The REBOT team is developing a robot-guided probe for controlled, minimally-invasive access to the deepest reaches of the lung. This will allow diagnosis and treatment of the most difficult-to-reach nodules, and could help improve outcomes for lung cancer. To complement conventional biopsy, REBOT will be equipped with optical probes for navigation and real-time ‘virtual’ biopsy of lung tissue, and be supported by an online planning, navigation and visualisation system.

REBOT is supported by EPSRC Grants EP/N019318/1 and EP/N019229/1.

 

Background

Lung cancer kills almost 1.6 million people worldwide each year, making it the most common cause of cancer death for both men and women. Improved outcomes are strongly associated with early diagnosis, but almost 75% of lung cancers are currently identified only at a late stage.

Close-up picture of one of the side-viewing probe prototype.

CT screening offers the best hope for early detection, allowing potentially cancerous nodules to be identified. A definitive diagnosis often then requires histological analysis of tissue excised from the site of the nodule. This is normally by trans-thoracic biopsy, in which a needle is inserted through the chest wall under CT guidance. This provides good diagnostic results, but is associated with complications, particularly pneumothoraces (collapsed lung).

Polar representation of an OCT image obtained with the side-viewing probe (tubular scattering phantom placed around the probe head).

More recently, technical advances have allowed biopsy to be performed through a bronchoscope, reducing the risk of complications and allowing the procedure to be performed during routine examination sessions. However, success is highly operator-dependent and for small remote nodules, the diagnostic rate (the yield) is poor. This is due to a number of factors, including the complexity of the bronchial tree, patient motion due to breathing, poor ergonomics, and the inability of bronchoscopes to provide access beyond fourth generation bronchial segments (the fourth level of ‘splitting’ in the bronchial tree). REBOT will address these challenge by providing robot guided imaging and intervention in the most distal regions of the lung.

Staff Involved

Principal Investigators: Prof Guang-Zhong Yang (Hamlyn Centre, Imperial College London), Prof Adrian Podoleanu (AOG).

Co-investigator, Clinical Lead:Dr Pallav Shah (National Heart and Lung Institute, Imperial College London).

Researcher Co-investigators: Dr Adrian Bradu (AOG), Dr Michael Hughes (AOG).

Research Associates:Dr Manuel J Marques (AOG), Dr Haojie Zhang (Hamlyn Centre, Imperial College London), Dr Anzhu Gao (Hamlyn Centre, Imperial College London).

Research Students: Ning Liu (The Hamlyn Centre, Imperial College London), Mali Shen (The Hamlyn Centre, Imperial College London).

Publications

Stemming directly from REBOT-related research: conference proceedings and presentations

 

Acknowledging support from REBOT: peer-reviewed publications

Acknowledging support from REBOT: conference proceedings

  • Cosmin Sinescu, Souman Barua, Florin Ionel Topala, Meda Lavinia Negrutiu, Virgil-Florin Duma, Alin Gabriel Gabor, Cristian Zaharia, Adrian Bradu, and Adrian Podoleanu , “Dental impression technique using optoelectronic devices,” Proc. SPIE 10591, 2nd Canterbury Conference on OCT with Emphasis on Broadband Optical Sources, 105910M (5 March 2018). KAR

Enabling work prior to the launch of REBOT