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2. Robotic Tissue Sampling for Safe Post-mortem Biopsy in Infectious Corpses

Author

Neidhardt, Maximilian, Gerlach, Stefan, Mieling, Robin, Laves, Max-Heinrich, Weiß, Thorben, Gromniak, Martin, Fitzek, Antonia, Möbius, Dustin, Kniep, Inga, Ron, Alexandra, Schädler, Julia, Heinemann, Axel, Püschel, Klaus, Ondruschka, Benjamin, and Schlaefer, Alexander

Subjects
Computer Science - Robotics, Electrical Engineering and Systems Science - Image and Video Processing, Quantitative Biology - Tissues and Organs
Abstract

In pathology and legal medicine, the histopathological and microbiological analysis of tissue samples from infected deceased is a valuable information for developing treatment strategies during a pandemic such as COVID-19. However, a conventional autopsy carries the risk of disease transmission and may be rejected by relatives. We propose minimally invasive biopsy with robot assistance under CT guidance to minimize the risk of disease transmission during tissue sampling and to improve accuracy. A flexible robotic system for biopsy sampling is presented, which is applied to human corpses placed inside protective body bags. An automatic planning and decision system estimates optimal insertion point. Heat maps projected onto the segmented skin visualize the distance and angle of insertions and estimate the minimum cost of a puncture while avoiding bone collisions. Further, we test multiple insertion paths concerning feasibility and collisions. A custom end effector is designed for inserting needles and extracting tissue samples under robotic guidance. Our robotic post-mortem biopsy (RPMB) system is evaluated in a study during the COVID-19 pandemic on 20 corpses and 10 tissue targets, 5 of them being infected with SARS-CoV-2. The mean planning time including robot path planning is (5.72+-1.67) s. Mean needle placement accuracy is (7.19+-4.22) mm.

Published
2022
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5. First report from the German COVID-19 autopsy registry

Author

Böcker, Jana, Schmidt, Jens, Tholen, Pauline, Majeed, Raphael, Wienströer, Jan, Weis, Joachim, Bremer, Juliane, Knüchel, Ruth, Breitbach, Anna, Cacchi, Claudio, Freeborn, Benita, Wucherpfennig, Sophie, Spring, Oliver, Braun, Georg, Römmele, Christoph, Märkl, Bruno, Claus, Rainer, Dhillon, Christine, Schaller, Tina, Sipos, Eva, Hirschbühl, Klaus, Wittmann, Michael, Kling, Elisabeth, Kröncke, Thomas, Heppner, Frank L., Meinhardt, Jenny, Radbruch, Helena, Streit, Simon, Horst, David, Elezkurtaj, Sefer, Quaas, Alexander, Göbel, Heike, Hansen, Torsten, Titze, Ulf, Lorenzen, Johann, Reuter, Thomas, Woloszyn, Jaroslaw, Baretton, Gustavo, Hilsenbeck, Julia, Meinhardt, Matthias, Pablik, Jessica, Sommer, Linna, Holotiuk, Olaf, Meinel, Meike, Mahlke, Nina, Esposito, Irene, Crudele, Graziano, Seidl, Maximilian, Amann, Kerstin U., Coras, Roland, Hartmann, Arndt, Eichhorn, Philip, Haller, Florian, Lange, Fabienne, Schmid, Kurt Werner, Ingenwerth, Marc, Rawitzer, Josefine, Theegarten, Dirk, Birngruber, Christoph G., Wild, Peter, Gradhand, Elise, Smith, Kevin, Werner, Martin, Schilling, Oliver, Acker, Till, Gattenlöhner, Stefan, Stadelmann, Christine, Metz, Imke, Franz, Jonas, Stork, Lidia, Thomas, Carolina, Zechel, Sabrina, Ströbel, Philipp, Wickenhauser, Claudia, Fathke, Christine, Harder, Anja, Ondruschka, Benjamin, Dietz, Eric, Edler, Carolin, Fitzek, Antonia, Fröb, Daniela, Heinemann, Axel, Heinrich, Fabian, Klein, Anke, Kniep, Inga, Lohner, Larissa, Möbius, Dustin, Püschel, Klaus, Schädler, Julia, Schröder, Ann-Sophie, Sperhake, Jan-Peter, Aepfelbacher, Martin, Fischer, Nicole, Lütgehetmann, Marc, Pfefferle, Susanne, Glatzel, Markus, Krasemann, Susanne, Matschke, Jakob, Jonigk, Danny, Werlein, Christopher, Schirmacher, Peter, Domke, Lisa Maria, Hartmann, Laura, Klein, Isabel Madeleine, Schwab, Constantin, Röcken, Christoph, Friemann, Johannes, Langer, Dorothea, Roth, Wilfried, Strobl, Stephanie, Rudelius, Martina, Stock, Konrad Friedrich, Weichert, Wilko, Delbridge, Claire, Kasajima, Atsuko, Kuhn, Peer-Hendrik, Slotta-Huspenina, Julia, Weirich, Gregor, Barth, Peter, Wardelmann, Eva, Evert, Katja, Büttner, Andreas, Manhart, Johannes, Nigbur, Stefan, Bittmann, Iris, Fend, Falko, Bösmüller, Hans, Granai, Massimo, Klingel, Karin, Warm, Verena, Steinestel, Konrad, Umathum, Vincent Gottfried, Rosenwald, Andreas, Kurz, Florian, Vogt, Niklas, von Stillfried, Saskia, Bülow, Roman David, Röhrig, Rainer, and Boor, Peter

