images. According to various embodiments, the automatic guidance includes occasional intervention by a physician or operator to modify the trajectory of the robotic arm based on the acquired magnetic resonance images to perform an alternative or additional medical procedure.

[0130] According to various embodiments of method S200, a robotic arm is configured for movement in six degrees of freedom, such as robotic arm 262. According to various embodiments, the robotic arm includes one or more mechanical arm segments connected in a configuration that allows the robotic arm to move, rotate, or pivot in the six degrees of freedom. According to various embodiments, the robotic arm is configured to access various anatomical parts of a subject.

[0131] According to various embodiments of method S200, critical structures are not damaged during needle insertion by robotic arm 262. For example, according to various embodiments for prostate biopsy, guided robotic system 200 is configured to avoid a needle attached to robotic arm 262 being inserted into a target portion of a subject passing through the urethra or entering the bladder. According to various embodiments for brachytherapy, the needle does not penetrate beyond the prostate into the bladder and does not resect the rectum or bladder.

[0132] According to various embodiments, in accordance with method S200, the acquired live magnetic resonance images are displayed in a graphical user interface (GUI) that includes functional buttons for controlling the procedure. According to various embodiments, the acquired live magnetic resonance images include a high-resolution image portion near the needle that will be inserted during the procedure and a low-resolution image portion farther from the needle. According to various embodiments, method S200 further includes modifying the acquired live magnetic resonance images for operation during performance of the procedure. According to various embodiments, method S200 further includes modifying the acquired live magnetic resonance images for operation during needle insertion. According to various embodiments, method S200 further includes overriding existing actions to manually modify the movement. According to various embodiments, method S200 further includes manually advancing the robotic arm by controlling the GUI using touch input, mouse input, or joystick input. According to various embodiments, method S200 further includes, after extracting the sample, performing automatic segmentation to capture the needle position, withdrawing the needle, and advancing the needle to the next target location.

[0133] In step S240, method S200 includes performing a procedure at the target portion of the subject. According to various embodiments, method S200 includes performing an appropriate medical procedure, including, but not limited to, transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, cerebral stenting, and intensity-modulated radiation therapy guidance. According to various embodiments, performing the procedure includes extracting a specimen, for example, for biopsy.

[0134] FIG. 8 is a flowchart of an example method S300 of using guided robot system 200, according to various embodiments. As shown in FIG. 8, method S300 includes, in step S310, sequentially acquiring magnetic resonance images of a subject. According to various embodiments, acquiring the images of the subject includes acquiring one or more target anatomical portions of the subject or patient. According to various embodiments, the magnetic resonance images are acquired from a magnetic resonance imaging device, such as magnetic imaging device 100 or 200, or from an external source. According to various embodiments, the magnetic resonance images are acquired from an external source, such as a physician, a patient, a user, or an operator.

[0135] In step S320, method S300 includes continuously identifying target portions of the subject in the magnetic resonance images. According to various embodiments, the acquired magnetic resonance images are automatically uploaded to a computer system, such as computer system 240, for analysis via one or more processes, including but not limited to artificial intelligence (AI), prior to identifying the target portions. According to various embodiments, the acquired magnetic resonance images are manually analyzed and input by a physician or operator into a computer system, such as computer system 240, which is used to automatically identify portions of the subject from the analyzed images.

[0136] In step S330, method S300 includes guiding a robotic arm, such as robotic arm 262, toward the identified target portion of the object, where magnetic resonance images are analyzed in real time to guide the robotic arm to the portion. According to various embodiments, continuously acquired magnetic resonance images are analyzed in real time or near real time to continuously identify the target portion of the object. According to various embodiments, guiding the robotic arm includes self-correction through image analysis. According to various embodiments, guiding the robotic arm includes occasional intervention by a physician or operator to modify the trajectory of the robotic arm based on the continuously acquired magnetic resonance images. According to various embodiments, guiding the robotic arm includes occasional intervention by a physician or operator to modify the trajectory of the robotic arm based on the continuously acquired magnetic resonance images to perform an alternative or additional medical procedure.

[0137] In step S340, method S300 includes inserting a needle into the target portion of the subject and extracting a sample. During insertion, vital structures are not damaged during needle insertion by robotic arm 262. For example, according to various embodiments for prostate biopsy, guided robotic system 200 is configured such that a needle attached to robotic arm 262 that is inserted into the target portion of the subject avoids passing through the urethra or entering the bladder. According to various embodiments for brachytherapy, the needle does not penetrate beyond the prostate into the bladder and does not resect the rectum or bladder.

