Looking Forward with Minimally Invasive Ultrasound

Minimally invasive procedures are increasingly replacing traditional open surgeries due to their shorter recovery time, reduced patient pain, reduced risk of infection and less trauma. However, since the physician has no direct view of the working field, visualization of these complex interventions is critical for success. Forward-looking (FL) ultrasound image guidance can aid minimally invasive procedures providing visual feedback of the working field, instrument location and treatment progress. Currently there are no clinically available devices that can provide minimally invasive 3D FL imaging. In this thesis we explored several innovative solutions towards miniaturized 3D FL imaging. We looked into methods to solve both hardware and image-related challenges resulting in mainly two approaches. The first approach consists in the realization of a complex multi-element transducer with an optimized design and an efficient interconnection and integration scheme. The second approach consists in the use of simple single-element transducers combined with steering catheters, optical shape sensing systems (OSS) and coding masks to achieve 3D FL imaging. The solutions presented in this thesis may lead to simple and versatile image guidance with steerable catheters that dynamically build up a volumetric image of the working field in real time. FL volumetric imaging could provide accurate representation of the anatomy and generate information regarding the location of therapeutic devices. This will aid the interventionalist to navigate towards the site of intervention while moving the instruments.

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