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INNOSC Theranostics and
Pharmacological Sciences Image-assisted personalized interventions

In addition to these distinctions, other applications 3.1. Closed-loop control of image-assisted robotics
can be identified. MRI is suitable for imaging entire body As mentioned earlier, for patient comfort and safety,
parts without constraints. Although MRI is universally therapy must be limited to the affected area during surgery
applicable, USI can serve as a replacement when or drug delivery. Such precision depends on the accuracy
appropriate for the object being examined. Moreover, of tool actuation and space localization. Accordingly,
USI offers good maneuverability and cost-effectiveness, the prerequisite for such high-performance topological
whereas MRI, although capable of producing high-quality tracking is image-supervised location identification. Such
images of soft tissues, is more complex and expensive. conditions require a collaborative organization working
Therefore, from the viewpoint of practical use, the choice
between the two scanners depends on the situation. USI autonomously, as demonstrated in a controlled drug
should be used whenever possible, whereas MRI should be release setting (Figure 1). This system includes the scanner,
reserved for imaging structures containing bone and/or air, tissue-affected area, drug delivery implant, control system,
3,4
such as the brain and certain other body parts. Typically, and drug supply.
clinical centers that perform MRI-guided procedures The accuracy involved in such a control process related
likely possess surgical imaging facilities, eliminating the to actuation and spatial localization would be influenced
need for scanner transport. In terms of cost, when patient by different disturbing factors, including the degree of
well-being is a consideration, MRI-guided interventions, complexity of the components of the combined procedure,
such as brain surgery, are the only nonionizing, minimally the associated detection uncertainties, and different
invasive treatment options. unanticipated external hazard incidents. Reliable control
In fact, MRI can provide high-level 3D images of the could be certified only after reducing these disturbing
object configuration, neighboring healthy tissues, and factors.
involved instruments; however, there are significant 3.1.1. Surgical interventions
challenges in its implementation to successfully guide the
intervention. These challenges include the use of three Image-assisted or laparoscopic intraoperative interventions
magnetic fields of different characters (magnitude and that meet safety requirements for imaging and interventional
frequency), presenting allergic responses to EM noise, and actions generally use MRI and USI scanners 3,4,6 or
imposing a restricted occupation zone inside the imaging laparoscopic strategies. However, in some cases, MRI
5
structure. The latter problem can be overcome using an open scanners are increasingly used in surgical interventions
scanner, although it involves tolerating the disadvantage increasingly, particularly for their superior ability to
of lower field intensity and therefore a slower process. differentiate tumors from normal tissues during surgeries
Nonetheless, MRI may be better than other scanners for and tumor extractions. 26-29 As mentioned earlier, MRI
several reasons. It has an incomparable contrast allowing is sensitive to EM noise; thus, all robotic materials
the visualization of tumors as well as other abnormalities inserted into the scaffold near body tissues must be MRI-
undetectable by other scanners. It has a true 3D imaging compatible (free of magnetic and conductive materials). In
capability, including multimodal detection, for example, such settings, an actuation action is necessary. Few high-
blood flow, temperature, and biomarker tracking. In these performance actuators are MRI-compatible. One possible
circumstances, the training of robotic assistance by an MRI class of actuation devices is piezoelectric actuators, which
can allow an excellent intervention. come in different categories. More information on their
structures, materials, fabrication, testing, and applications
3. Control and monitoring of image-guided is described elsewhere. 30-39 These devices must be tested
interventions to confirm their compliance, that is, to ensure that they
Intraoperative imaging strategies have created a need for do not disturb the field distribution produced by the
medical tools that address the requirements of different radiofrequency (RF) coil used for imaging. Such devices are
imaging techniques. Developments in image resolution and composed of piezoelectric materials, which are dielectrics
disconnection capabilities have enabled new interventions. and thin electrodes. Although dielectrics are not expected
3D imaging techniques provide realistic and detailed to disturb the field, conductive electrodes, even those of
views of living tissues; however, the tool must be activated minimal size, must be carefully tested and regulated.
within a specific area by locating the image coordinates. 3.1.2. Drug delivery interventions
Moreover, operative drug delivery procedures can deliver
drugs to the target site, maintaining therapeutic drug levels Conventional drug administration by intermittent oral
with minimal impact on surrounding healthy tissues. This or intravenous release can cause extraordinary blood
can be facilitated by drug-delivery implants. drug concentrations immediately after delivery, probably

Volume 8 Issue 1 (2025) 3 doi: 10.36922/itps.4567