[0138] According to various embodiments of method S300, continuously acquired live magnetic resonance images are displayed in a graphical user interface (GUI) that includes functional buttons for control during needle insertion. According to various embodiments, the continuously acquired live magnetic resonance images include a high-resolution image portion near the needle and a low-resolution image portion far from the needle. According to various embodiments, method S300 further includes automatically correcting the continuously acquired live magnetic resonance images to compensate for motion blur during needle insertion. According to various embodiments, method S300 further includes automatically correcting the needle trajectory during insertion based on the corrected acquired live magnetic resonance images. According to various embodiments, method S300 further includes overriding an existing guided trajectory to manually correct for motion blur. According to various embodiments, method S300 further includes manually advancing the robotic arm by controlling the GUI using touch input, mouse input, or joystick input. According to various embodiments, the method S300 further includes, after extracting the sample, performing automatic segmentation to capture the needle's location, withdrawing the needle, and advancing the needle to a next target location. According to various embodiments, directing the needle attached to the robotic arm to the identified target portion of the subject includes directing it through a hole in the center of a magnetic imaging device configured to continuously acquire magnetic resonance images.

[0139] According to various embodiments of step S340, the extracted specimen is for analysis in medical procedures including, but not limited to, transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, cerebral stenting, and intensity modulated radiation therapy guidance.

[0140] 9 is a flowchart of an exemplary method S400 of using guided robotic system 200, according to various embodiments. As shown in FIG. 9, method S400 includes acquiring a live magnetic resonance image of a subject in step S410. According to various embodiments, acquiring the live magnetic resonance image of the subject includes acquiring one or more target anatomical portions of the subject or patient. According to various embodiments, the live magnetic resonance image is acquired from a magnetic resonance imaging device, such as magnetic imaging device 100 or 200.

[0141] In step S420, method S400 includes continuously identifying target portions of the subject in the live magnetic resonance images. According to various embodiments, the acquired live magnetic resonance images are automatically uploaded to a computer system, such as computer system 240, for analysis via one or more processes, including but not limited to artificial intelligence (AI), prior to identifying the target portions. According to various embodiments, the acquired live magnetic resonance images are manually analyzed and input by a physician or operator into a computer system, such as computer system 240, which is used to automatically identify portions of the subject from the analyzed images.

[0142] In step S430, the method S300 includes directing an end effector attached to the mechanical arm toward the identified target portion of the subject. According to various embodiments, the end effector is configured to deliver multiple needles.

[0143] In step S440, method S300 includes inserting multiple needles, one at a time or sequentially, into a target portion of the subject to extract multiple samples from the target portion of the subject. According to various embodiments of step S440, vital structures of the subject are not damaged during needle insertion by robotic arm 262. For example, according to various embodiments for prostate biopsy, guided robotic system 200 is configured to prevent a needle attached to robotic arm 262 that is inserted into the target portion of the subject from passing through the urethra or entering the bladder. According to various embodiments for brachytherapy, the needle does not penetrate beyond the prostate into the bladder and does not resect the rectum or bladder.

[0144] According to various embodiments of method S400, the acquired live magnetic resonance images are displayed in a graphical user interface (GUI) including functional buttons for control during insertion of the multiple needles. According to various embodiments, the acquired live magnetic resonance images include a high-resolution image portion near the insertion needle and a low-resolution image portion far from the insertion needle. According to various embodiments, method S400 further includes automatically correcting the acquired live magnetic resonance images to compensate for motion blur during insertion of the multiple needles. According to various embodiments, method S400 further includes automatically correcting the trajectory of the inserted needle during insertion based on the corrected acquired live magnetic resonance images. According to various embodiments, method S400 further includes manually correcting for motion blur, overriding an existing guided trajectory. According to various embodiments, method S400 further includes manually advancing the mechanical arm by controlling the GUI using touch input, mouse input, or joystick input. According to various embodiments, the method S400 further includes, after extracting the sample, performing automatic segmentation to capture the location of the inserted needle, removing the inserted needle, and inserting an additional needle at a next location. According to various embodiments, guiding the end effector attached to the mechanical arm toward the identified target portion of the object includes guiding it through a central bore of a single-sided magnetic imaging device configured to continuously acquire magnetic resonance images.

[0145] According to various embodiments of step S440, the plurality of extracted samples are for analysis in one or more medical procedures, including, but not limited to, transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, cerebral stenting, and intensity-modulated radiation therapy guidance.

[0146] 10-14 illustrate a magnetic resonance imaging system 700. As shown in FIGS. 10 and 11, the magnetic resonance imaging system 700 includes a housing 720. The housing 720 includes a front surface 725. According to various embodiments, the front surface 725 can be a concave front surface. According to various embodiments, the front surface 725 can be a recessed front surface.

