可操控的穿刺导引针让宫颈癌放疗更精准，减少创伤。
The OncoReach Stylet for Brachytherapy: Design Evaluation and Pilot Study
- 用肌腱驱动的可弯曲导引针，兼容标准针具。
- 实验显示能从中间入口到达侧边肿瘤靶点，提升路径灵活性。
- 适合需要微创精准放疗的临床医生和研发人员参考。
宫颈癌是女性全球癌症负担中的重要部分。间质性近距离放疗（ISBT）是治疗宫颈癌的标准手段，通常通过直形空心针将放射源插入肿瘤或其周围组织。然而，直针限制了手术路径只能为直线。本文提出一种名为OncoReach的便携式、肌腱驱动可操控导引针，适配15号和13号标准针。基于前期工作，我们评估了针管直径、球形关节数量与位置，包括不对称盘设计，以优化弯曲柔韧性并保持轴向刚度。自由空间实验量化了不同配置下的针尖偏移，两管柯瑟拉特杆模型对多数试验中针体中心线形状预测准确。最优配置被集成至可重复使用的手持原型中，支持手动操作。采用患者衍生的多组分子宫与盆腔模拟模型，由一名专家进行先导研究。结果表明，该导引针可实现从非侵入性中线入口到达侧向最远靶点的引导，凸显可操控导引针的重要性。
原文摘要 · Abstract (English)
Cervical cancer accounts for a significant portion of the global cancer burden among women. Interstitial brachytherapy (ISBT) is a standard procedure for treating cervical cancer; it involves placing a radioactive source through a straight hollow needle within or in close proximity to the tumor and surrounding tissue. However, the use of straight needles limits surgical planning to a linear needle path. We present the OncoReach stylet, a handheld, tendon-driven steerable stylet designed for compatibility with standard ISBT 15- and 13-gauge needles. Building upon our prior work, we evaluated design parameters like needle gauge, spherical joint count and spherical joint placement, including an asymmetric disk design to identify a configuration that maximizes bending compliance while retaining axial stiffness. Free space experiments quantified tip deflection across configurations, and a two-tube Cosserat rod model accurately predicted the centerline shape of the needle for most trials. The best performing configuration was integrated into a reusable handheld prototype that enables manual actuation. A patient-derived, multi-composite phantom model of the uterus and pelvis was developed to conduct a pilot study of the OncoReach steerable stylet with one expert user. Results showed the ability to steer from less-invasive, medial entry points to reach the lateral-most targets, underscoring the significance of steerable stylets.
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