Published
2022
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6. Needle insertion planning for obstacle avoidance in robotic biopsy

Author

Gerlach Stefan, Neidhardt Maximilian, Weiß Thorben, Laves Max-Heinrich, Stapper Carolin, Gromniak Martin, Kniep Inga, Möbius Dustin, Heinemann Axel, Ondruschka Benjamin, and Schlaefer Alexander

Subjects
robotics, biopsy, forensic medicine, needle placement, path planning, Medicine
Abstract

Understanding the underlying pathology in different tissues and organs is crucial when fighting pandemics like COVID-19. During conventional autopsy, large tissue sample sets of multiple organs can be collected from cadavers. However, direct contact with an infectious corpse is associated with the risk of disease transmission and relatives of the deceased might object to a conventional autopsy. To overcome these drawbacks, we consider minimally invasive autopsies with robotic needle placement as a practical alternative. One challenge in needle based biopsies is avoidance of dense obstacles, including bones or embedded medical devices such as pacemakers. We demonstrate an approach for automated planning and visualising suitable needle insertion points based on computed tomography (CT) scans.

Published
2021
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9. Prospective postmortem evaluation of 735 consecutive SARS-CoV-2-associated death cases

Author

Fitzek, Antonia, Schädler, Julia, Dietz, Eric, Ron, Alexandra, Gerling, Moritz, Kammal, Anna L., Lohner, Larissa, Falck, Carla, Möbius, Dustin, Goebels, Hanna, Gerberding, Anna-Lina, Schröder, Ann Sophie, Sperhake, Jan-Peter, Klein, Anke, Fröb, Daniela, Mushumba, Herbert, Wilmes, Sandra, Anders, Sven, Kniep, Inga, Heinrich, Fabian, Langenwalder, Felicia, Meißner, Kira, Lange, Philine, Zapf, Antonia, Püschel, Klaus, Heinemann, Axel, Glatzel, Markus, Matschke, Jakob, Aepfelbacher, Martin, Lütgehetmann, Marc, Steurer, Stefan, Thorns, Christoph, Edler, Carolin, and Ondruschka, Benjamin

Published
2021
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13. Needle insertion planning for obstacle avoidance in robotic biopsy

Author

Gerlach, Stefan, Neidhardt, Maximilian, Weiß, Thorben, Laves, Max-Heinrich, Stapper, Carolin, Gromniak, Martin, Kniep, Inga, Möbius, Dustin, Heinemann, Axel, Ondruschka, Benjamin, Schlaefer, Alexander, Gerlach, Stefan, Neidhardt, Maximilian, Weiß, Thorben, Laves, Max-Heinrich, Stapper, Carolin, Gromniak, Martin, Kniep, Inga, Möbius, Dustin, Heinemann, Axel, Ondruschka, Benjamin, and Schlaefer, Alexander