[0147] As shown in Figures 10 and 11, the housing 720 includes a permanent magnet 730, a radio frequency transmit coil 740, a gradient coil set 750, an electromagnet 760, and a radio frequency receive coil 770. As shown in Figures 12 and 13, the permanent magnet 730 may include multiple magnets arranged in an array configuration. The multiple magnets forming the permanent magnet 730 cover the entire surface, as shown in the elevation view of Figure 12, and are depicted as horizontal bars, as shown in the side view selection of Figure 13. Referring primarily to Figure 10, the main permanent magnet array may include at least one access opening 735 for accessing the patient from multiple sides of the system.

[0148] According to various embodiments, the permanent magnet 730 provides a static magnetic field to the region of interest 790. According to various embodiments, the permanent magnet 730 may include multiple cylindrical permanent magnets in a parallel configuration, as shown in FIGS. 12 and 13 . According to various embodiments, the permanent magnet 730 may include any suitable magnetic material, including, but not limited to, rare earth-based magnetic materials, such as Nd-based magnetic materials. As shown in FIG. 10 , the main permanent magnet may include at least one access opening 735 for accessing the patient from the opposite side of the system through the body of the magnetic imaging system 700.

[0149] According to various embodiments, using the magnetic resonance imaging system illustrated in FIG. 14, a patient can be positioned in any number of different positions depending on the type of anatomical scan desired. FIG. 14 shows an exemplary position when the abdominal region is scanned. The patient can lie on a surface in a lateral position. As shown, for an abdominal scan, the patient may be positioned to lie on their side facing the hole, with the arm closest to the table extended and the other at the side of the body. The abdominal region can be positioned so that it is in front of the hole. The robotic system can be positioned on the opposite side of the magnetic resonance imaging system such that the robotic system is away from the patient. The robotic arm of the robotic system can reach through an access opening in the magnetic resonance imaging system to perform a procedure on the patient. In this exemplary setup, there is the robotic system, then the magnetic resonance imaging system, and then the patient. This example setup positions the patient close to the magnetic resonance imaging system and only allows the robotic system arm to reach through the access opening toward the patient, thereby moving the robotic system motors away from the magnetic resonance imaging system and reducing interference with magnetic resonance imaging. In another example, the robotic system arm can reach around the side of the magnetic resonance imaging system to reach the patient. In both examples, the magnetic resonance imaging system is intermediate the patient and the proximal portion of the robotic arm. [Example]

[0150] Example 1 A guided robotic system comprising: a magnetic imaging device for continuously acquiring magnetic resonance images of a subject; a robotic arm; and a computer system for analyzing the magnetic resonance images and identifying portions of the subject, wherein the magnetic resonance images are analyzed in real time to guide the robotic arm to the portions of the subject.

[0151] Example 2 The system of Example 1, wherein the robotic arm is attached to a component configured for drug delivery.

[0152] Example 3 3. The system of any one of Examples 1 and 2, wherein the robotic arm is configured to insert a needle into the portion to extract the sample.

[0153] Example 4 The system of any one of Examples 1, 2, and 3, wherein the robotic arm is configured to place a stent on the portion.

[0154] Example 5 The system of any one of Examples 1, 2, 3, and 4, wherein the robotic arm is attached to a needle configured to remove the sample from the portion.

[0155] Example 6 6. The system of any one of Examples 1, 2, 3, 4, and 5, wherein the robotic arm is configured to remove the identified portion by cutting the portion.

[0156] Example 7 The system of any one of Examples 1, 2, 3, 4, 5, and 6, wherein the robotic arm is attached to an end effector that includes multiple needles.

[0157] Example 8 The system of any one of Examples 1, 2, 3, 4, 5, 6, and 7, wherein the robotic arm is attached to an end effector configured to deliver one or more stents.

[0158] Example 9 9. The system of any one of Examples 1, 2, 3, 4, 5, 6, 7, and 8, wherein the robotic arm is attached to an end effector configured to transport one or more brachytherapy seeds.

[0159] Example 10 10. The system of any one of Examples 1, 2, 3, 4, 5, 6, 7, 8, and 9, wherein the robotic arm is configured to extract a specimen for examination in a medical procedure from a list of medical procedures consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stent insertion, cerebral stent insertion, and intensity modulated radiation therapy guidance.

[0160] Example 11 A method of using a guided robotic system, the method including: acquiring live magnetic resonance images of a subject; performing image analysis of the live magnetic resonance images to continuously identify target portions of the subject; automatically guiding a robotic arm toward the identified target portions of the subject based on the live magnetic resonance images; and performing a procedure at the target portions of the subject.

[0161] Example 12 The method of Example 11, wherein the acquired live magnetic resonance images are displayed within a graphical user interface (GUI) that includes functional buttons for controlling treatment.

