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This thesis proposes a multidirectional methodological framework for a comprehensive ergonomic analysis and modelling of workflow for multi-modal vascular image-guided procedures (IGPs). Two approaches are employed to analyse the workflow: Discrete Event Simulation (DES) and purpose-oriented physical models. In contrast to previous studies, the proposed methodology looks in detail the actions carried out within the intervention rooms and the clinical experience during the procedures with three main objectives: to provide a deeper understanding of vascular procedures, to predict the impact of protocol modifications and to offer a framework to develop new image-guided protocols for the alternative use of Magnetic Resonance (MR) imaging in comparison with X-Ray Digital Subtraction Angiography (DSA). The methodological framework includes an assessment of commercial simulation software packages to evaluate their fitness to the specific requirements of this research. The novel methodology is applied to several cases studies of common vascular IGPs. In addition, a case of MR – guided focused ultrasound intervention demonstrates how it is possible to extend the framework to study non-vascular IGPs. The multi-disciplinary methodological framework described opens a new way to understand IGPs that could be used in prospective applications such as medical education and medical devices regulations.

Percutaneous needle placement, a minimally invasive procedure performed dozens of millions in the U.S. each year, relies on dedicated skill and long-term training due to difficult control of needle trajectory inside tissue and mental registration of images to locations inside the patient. Inaccurate needle placement may miss cancer tumors during diagnosis or eradicate healthy tissue during therapy. MRI provides ideal procedure guidance with the merit of excellent soft tissue contrast and volumetric imaging for high spatial resolution visualization of targets and surgical tool. However, manual insertion in the bore of an MRI scanner has awkward ergonomics due to difficult access to the patient, making both training and intervention even harder. To overcome the challenges related to MRI electromagnetic compatibility and mechanical constraints of the confined close-bore, a modular networked robotic system utilizing piezoelectric actuation for fully actuated prostate biopsy and brachytherapy is developed and evaluated with accuracy study. To enhance manipulation dexterity, two kinds of steerable continuum needle robots are developed. The asymmetric tip needle robot performs needle rotation and translation control to minimize tissue deformation, and increase steering dexterity to compensate placement error under continuous MRI guidance. The MRI-guided concentric tube robot is deployed to access delicate surgical sites that are traditionally inaccessible by straight and rigid surgical tools without relying on tissue reaction force. The master-slave teleoperation system with hybrid actuation is the first of its kind for prostate intervention with force feedback. The teleoperation controller provides the feel and functionality of manual needle insertion. Fabry- Perot interferometer based fiber optic force sensor is developed for the slave manipulator to measure needle insertion force and render proprioception feedback during teleoperation.