Magnetic resonance imaging (MRI) can provide high-quality 3-D visualization of target anatomy, surrounding tissue, and instrumentation, but there are significant challenges in harnessing it for effectively guiding interventional procedures. Challenges include the strong static magnetic field, rapidly switching magnetic field gradients, high-power radio frequency pulses, sensitivity to electrical noise, and constrained space to operate within the bore of the scanner. MRI has a number of advantages over other medical imaging modalities, including no ionizing radiation, excellent soft-tissue contrast that allows for visualization of tumors and other features that are not readily visible by other modalities, true 3-D imaging capabilities, including the ability to image arbitrary scan plane geometry or perform volumetric imaging, and capability for multimodality sensing, including diffusion, dynamic contrast, blood flow, blood oxygenation, temperature, and tracking of biomarkers. The use of robotic assistants within the MRI bore, alongside the patient during imaging, enables intraoperative MR imaging (iMRI) to guide a surgical intervention in a closed-loop fashion that can include tracking of tissue deformation and target motion, localization of instrumentation, and monitoring of therapy delivery. With the ever-expanding clinical use of MRI, MRI-compatible robotic systems have been heralded as a new approach to assist interventional procedures to allow physicians to treat patients more accurately and effectively. Deploying robotic systems inside the bore synergizes the visual capability of MRI and the manipulation capability of robotic assistance, resulting in a closed-loop surgery architecture. This article details the challenges and history of robotic systems intended to operate in an MRI environment and outlines promising clinical applications and associated state-of-the-art MRI-compatible robotic systems and technology for making this possible.

中文翻译：

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MRI 引导机器人辅助手术和干预的最新技术和未来机遇

磁共振成像 (MRI) 可以提供目标解剖结构、周围组织和仪器的高质量 3D 可视化，但利用它来有效指导介入手术存在重大挑战。挑战包括强静态磁场、快速切换磁场梯度、高功率射频脉冲、对电噪声的敏感性以及扫描仪孔内操作空间有限。与其他医学成像方式相比，MRI 具有许多优势，包括无电离辐射、出色的软组织对比度，可以可视化肿瘤和其他方式不易看到的其他特征、真正的 3D 成像功能，包括对任意扫描平面几何形状进行成像或执行体积成像，以及多模态传感能力，包括扩散、动态对比度、血流、血氧、温度和生物标记物跟踪。在 MRI 孔内使用机器人助手，在成像过程中与患者并肩工作，使得术中 MR 成像 (iMRI) 能够以闭环方式指导手术干预，其中包括跟踪组织变形和目标运动、器械定位以及手术干预。监测治疗实施。随着 MRI 的临床应用不断扩大，与 MRI 兼容的机器人系统被誉为一种辅助介入手术的新方法，使医生能够更准确、更有效地治疗患者。在钻孔内部署机器人系统可以协同 MRI 的视觉能力和机器人辅助的操纵能力，形成闭环手术架构。本文详细介绍了在 MRI 环境中运行的机器人系统面临的挑战和历史，并概述了有前途的临床应用以及相关的最先进的 MRI 兼容机器人系统和技术，使这成为可能。