[0162] Example 13 The method of any one of Examples 11 and 12, wherein the acquired live magnetic resonance images include high-resolution image portions near the needle inserted during the procedure and low-resolution image portions farther from the needle.

[0163] Example 14 14. The method of any one of Examples 11, 12, and 13, further comprising correcting live magnetic resonance images acquired for patient movement during performance of the procedure.

[0164] Example 15 The method of any one of Examples 11, 12, 13, and 14, further comprising correcting live magnetic resonance images acquired for motion artifact during needle insertion.

[0165] Example 16 The method of any one of Examples 11, 12, 13, 14, and 15, further comprising overriding existing actions to manually correct patient movement.

[0166] Example 17 17. The method of any one of Examples 11, 12, 13, 14, 15 and 16, further comprising manually advancing the robotic arm by controlling the GUI using touch input, mouse input, or joystick input.

[0167] Example 18 The method of any one of Examples 11, 12, 13, 14, 15, 16, and 17, further comprising providing a needle attached to a robotic arm, performing automatic segmentation to capture the position of the needle, removing the needle, and advancing the needle to a next target location.

[0168] Example 19 The method of any one of Examples 11, 12, 13, 14, 15, 16, 17, and 18, wherein the procedure comprises one from the list of medical procedures consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, cerebral stenting, and intensity modulated radiation therapy guidance.

[0169] Example 20 1. A method of using a guided robotic system, the method comprising: continuously acquiring magnetic resonance images of a subject; continuously identifying a target portion of the subject within the magnetic resonance images; guiding a needle attached to a robotic arm toward the identified target portion of the subject, wherein the magnetic resonance images are analyzed in real time to guide the needle to the target portion of the subject; and inserting the needle into the target portion of the subject and extracting a sample.

[0170] Example 21 The method of Example 20, wherein continuously acquired live magnetic resonance images are displayed within a graphical user interface (GUI) that includes functional buttons for control during needle insertion.

[0171] Example 22 22. The method of any one of Examples 20 and 21, wherein the continuously acquired live magnetic resonance images include a high-resolution image portion near the needle and a low-resolution image portion farther from the needle.

[0172] Example 23 23. The method of any one of Examples 20, 21, and 22, further comprising automatically correcting continuously acquired live magnetic resonance images to compensate for blurring due to movement during needle insertion.

[0173] Example 24 24. The method of example 23, further comprising automatically correcting the needle trajectory during insertion based on the corrected acquired live magnetic resonance image.

[0174] Example 25 24. The method of example 23, further comprising overriding an existing guidance trajectory to manually correct for motion blur.

[0175] Example 26 The method of any one of Examples 20, 21, 22, 23, 24, and 25, further comprising manually advancing the robotic arm by controlling the GUI using touch input, mouse input, or joystick input.

[0176] Example 27 The method of any one of Examples 20, 21, 22, 23, 24, 25, and 26, further comprising performing automatic segmentation to capture the needle position, removing the needle, and advancing the needle to the next target position.

[0177] Example 28 The method of any one of Examples 20, 21, 22, 23, 24, 25, 26, and 27, wherein the extracted specimen is examined with a medical procedure from the list consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, cerebral stenting, and intensity-modulated radiation therapy guidance.

[0178] Example 29 30. The method of any one of Examples 20, 21, 22, 23, 24, 25, 26, 27, and 28, wherein the guiding further comprises guiding the needle through a hole in the center of a magnetic imaging device configured to continuously acquire magnetic resonance images.

[0179] Example 30 1. A method of using a guidance system, the method comprising: acquiring live magnetic resonance images of a subject; continuously identifying a target portion of the subject within the live magnetic resonance images; guiding an end effector attached to a mechanical arm toward the identified target portion of the subject, the end effector carrying a plurality of needles; and inserting the plurality of needles one at a time into the target portion of the subject and extracting a plurality of samples from the target portion of the subject.

[0180] Example 31 The method of Example 30, wherein the acquired live magnetic resonance images are displayed within a graphical user interface (GUI) that includes functional buttons for control during multiple needle insertion.

[0181] Example 32 The method of any one of Examples 30 and 31, wherein the acquired live magnetic resonance image includes a high-resolution image portion near the insertion needle and a low-resolution image portion far from the insertion needle.

[0182] Example 33 The method of any one of Examples 30, 31, and 32, further comprising automatically correcting the acquired live magnetic resonance images to correct for blurring due to movement during insertion of multiple needles.

[0183] Example 34 34. The method of example 33, further comprising automatically correcting the trajectory of the inserted needle during insertion based on the corrected acquired live magnetic resonance image.