Abstract

Understanding the underlying pathology in different tissues and organs is crucial when fighting pandemics like COVID-19. During conventional autopsy, large tissue sample sets of multiple organs can be collected from cadavers. However, direct contact with an infectious corpse is associated with the risk of disease transmission and relatives of the deceased might object to a conventional autopsy. To overcome these drawbacks, we consider minimally invasive autopsies with robotic needle placement as a practical alternative. One challenge in needle based biopsies is avoidance of dense obstacles, including bones or embedded medical devices such as pacemakers. We demonstrate an approach for automated planning and visualising suitable needle insertion points based on computed tomography (CT) scans. Needle paths are modeled by a line between insertion and target point and needle insertion path occlusion from obstacles is determined by using central projections from the biopsy target to the surface of the skin. We project the maximum and minimum CT attenuation, insertion depth, and standard deviation of CT attenuation along the needle path and create two-dimensional intensity-maps projected on the skin. A cost function considering these metrics is introduced and minimized to find an optimal biopsy needle path. Furthermore, we disregard insertion points without sufficient room for needle placement. For visualisation, we display the color-coded cost function so that suitable points for needle insertion become visible. We evaluate our system on 10 post mortem CTs with six biopsy targets in abdomen and thorax annotated by medical experts. For all patients and targets an optimal insertion path is found. The mean distance to the target ranges from (49.9 ± 12.9)mm for the spleen to (90.1 ± 25.8)mm for the pancreas.

Published
2022

14. First report from the German COVID-19 autopsy registry

Author

von Stillfried, Saskia, primary, Bülow, Roman David, additional, Röhrig, Rainer, additional, Boor, Peter, additional, Böcker, Jana, additional, Schmidt, Jens, additional, Tholen, Pauline, additional, Majeed, Raphael, additional, Wienströer, Jan, additional, Weis, Joachim, additional, Bremer, Juliane, additional, Knüchel, Ruth, additional, Breitbach, Anna, additional, Cacchi, Claudio, additional, Freeborn, Benita, additional, Wucherpfennig, Sophie, additional, Spring, Oliver, additional, Braun, Georg, additional, Römmele, Christoph, additional, Märkl, Bruno, additional, Claus, Rainer, additional, Dhillon, Christine, additional, Schaller, Tina, additional, Sipos, Eva, additional, Hirschbühl, Klaus, additional, Wittmann, Michael, additional, Kling, Elisabeth, additional, Kröncke, Thomas, additional, Heppner, Frank