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Orbach DB, Wilkins-Haug LE, Benson CB, Rangwala SD, Pak C, Saffarzadeh M, Weinstock P. Overcoming roadblocks in clinical innovation via high fidelity simulation: use of a phantom simulator to achieve FDA and IRB approval of a clinical trial of fetal embolization of vein of Galen malformations. J Neurointerv Surg 2023; 15:1218-1223. [PMID: 36690441 DOI: 10.1136/jnis-2022-019658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Vein of Galen malformation (VOGM) is a rare, life-threatening vascular malformation in neonates and is treated with embolization. However, even at the most experienced centers, patients face high mortality and morbidity. In utero treatment options have been limited by lack of animal models or simulations. OBJECTIVE To create a novel ultrasound phantom simulator for a preclinical feasibility study of in utero fetal intervention for VOGM. METHODS Novel phantoms were designed and built in two configurations of spherical and windsock shape from cryogel material to mimic the salient vasculature of the fetal VOGM, based on real-patient fetal MR imaging dimensions. Critical anatomy was realistically mimicked within this model and transtorcular ultrasound-guided coil deployment was simulated. Each phantom model was assessed before and after treatment to evaluate coil mass deposition within the target. RESULTS The two phantoms underwent pretreatment T2-weighted MR imaging assessment, ultrasound-guided embolization, post-treatment MR and fluoroscopic imaging, and visual inspection of the sliced phantoms for target embolization verification. Postoperative MR scans confirmed realistic compact deposition of the coil masses within the central cavity. Phantom embolization results were submitted as part of the institutional review board and US Food and Drug Administration investigative device exemption approval for a first-in-humans clinical trial of fetal intervention for VOGM. CONCLUSIONS A phantom simulator for fetal intervention of VOGM produces lifelike results during trial interventions, removing obstacles to feasibility and safety evaluations, typically precluded by non-availability of appropriate animal models. The study provides a proof of concept for potentially wider applications of medical simulation to enable novel procedural advancements in neurointerventions.
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Affiliation(s)
- Darren B Orbach
- Department of Neurointerventional Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Louise E Wilkins-Haug
- Division of Maternal Fetal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Carol B Benson
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Shivani D Rangwala
- Department of Neurological Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Neurological Surgery, University of Southern California, Los Angeles, California, USA
| | - Christopher Pak
- Boston Children's Hospital Simulator Program (SIMPeds), Boston Children's Hospital, Boston, Massachusetts, USA
| | - Mona Saffarzadeh
- Boston Children's Hospital Simulator Program (SIMPeds), Boston Children's Hospital, Boston, Massachusetts, USA
| | - Peter Weinstock
- Department of Anesthesia, BCH Simulator Program, Boston Children's Hospital, Boston, Massachusetts, USA
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Dare N, Ramis M. Factors influencing duration of neonatal cranial ultrasound: A pilot study of retrospective data. SONOGRAPHY 2021. [DOI: 10.1002/sono.12297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Naomi Dare
- Mater Health, Raymond Terrace South Brisbane Queensland Australia
| | - Mary‐Anne Ramis
- Mater Health, Raymond Terrace South Brisbane Queensland Australia
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Prabhu SP. 3D Modeling and Advanced Visualization of the Pediatric Brain, Neck, and Spine. Magn Reson Imaging Clin N Am 2021; 29:655-666. [PMID: 34717852 DOI: 10.1016/j.mric.2021.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The ready availability of advanced visualization tools on picture archiving and communication systems workstations or even standard laptops through server-based or cloud-based solutions has enabled greater adoption of these techniques. We describe how radiologists can tailor imaging techniques for optimal 3D reconstructions provide a brief overview of the standard and newer "on-screen" techniques. We describe the process of creating 3D printed models for surgical simulation and education, with examples from the authors' institution and the existing literature. Finally, the review highlights current uses and potential future use cases for virtual reality and augmented reality applications in a pediatric neuroimaging setting.
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Affiliation(s)
- Sanjay P Prabhu
- Neuroradiology Division, Department of Radiology, Boston Children's Hospital, Harvard Medical School, SIMPeds3D Print, 300 Longwood Avenue, Boston, MA 02115, USA.
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4
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Joshi A, Bloom DA. See One, Sim Many, Do One, Teach One: Opportunities to Improve Resident Skills and Standardize Competencies in Radiology. Acad Radiol 2021; 28:868-870. [PMID: 33334654 DOI: 10.1016/j.acra.2020.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 10/22/2022]
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Gorelik N, Patil K, Chen SJS, Bhatnagar S, Faingold R. Impact of Simulation Training on Radiology Resident Performance in Neonatal Head Ultrasound. Acad Radiol 2021; 28:859-867. [PMID: 32768353 DOI: 10.1016/j.acra.2020.06.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 11/16/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to determine whether resident performance in head ultrasound on neonates improves following brain phantom simulation training. MATERIALS AND METHODS Ten junior radiology residents with at least one year of radiology training were divided into two equal groups. Both groups received a detailed head ultrasound protocol sheet and observed a technologist perform a head ultrasound on a neonatal patient at the beginning of their first pediatric radiology rotation. Both groups of residents also received teaching with a brain phantom model. Group A residents independently performed one head ultrasound exam, subsequently received phantom simulation training, and then performed a post-training head ultrasound exam. Group B residents received phantom simulation training prior to their first head ultrasound exam. Three pediatric radiologists independently and blindly reviewed the ultrasound images of each head ultrasound exam for proficiency of image acquisition using a validated scoring system. Scores of Group A residents prior to phantom training were compared to their scores after phantom training as well as to scores of Group B residents using simple linear regression. RESULTS There was a statistically significant improvement in the performance of head ultrasound on neonates when comparing the same residents pre- and postphantom training (p = 0.003). Residents who initially trained with the phantom performed significantly better on their first head ultrasound examination on a neonate than those residents who did not (p = 0.005). CONCLUSION Our novel head ultrasound phantom training model significantly improves radiology resident performance of head ultrasound on neonates and may, therefore, be beneficial for residency education.