[0184] Example 35 The method of any one of Examples 30, 31, 32, 33, and 34, further comprising overriding an existing guidance trajectory to manually correct for motion blur.

[0185] Example 36 The method of any one of Examples 30, 31, 32, 33, 34, and 35, further comprising manually advancing the mechanical arm by controlling the GUI using touch input, mouse input, or joystick input.

[0186] Example 37 The method of any one of Examples 30, 31, 32, 33, 34, 35, and 36, comprising performing automatic segmentation to capture the location of the inserted needle, removing the inserted needle, and inserting an additional needle at the next location.

[0187] Example 38 38. The method of any one of Examples 30, 31, 32, 33, 34, 35, 36, and 37, wherein the extracted specimen is examined with one or more medical procedures from the list consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, cerebral stenting, and intensity modulated radiation therapy guidance.

[0188] Example 39 The method of any one of Examples 30, 31, 32, 33, 34, 35, 36, 37, and 38, wherein guiding an end effector attached to the mechanical arm toward the identified target portion of the subject includes guiding it through a central hole in a single-sided magnetic imaging device configured to continuously acquire magnetic resonance images.

[0189] Example 40 1. A guided robotic system comprising: an imaging device for real-time imaging of a subject; a computer system for analyzing the images in real time; and a robotic arm configured to guide the robotic arm during a surgical procedure based on the real-time analysis of the images, the robotic arm including a proximal end and a distal end configured to hold a robotic surgical tool, wherein the imaging device is located intermediate the proximal end of the robotic arm and the subject during the surgical procedure.

[0190] Example 41 The system of Example 40, wherein the distal end of the robotic arm is attached to a component configured for drug delivery.

[0191] Example 42 The system of any one of Examples 40 and 41, wherein the distal end of the robotic arm is configured to insert a needle into the object to extract a sample.

[0192] Example 43 The system of any one of Examples 40, 41, and 42, wherein the robotic arm is configured to place a stent in the subject.

[0193] Example 44 The system of any one of Examples 40, 41, 42, and 43, wherein the robotic arm is attached to a needle configured to remove a sample from a subject.

[0194] Example 45 The system of any one of Examples 40, 41, 42, 43, and 44, wherein the robotic arm is attached to the ablation tool.

[0195] Example 46 The system of any one of Examples 40, 41, 42, 43, 44, and 45, wherein the distal end of the robotic arm is attached to an end effector containing multiple needles.

[0196] Example 47 The system of any one of Examples 40, 41, 42, 43, 44, 45, and 46, wherein the distal end of the robotic arm is attached to an end effector configured to deliver one or more stents.

[0197] Example 48 The system of any one of Examples 40, 41, 42, 43, 44, 45, 46, and 47, wherein the distal end of the robotic arm is attached to an end effector configured to transport one or more brachytherapy seeds.

[0198] Example 49 49. The system of any one of Examples 40, 41, 42, 43, 44, 45, 46, 47, and 48, wherein the robotic arm is configured to extract a specimen for examination in a medical procedure from a list of medical procedures consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stent insertion, cerebral stent insertion, and intensity modulated radiation therapy guidance.

[0199] Example 50 The system of any one of Examples 40, 41, 42, 43, 44, 45, 46, 47, 48, and 49, wherein the robotic arm is configured to extend through a hole in the imaging device to position a distal end of the robotic arm proximate to the subject.

[0200] Example 51 Any one of the systems of Examples 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, and 50, wherein the robotic arm includes a motor and the imaging device includes an active noise cancellation module configured to detect noise generated by the motor and remove the detected noise from the acquired signal.

[0201] Example 52 52. The system of any one of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, and 51, wherein the imaging device is a single-sided magnetic resonance imaging device having a hole in its center.

[0202] While several embodiments have been illustrated and described, it is not the intention of the applicant to restrict or limit the scope of the appended claims to such details. Numerous modifications, variations, changes, substitutions, combinations, and equivalents to these embodiments may be implemented and will occur to those skilled in the art without departing from the scope of the present disclosure. Furthermore, the structure of each element associated with the described embodiments may alternatively be described as a means for providing the function performed by the element. Also, where materials are disclosed for particular components, other materials may be used. It should therefore be understood that the foregoing description and the appended claims are intended to cover all such modifications, combinations, and variations that are within the scope of the disclosed embodiments. The appended claims are intended to cover all such modifications, variations, changes, substitutions, alterations, and equivalents.

