Endoscopic OCT Guiding Percutaneous Nephrostomy
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Solution Overview
Problem
Current imaging modalities for percutaneous nephrostomy (PCN) needle placement in urological procedures suffer from inadequate spatial resolution, leading to high failure rates and complications such as bleeding and renal injury due to difficulty in accurately locating the needle tip position within the kidney, especially in non-dilated systems or complex stone diseases.
Innovation Solution
An endoscopic Optical Coherence Tomography (OCT) system integrated with neural networks is used to distinguish renal tissue types and blood vessels, providing real-time 3D imaging and automatic classification of renal cortex, medulla, and calyx, guiding precise needle placement and reducing the risk of vascular injury.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional imaging modalities (ultrasound, fluoroscopy, CT) are used for PCN needle placement guidance, then the procedure can be performed with standard equipment, but the spatial resolution is inadequate for accurately locating the needle tip position
Solution Approach 1:
The endoscope is inserted inside the PCN needle, creating a nested configuration where the imaging device resides within the needle structure. This allows the imaging system to travel with the needle to the target location, providing high-resolution imaging exactly where needed without requiring separate complex imaging equipment.
Solution Approach 2:
The patent replaces conventional mechanical imaging systems (ultrasound transducers, fluoroscopy equipment, CT scanners) with an optical imaging system based on Optical Coherence Tomography. OCT uses light interference principles to achieve micrometer-scale resolution, substituting mechanical scanning and large equipment with optical field-based imaging.
2Reliability
If multiple needle insertion attempts are performed to achieve correct PCN placement, then the likelihood of renal injury increases and operational time lengthens
Solution Approach 1:
The endoscopic OCT system performs preliminary imaging of the renal tissue ahead of the needle tip before the needle actually contacts or penetrates the target structure. This allows the operator to identify the optimal insertion path and confirm correct positioning in advance, ensuring first-attempt success and avoiding repeated insertions that would increase operational time and injury risk.
Solution Approach 2:
The real-time OCT imaging provides continuous visual feedback during needle insertion, allowing the operator to monitor needle position relative to renal structures and adjust the insertion path accordingly. This feedback loop enables precise positioning on the first attempt by showing the operator exactly where the needle tip is relative to blood vessels and collecting system structures.
3Object-affected harmful factors
If fluoroscopy is used for PCN guidance, then the procedure can be performed with standard equipment, but soft tissue contrast is insufficient to differentiate critical tissues such as blood vessels
Solution Approach 1:
The patent replaces fluoroscopy's X-ray-based imaging with Optical Coherence Tomography, which uses near-infrared light to image tissue. OCT provides inherent soft tissue contrast based on optical scattering properties, allowing differentiation of blood vessels, renal parenchyma, and collecting system structures without requiring contrast agents or relying on density differences that limit fluoroscopy.
Solution Approach 2:
The endoscope acts as an intermediary carrier that delivers the OCT imaging system directly to the needle tip location. This intermediary device enables high-resolution optical imaging within the confined space of the needle, providing detailed visualization of blood vessels and tissue structures that would be invisible to both fluoroscopy and external ultrasound.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The OCT system achieves an average classification accuracy of 82.6% for renal tissue types, significantly reducing the risk of complications by enabling precise needle placement and real-time detection of blood vessels, thereby improving the safety and efficiency of PCN procedures.
Implementation Method 1
OCT is a well-established, non-invasive biomedical imaging modality which can image subsurface tissue with the penetration depth of several millimeters. By obtaining and processing the coherent infrared light backscattered from the reference arm and sample arm, OCT can provide 2D cross-sectional images with high axial resolution ( ̃10 μm)
Implementation Method 2
a neural network classifier to distinguish types of renal tissue and other components. The types of renal tissue include the cortex, medulla, and calyx. Other components include blood vessels and diseased renal tissues
Data Source
AI summary
A method comprises obtaining an endoscope; obtaining a needle; inserting the endoscope into the needle to obtain a system; inserting the system into an animal body; and distinguishing components of the animal body using the endoscope and while the system remains in the animal body. A system comprises a needle; and an endoscope inserted into the needle and configured to: store a convolutional neural network (CNN); distinguish among a cortex of a kidney of an animal body, a medulla of the kidney, and a calyx of the kidney using the CNN; and distinguish between vascular tissue and non-vascular tissue in the animal body using the CNN.