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Space-age robot making cancer biopsies more accurate

Dr. Mehran Anvari and the Image Guided Automated Robot (IGAR)

Dr. Mehran Anvari and the Image Guided Automated Robot (IGAR)

Women from Ontario and Quebec will continue to be among the world’s first to have a breast biopsy taken by a robotic surgeon that can trace its technological pedigree to the Canadarm and International Space Station. The made-in-Canada technology promises to be less time consuming and more accurate than current manual procedures and can be operated by a radiologist remotely, ensuring equal access to surgical care across all of Canada.

The IGAR (Image Guided Automated Robotic) system passed its first safety trials with encouraging results: patients reported less pain and overall higher acceptance compared to a manual procedure. In 2015, IGAR will begin two-year Phase II clinical trials at St. Joseph’s Healthcare Hamilton and Hôpital du Saint-Sacrement in Quebec City.

“The initial pilot study showed that doing minimally-invasive biopsies from a distance is really feasible,” says Nathalie Duchesne, co-investigator on the clinical study and a breast radiologist at the Hôpital du Saint-Sacrement, CHU de Quebec. “At a time when we have a shortage of radiologists and when not all women have access to the expertise and to minimally-invasive technologies at their local hospital, it means you would only need a technologist at a remote location with an IGAR system that is guided by an expert- or sub-specialized radiologist (not a general radiologist) located at a different hospital. It would improve patient care and save money as well.”

Transforming space robotics into a medical platform technology has been the job of the Centre for Surgical Invention and Innovation (CSii) since its launch in 2009. The Hamilton-based CECR partnered early on with MacDonald Dettwiler and Associates Inc., makers of the Canadarm, to design and manufacture the system.

MDA’s goal is to take the sophisticated robotic capabilities it had developed for NASA’s Space Shuttle and International Space Station programs and adapt them for the healthcare market, particularly minimally invasive surgical procedures.

“Because of CSii’s strong links to McMaster University and hospitals in Hamilton and other cities, we were able to make strong connections very quickly with academic researchers and clinicians,” says Tim Fielding, Product Development Manager at MDA. “Those connections make it possible for everyone to share their ideas, their views on which research is relevant, what technology to develop and how to apply it.”

CSii has partnered with corporations that are among the world’s leaders in breast imaging and biopsy equipment. The aim is to manufacture a system that hospitals can buy for under $500,000, significantly less expensive than the commercial surgical robots on the market today which can cost over $1 million.

The IGAR-Breast robotic system is designed to work in combination with an MRI scanner, essential equipment for detecting suspicious breast lesions early. The radiologist uses specially designed imaging software to tag the potential target and tell IGAR what path to take. The software ensures that the radiologist—regardless of their experience—is able to hit the target every time with millimetre accuracy. Targeted biopsy retrieval will make the procedure more accurate, reduce errors and for women living outside major cities, allow treatment to begin sooner.

“When we inject an anesthetic into dense or fatty breasts, there’s resistance which can make the delivery of the anesthetic unequal,” says Dr. Duchesne. “That’s not an issue for IGAR which is like cruise control on your car. Whether the road is flat or up hill, a car will keep the same speed. Likewise, IGAR will maintain the same speed of injection which will result in a more comfortable procedure for the patient.”

IGAR’s biggest commercial strength is its multi-platform system, which can be adapted for many applications. Early detection of breast cancer is just the beginning. Early in 2014, CSii struck an agreement with California-based Sanarus Technologies to incorporate the California-based company’s cancer-killing cryoablation technology into IGAR.

CSii is also working with Toronto-based Health Technology Exchange to assess the commercial opportunities for IGAR globally, particularly in the United States, Europe and Asia.

“We see this area of medical imaging guidance as having a lot of potential for the future. It’s something we want to explore for a number of different clinical applications,” adds Fielding.