[0203] The foregoing detailed description describes various forms of apparatus and / or processes through the use of block diagrams, flowcharts, and / or examples. To the extent that such block diagrams, flowcharts, and / or examples include one or more functions and / or operations, it will be understood by those skilled in the art that each function and / or operation within such block diagrams, flowcharts, and / or examples, individually and / or collectively, can be implemented by a wide range of hardware, software, firmware, or substantially any combination. Those skilled in the art will recognize that some aspects of the embodiments disclosed herein may equivalently be implemented, in whole or in part, as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or as substantially any combination thereof, in integrated circuits, and that designing circuitry and / or writing software and / or firmware code is within the skill of those skilled in the art in light of this disclosure. Furthermore, those skilled in the art will understand that the mechanisms of the subject matter described herein can be distributed as one or more program products in a variety of forms, and that the exemplary forms of the subject matter described herein apply regardless of the particular type of signal-transport medium used to actually effect the distribution.

[0204] The instructions used to program logic to implement various disclosed aspects may be stored in memory within the system, such as dynamic random access memory (DRAM), cache, flash memory, or other storage device. Additionally, the instructions may be distributed over a network or via other computer-readable media. Thus, a machine-readable medium may include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), including, but not limited to, a floppy disk, an optical disk, a compact disk read-only memory (CD-ROM), a magneto-optical disk, a read-only memory (ROM), a random access memory (RAM), an erasable programmable read-only memory (EPROM), an electrically erasable programmable read-only memory (EEPROM), a magnetic or optical card, flash memory, or tangible machine-readable storage used in transmitting information over the Internet via an electrical, optical, acoustic, or other form of propagated signal (e.g., carrier wave, infrared signal, digital signal, etc.). Accordingly, non-transitory computer-readable media includes any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).

[0205] As used in any aspect of the present specification, the term "control circuitry" may refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor, including one or more individual instruction processing cores, processing units, processors, microcontrollers, microcontroller units, controllers, digital signal processors (DSPs), programmable logic devices (PLDs), programmable logic arrays (PLAs), or field programmable gate arrays (FPGAs)), state machine circuitry, firmware that stores instructions executed by programmable circuitry, and any combination thereof. Control circuitry may be embodied, collectively or individually, as circuitry that forms part of a larger system, e.g., an integrated circuit (IC), an application specific integrated circuit (ASIC), a system on a chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smartphone, etc. Thus, "control circuitry" as used herein includes, but is not limited to, electrical circuitry having at least one discrete electrical circuit, electrical circuitry having at least one integrated circuit, electrical circuitry having at least one application-specific integrated circuit, electrical circuitry forming a general-purpose computing device configured by a computer program (e.g., a general-purpose computer configured by a computer program to at least partially execute a process and / or a device described herein, or a microprocessor configured by a computer program to at least partially execute a process and / or a device described herein), electrical circuitry forming a memory device (e.g., in the form of random access memory), and / or electrical circuitry forming a communications device (e.g., a modem, a communications switch, an optoelectronic device). Those skilled in the art will recognize that the subject matter described herein can be implemented in an analog or digital fashion or some combination thereof.

[0206] As used in any aspect herein, the term "logic" may refer to an application, software, firmware, and / or circuitry configured to perform any of the foregoing operations. Software may be embodied as a software package, code, instructions, an instruction set, and / or data recorded on a non-transitory computer-readable storage medium. Firmware may be embodied as hard-coded (e.g., non-volatile) code, instructions, or an instruction set, and / or data within a memory device.

[0207] As used in any aspect of this specification, the terms "component," "system," "module," etc. may refer to a computer-related entity, i.e., either hardware, a combination of hardware and software, software, or software in execution.

[0208] As used in any aspect herein, an "algorithm" refers to a self-consistent sequence of steps leading to a desired result, where the "steps" refer to manipulations of physical quantities and / or logical states, although not necessarily in the form of electrical or magnetic signals capable of being stored, moved, combined, compared, and otherwise manipulated. These signals are commonly referred to as bits, values, elements, symbols, characters, terms, numbers, or the like. These and similar terms may be associated with the appropriate physical quantities or are merely convenient labels applied to these quantities and / or states.

[0209] The network may include a packet-switched network. The communication devices can communicate with each other using a selected packet-switched network communication protocol. An example of one communication protocol may include an Ethernet communication protocol, which may enable communication using the Transmission Control Protocol / Internet Protocol (TCP / IP). The Ethernet protocol may conform to or adapt to the Ethernet standard published by the Institute of Electrical and Electronics Engineers (IEEE), entitled "IEEE 802.3 Standard," published in December 2008, and / or later versions of this standard. Alternatively or additionally, the communication devices can communicate with each other using an X.25 communication protocol. The X.25 communication protocol may conform to or adapt to standards promulgated by the International Telecommunication Union Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, the communication devices can communicate with each other using a frame relay communication protocol. The frame relay communication protocol may conform to or adapt to standards promulgated by the Consultative Committee for International Telegraph and Telephone (CCITT) and / or the American National Standards Institute (ANSI). Alternatively or additionally, the transceivers may communicate with each other using an Asynchronous Transfer Mode (ATM) communication protocol. The ATM communication protocol may conform to or be compatible with the ATM standard published by the ATM Forum entitled "ATM-MPRS Network Interworking 2.0," published in August 2001, and / or later versions of this standard. Of course, different and / or later developed connection-oriented network communication protocols are also contemplated herein.

