Assistive technology for ultrasound-guided central venous catheter placement

Identifying diversity of patient anatomy through automated image analysis of clinical ultrasounds

PURPOSE

Central venous catheterization (CVC) carries inherent risks which can be mitigated through the use of appropriate ultrasound-guidance during needle insertion. This study aims to comprehensively understand patient anatomy as it is visualized during CVC by employing a semi-automated image analysis method to track the internal jugular vein and carotid artery throughout recorded ultrasound videos.

METHODS

The ultrasound visualization of 50 CVC procedures were recorded at Penn State Health Milton S. Hershey Medical Center. The developed algorithm was used to detect the vessel edges, calculating metrics such as area, position, and eccentricity.

RESULTS

Results show typical anatomical variations of the vein and artery, with the artery being more circular and posterior to the vein in most cases. Notably, two cases revealed atypical artery positions, emphasizing the algorithm's precision in detecting anomalies. Additionally, dynamic vessel properties were analyzed, with the vein compressing on average to 13.4% of its original size and the artery expanding by 13.2%.

CONCLUSION

This study provides valuable insights which can be used to increase the accuracy of training simulations, thus enhancing medical education and procedural expertise. Furthermore, the novel approach of employing automated data analysis techniques to clinical recordings showcases the potential for continual assessment of patient anatomy, which could be useful in future advancements.

Integrating robot-assisted ultrasound tracking and 3D needle shape prediction for real-time tracking of the needle tip in needle steering procedures

BACKGROUND

Needle insertions have been used in several minimally invasive procedures for diagnostic and therapeutic purposes. Real-time position of the needle tip is an important information in needle steering systems.

METHODS

This work introduces a robot-assisted ultrasound tracking (R-AUST) system integrated with a needle shape prediction method to provide 3D position of the needle tip. The tracking system is evaluated in phantom and ex vivo beef liver tissues.

RESULTS

An average error of 0.60 mm was found for needle insertion tests inside the phantom tissue. The R-AUST integrated with shape prediction in the beef liver tissue was able to track the needle tip with an average and maximum error of 0.37 and 0.67 mm, respectively. The average error reported in this work is within the mean allowable needle placement error (<2.7 mm) in targeted procedures.

CONCLUSIONS

Integration of R-AUST tracking method with needle shape prediction results in a reasonably accurate real-time tracking suitable for ultrasound-guided needle insertions.