L., additional, Meinhardt, Jenny, additional, Radbruch, Helena, additional, Streit, Simon, additional, Horst, David, additional, Elezkurtaj, Sefer, additional, Quaas, Alexander, additional, Göbel, Heike, additional, Hansen, Torsten, additional, Titze, Ulf, additional, Lorenzen, Johann, additional, Reuter, Thomas, additional, Woloszyn, Jaroslaw, additional, Baretton, Gustavo, additional, Hilsenbeck, Julia, additional, Meinhardt, Matthias, additional, Pablik, Jessica, additional, Sommer, Linna, additional, Holotiuk, Olaf, additional, Meinel, Meike, additional, Mahlke, Nina, additional, Esposito, Irene, additional, Crudele, Graziano, additional, Seidl, Maximilian, additional, Amann, Kerstin U., additional, Coras, Roland, additional, Hartmann, Arndt, additional, Eichhorn, Philip, additional, Haller, Florian, additional, Lange, Fabienne, additional, Schmid, Kurt Werner, additional, Ingenwerth, Marc, additional, Rawitzer, Josefine, additional, Theegarten, Dirk, additional, Birngruber, Christoph G., additional, Wild, Peter, additional, Gradhand, Elise, additional, Smith, Kevin, additional, Werner, Martin, additional, Schilling, Oliver, additional, Acker, Till, additional, Gattenlöhner, Stefan, additional, Stadelmann, Christine, additional, Metz, Imke, additional, Franz, Jonas, additional, Stork, Lidia, additional, Thomas, Carolina, additional, Zechel, Sabrina, additional, Ströbel, Philipp, additional, Wickenhauser, Claudia, additional, Fathke, Christine, additional, Harder, Anja, additional, Ondruschka, Benjamin, additional, Dietz, Eric, additional, Edler, Carolin, additional, Fitzek, Antonia, additional, Fröb, Daniela, additional, Heinemann, Axel, additional, Heinrich, Fabian, additional, Klein, Anke, additional, Kniep, Inga, additional, Lohner, Larissa, additional, Möbius, Dustin, additional, Püschel, Klaus, additional, Schädler, Julia, additional, Schröder, Ann-Sophie, additional, Sperhake, Jan-Peter, additional, Aepfelbacher, Martin, additional, Fischer, Nicole, additional, Lütgehetmann, Marc, additional, Pfefferle, Susanne, additional, Glatzel, Markus, additional, Krasemann, Susanne, additional, Matschke, Jakob, additional, Jonigk, Danny, additional, Werlein, Christopher, additional, Schirmacher, Peter, additional, Domke, Lisa Maria, additional, Hartmann, Laura, additional, Klein, Isabel Madeleine, additional, Schwab, Constantin, additional, Röcken, Christoph, additional, Friemann, Johannes, additional, Langer, Dorothea, additional, Roth, Wilfried, additional, Strobl, Stephanie, additional, Rudelius, Martina, additional, Stock, Konrad Friedrich, additional, Weichert, Wilko, additional, Delbridge, Claire, additional, Kasajima, Atsuko, additional, Kuhn, Peer-Hendrik, additional, Slotta-Huspenina, Julia, additional, Weirich, Gregor, additional, Barth, Peter, additional, Wardelmann, Eva, additional, Evert, Katja, additional, Büttner, Andreas, additional, Manhart, Johannes, additional, Nigbur, Stefan, additional, Bittmann, Iris, additional, Fend, Falko, additional, Bösmüller, Hans, additional, Granai, Massimo, additional, Klingel, Karin, additional, Warm, Verena, additional, Steinestel, Konrad, additional, Umathum, Vincent Gottfried, additional, Rosenwald, Andreas, additional, Kurz, Florian, additional, and Vogt, Niklas, additional