[0210] Unless otherwise specified as is apparent from the foregoing disclosure, discussions throughout the foregoing disclosure using terms such as "processing," "computing," "calculating," "determining," "displaying," and the like will be understood to refer to the operations and processes of a computer system or similar electronic computing device that manipulates and transforms data represented as physical (electronic) quantities in the registers and memory of the computer system into other data similarly represented as physical quantities in the memory or registers of the computer system, or other such information storage, transmission, or display device.

[0211] One or more components may be referred to herein as being "configured," "configurable," "operable," "adapted," "capable," "compatible," etc. Those skilled in the art will recognize that unless the context requires otherwise, "configured" may generally encompass active state components and / or inactive state components and / or standby state components.

[0212] The terms "proximal" and "distal" are used herein with reference to a clinician manipulating the handle portion or housing of a surgical instrument. The term "proximal" refers to the portion closest to the clinician and / or robotic arm, and the term "distal" refers to the portion located away from the clinician and / or robotic arm. It will be further understood that for convenience and clarity, spatial terms such as "vertical," "horizontal," "upper," and "lower" may be used herein with respect to the drawings. However, robotic surgical tools are used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

[0213] Those skilled in the art will generally understand that the terms used herein, and particularly in the appended claims (e.g., the body of the appended claims), are generally intended as "open" terms (e.g., the term "including" should be interpreted as "including but not limited to," the term "having" should be interpreted as "having at least," the term "includes" should be interpreted as "including but not limited to," etc.). It will be further understood by those skilled in the art that where a specific number of claim recitations are intended to be introduced, such intention will be explicitly stated in the claim, and that in the absence of such a statement, no such intention exists. For example, to aid in understanding, the following appended claims may include the use of the introductory phrases "at least one" and "one or more" to introduce claim recitations. However, the use of such phrases should not be construed as limiting a particular claim containing such an introduced claim recitation to claims containing only one such recitation, even if the same claim contains an introductory phrase such as "one or more" or "at least one" and an indefinite article such as "a" or "an" (e.g., "a" and / or "an" are normally interpreted to mean "at least one" or "one or more"). The same applies to the use of a particular article used to introduce a claim recitation.

[0214] Furthermore, even when a specific number of introduced claim recitations is explicitly recited, those skilled in the art will recognize that such recitation should generally be interpreted to mean at least the recited number (e.g., an explicit recitation of "two recitations" without other modifiers generally means at least two recitations, or more than two recitations. Furthermore, in examples using a convention similar to "at least one of A, B, and C, etc.", such a structure is generally intended in the sense that those skilled in the art would understand the convention (e.g., "a system having at least one of A, B, and C" includes, but is not limited to, A alone, B alone, C alone, a system having A and B together, a system having A and C together, and / or a system having A, B, and C together). In examples where a convention is used, such construction is generally intended in the sense that one of ordinary skill in the art would understand the convention (e.g., "a system having at least one of A, B, or C" includes, but is not limited to, A alone, B alone, C alone, a system having A and B together, a system having A and C together, and / or a system having A, B, and C together). Those of ordinary skill in the art will further understand that, whether in the description, claims, or drawings, typically disjunctive terms and / or phrases presenting two or more alternative terms, unless the context dictates otherwise, should be understood to contemplate the possibility of including one of the terms, either of the terms, or both terms. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "A and B."

[0215] With respect to the appended claims, those skilled in the art will understand that the actions recited therein may generally occur in any order. Also, while various operational flow diagrams are shown in sequences, it should be understood that various actions may occur in other orders than those depicted, or may occur simultaneously. Examples of such alternative orders include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplemental, simultaneous, reverse, or other variant orders, unless the context dictates otherwise. Furthermore, unless the context dictates otherwise, terms such as "responsive," "related," or other past tense adjectives are generally not intended to exclude such variants.

[0216] It should be noted that any reference to "one embodiment," "an embodiment," "an example," "one example," etc. means that a particular feature, structure, or characteristic described in connection with an embodiment is included in at least one embodiment. Thus, the appearances of the phrases "in one embodiment," "in an embodiment," "in an example," "in one example," and "in one example" in various places throughout this specification do not necessarily all refer to the same embodiment. Furthermore, particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments.

[0217] Any patent applications, patents, non-patent publications, or other disclosure materials referenced herein and / or listed in any application data sheet are incorporated herein by reference to the extent that they do not conflict with the materials incorporated herein. Accordingly, and to the extent necessary, the present disclosure as expressly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated herein by reference but that conflicts with existing definitions, statements, or other disclosure materials set forth herein is incorporated only to the extent that no conflict arises between the incorporated material and the existing disclosure materials.

[0218] In summary, numerous benefits are described that accrue from employing the concepts described herein. The foregoing description of one or more embodiments is presented for purposes of illustration and description. It is not intended to be exhaustive or limited to the precise forms disclosed. Modifications or variations are possible in light of the above teachings. The one or more embodiments have been selected and described in order to explain the principles and practical applications, thereby enabling those skilled in the art to utilize the various embodiments, with various modifications suitable for the particular use intended. The claims filed herein are intended to define the overall scope.

Claims

1. 1. A guided robot system, comprising: a magnetic imaging device for continuously acquiring magnetic resonance images of a subject; A robotic arm, a computer system for analyzing the magnetic resonance image and identifying the portion of the subject; A guided robotic system, wherein the magnetic resonance images are analyzed in real time to guide the robotic arm to the portion of the subject.

2. The system of claim 1 , wherein the robotic arm is attached to a component configured for drug delivery.

3. The system of claim 1 or 2, wherein the robotic arm is configured to insert a needle into the portion of the subject to extract a sample.

4. The system of any one of claims 1 to 3, wherein the robotic arm is configured to place a stent in the portion of the subject.

5. The system of any one of claims 1 to 4, wherein the robotic arm is configured to remove the identified portion by cutting the portion of the object.

6. 6. The system of any one of claims 1 to 5, wherein the robotic arm is configured to extract a specimen for examination in a medical procedure from a list of medical procedures consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, brain stenting, and intensity modulated radiation therapy guidance.

7. 1. A method of using a guided robotic system, comprising: acquiring a live magnetic resonance image of the subject; performing image analysis of the live magnetic resonance images to continuously identify target portions of the subject; automatically guiding a robotic arm toward an identified target portion of the subject based on the live magnetic resonance image; and and performing a treatment at the target portion of the subject.

8. 1. A guided robot system, comprising: an imaging device for real-time imaging of the object; a computer system for analyzing the images in real time; a robotic system including a robotic arm, the robotic system configured to guide the robotic arm during a surgical procedure based on real-time analysis of the image, the robotic arm comprising: a proximal end; a distal end configured to hold a robotic surgical tool; and A guided robotic system, wherein the imaging device is positioned intermediate the proximal end of the robotic arm and the subject during the surgical procedure.

9. The system of claim 8 , wherein the distal end of the robotic arm is attached to a component configured for drug delivery.

10. 10. The system of claim 8 or 9, wherein the distal end of the robotic arm is configured to insert a needle into the object to extract a sample.

11. The system of any one of claims 8 to 10, wherein the robotic arm is configured to place a stent in the subject.

12. The system of any one of claims 8 to 11, wherein the robotic arm is attached to a needle configured to remove a sample from the object.

13. The system of any one of claims 8 to 12, wherein the robotic arm is attached to an ablation tool.

14. The system of any one of claims 8 to 13, wherein the distal end of the robotic arm is attached to an end effector including a plurality of needles.

15. The system of any one of claims 8 to 14, wherein the distal end of the robotic arm is attached to an end effector configured to deliver one or more stents.

16. The system of any one of claims 8 to 15, wherein the distal end of the robotic arm is attached to an end effector configured to transfer one or more brachytherapy seeds.

17. 17. The system of any one of claims 8 to 16, wherein the robotic arm is configured to extract a specimen for examination in a medical procedure from a list of medical procedures consisting of transperineal biopsy, transperineal LDR brachytherapy, transperineal HDR brachytherapy, transperineal laser ablation, transperineal cryoablation, transrectal HIFU, breast biopsy, deep brain stimulation (DBS), brain biopsy, liver biopsy, kidney biopsy, lung biopsy, coronary stenting, brain stenting, and intensity modulated radiation therapy guidance.

18. The system of any one of claims 8 to 17, wherein the robotic arm is configured to extend through a hole in the imaging device to position the distal end of the robotic arm proximate to the subject.

19. the robot arm includes a motor, and the imaging device includes: detecting noise generated by the motor; A system according to any one of claims 8 to 18, comprising an active noise cancellation module configured to remove detected noise from the acquired signal.

20. The system of any one of claims 1 to 6, 8 to 19, wherein the imaging device is a single-sided magnetic resonance imaging device having a hole in its center.

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