Published
2022
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15. Intracranial hemorrhage in COVID-19 patients during extracorporeal membrane oxygenation for acute respiratory failure : a nationwide register study report

Author

von Stillfried, Saskia, Bülow, Roman David, Wienströer, Jan, Pfefferle, Susanne, Glatzel, Markus, Krasemann, Susanne, Matschke, Jakob, Jonigk, Danny, Werlein, Christopher, Schirmacher, Peter, Domke, Lisa Maria, Hartmann, Laura, Klein, Isabel Madeleine, Weis, Joachim, Schwab, Constantin, Röcken, Christoph, Friemann, Johannes, Langer, Dorothea, Roth, Wilfried, Strobl, Stephanie, Rudelius, Martina, Stock, Konrad Friedrich, Weichert, Wilko, Delbridge, Claire, Bremer, Juliane, Kasajima, Atsuko, Kuhn, Peer-Hendrik, Slotta-Huspenina, Julia, Weirich, Gregor, Barth, Peter, Wardelmann, Eva, Schnepper, Alexander, Evert, Katja, Büttner, Andreas, Manhart, Johannes, Knüchel, R., Nigbur, Stefan, Bittmann, Iris, Fend, Falko, Bösmüller, Hans, Granai, Massimo, Klingel, Karin, Warm, Verena, Steinestel, Konrad, Umathum, Vincent Gottfried, Rosenwald, Andreas, Breitbach, Anna, Kurz, Florian, Vogt, Niklas, Cacchi, Claudio, Freeborn, Benita, Wucherpfennig, Sophie, Spring, Oliver, Braun, Georg, Röhrig, Rainer, Römmele, Christoph, Märkl, Bruno, Claus, Rainer, Dhillon, Christine, Schaller, Tina, Sipos, Eva, Hirschbühl, Klaus, Wittmann, Michael, Kling, Elisabeth, Kröncke, Thomas, Meybohm, Patrick, Heppner, Frank L., Meinhardt, Jenny, Radbruch, Helena, Streit, Simon, Horst, David, Elezkurtaj, Sefer, Quaas, Alexander, Göbel, Heike, Hansen, Torsten, Titze, Ulf, Boor, Peter, Lorenzen, Johann, Reuter, Thomas, Woloszyn, Jaroslaw, Baretton, Gustavo, Hilsenbeck, Julia, Meinhardt, Matthias, Pablik, Jessica, Sommer, Linna, Holotiuk, Olaf, Meinel, Meike, DeRegCOVID Collaborators, Mahlke, Nina, Esposito, Irene, Crudele, Graziano, Seidl, Maximilian, Amann, Kerstin U., Coras, Roland, Hartmann, Arndt, Eichhorn, Philip, Haller, Florian, Lange, Fabienne, Böcker, Jana, Schmid, Kurt Werner, Ingenwerth, Marc, Rawitzer, Josefine, Theegarten, Dirk, Birngruber, Christoph G., Wild, Peter, Gradhand, Elise, Smith, Kevin, Werner, Martin, Schilling, Oliver, Schmidt, Jens, Acker, Till, Gattenlöhner, Stefan, Stadelmann, Christine, Metz, Imke, Franz, Jonas, Stork, Lidia, Thomas, Carolina, Zechel, Sabrina, Ströbel, Philipp, Wickenhauser, Claudia, Tholen, Pauline, Fathke, Christine, Harder, Anja, Ondruschka, Benjamin, Dietz, Eric, Edler, Carolin, Fitzek, Antonia, Fröb, Daniela, Heinemann, Axel, Heinrich, Fabian, Klein, Anke, Majeed, Raphael, Kniep, Inga, Lohner, Larissa, Möbius, Dustin, Püschel, Klaus, Schädler, Julia, Schröder, Ann-Sophie, Sperhake, Jan-Peter, Aepfelbacher, Martin, Fischer, Nicole, and Lütgehetmann, Marc

Subjects
ddc:610
Published
2022
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19. Dying From Or With SARS-CoV-2 – Prospective Postmortem Evaluation of 735 Consecutive Death Cases –

Author

Fitzek, Antonia, primary, Schädler, Julia, additional, Dietz, Eric, additional, Ron, Alexandra, additional, Gerling, Moritz, additional, Kammal, Anna Lena, additional, Lohner, Larissa, additional, Falck, Carla, additional, Möbius, Dustin, additional, Goebels, Hanna, additional, Gerberding, Anna Lina, additional, Schröder, Ann Sophie, additional, Sperhake, Jan-Peter, additional, Klein, Anke, additional, Fröb, Daniela, additional, Mushumba, Herbert, additional, Wilmes, Sandra, additional, Anders, Sven, additional, Kniep, Inga, additional, Heinrich, Fabian, additional, Langenwalder, Felicitas, additional, Meißner, Kira, additional, Lange, Philine, additional, Zapf, Antonia, additional, Püschel, Klaus, additional, Heinemann, Axel, additional, Glatzel, Markus, additional, Matschke, Jakob, additional, Aepfelbacher, Martin, additional, Lütgehetmann, Marc, additional, Steurer, Stefan, additional, Torns, Christoph, additional, Edler, Carolin, additional, and Ondruschka, Benjamin, additional

Published
2021
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23. Subthalamic nucleus volumes are highly consistent but decrease age-dependently-a combined magnetic resonance imaging and stereology approach in humans

Author

Zwirner, Johann, primary, Möbius, Dustin, additional, Bechmann, Ingo, additional, Arendt, Thomas, additional, Hoffmann, Karl-Titus, additional, Jäger, Carsten, additional, Lobsien, Donald, additional, Möbius, Robert, additional, Planitzer, Uwe, additional, Winkler, Dirk, additional, Morawski, Markus, additional, and Hammer, Niels, additional

Published
2016
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