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Affiliation(s)
- Natalia Gorelik
- Department of Diagnostic Radiology, McGill University Health Center, 1001 Decarie Blvd, Montreal, QC, Canada H4A 3J1.
| | - Kedar Patil
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Sean Jy-Shyang Chen
- McConnell Brain Imaging, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Sahir Bhatnagar
- Departments of Epidemiology, Biostatistics and Occupational Health, Diagnostic Radiology, McGill University, Montreal, QC, Canada
| | - Ricardo Faingold
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Prabhu SP, Breen MA. Challenges within our current education model and where to direct innovation: the three-strand triquetra approach. Pediatr Radiol 2021; 51:1097-1100. [PMID: 33245374 PMCID: PMC7692422 DOI: 10.1007/s00247-020-04911-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/01/2020] [Accepted: 11/09/2020] [Indexed: 11/20/2022]
Affiliation(s)
- Sanjay P. Prabhu
- grid.2515.30000 0004 0378 8438Department of Radiology, Boston Children’s Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA 02115 USA
| | - Micheál A. Breen
- grid.2515.30000 0004 0378 8438Department of Radiology, Boston Children’s Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA 02115 USA
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Gallagher P, Smith R, Sheppard G. Use of three-dimensional printing for simulation in ultrasound education: a scoping review. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 7:410-413. [DOI: 10.1136/bmjstel-2020-000663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/24/2020] [Accepted: 08/25/2020] [Indexed: 11/04/2022]
Abstract
BackgroundThere is a significant learning curve when teaching ultrasonography to medical trainees; task trainers can help learners to bridge this gap and develop their skills. Three-dimensional printing technology has the potential to be a great tool in the development of such simulators.
ObjectiveThis scoping review aimed to identify what 3D-printed models have been used in ultrasound education to date, how they were created and the pros and limitations involved.DesignResearchers searched three online databases to identify 3D-printed ultrasound models used in medical education.ResultsTwelve suitable publications were identified for inclusion in this review. The models from included articles simulated largely low frequency and/or high stakes events, with many models simulating needle guidance procedures. Most models were created by using patient imaging data and a computer-aided design software to print structures directly or print casting molds. The benefits of 3D-printed educational trainers are their low cost, reproducibility, patient specificity and accuracy. The current limitations of this technology are upfront investments and a lack of optimisation of materials.ConclusionsThe use of 3D-printed ultrasound task trainers is in its infancy, and more research is needed to determine whether or not this technology will benefit medical learners in the future.
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La Torre A, Visioli CB. Neonatal brain ultrasound training for beginners: Could a head phantom be useful? ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2020; 28:180-186. [PMID: 32831891 DOI: 10.1177/1742271x19894612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/21/2019] [Indexed: 11/16/2022]
Abstract
Background The traditional method of teaching the technique of neonatal brain ultrasonography is based upon the interaction between the practitioner and the neonate under the supervision of a tutor. This approach has disadvantages in that it may result in a longer imaging examination and the patient may become agitated. As demand for ultrasound services escalates and departments get busier, this often means that the trainee and supervisor are under pressure to work rapidly. Such environments are common but not conducive to the development of adequate skills and competencies. A neonatal head phantom used as part of a dedicated study day could help the beginner to learn basic elements of the ultrasound examination within a safe stress-free environment. It offers the opportunity to repeat the examination as often as the trainee wishes without time pressures and the distraction of a moving and potentially very sick baby. Aim The aim of this study is to evaluate the efficacy of a commercial phantom as a means for the practitioner to acquire the fundamental principles of neonatal brain ultrasound. Method A total of 17 participants attending a one day neonatal ultrasound course aimed at beginners were invited to complete a short two-part questionnaire that assessed their perceived improvement in scanning ability before and after using a commercially available head phantom. Results Of the 14 returned questionnaires, the overall perceived understanding, ability and confidence improved and anxiety levels about the procedure fell. The median pre-training score was 9.0 compared with the median post-training score of 12.0 (P = 0.005, Wilcoxon signed-rank test). At least 79% (up to 86%) of participants valued their experience with the phantom and would recommend the course to colleagues. Furthermore, about two-thirds reported that they would like to have additional practise with the phantom. Preliminary data from this study suggest that beginners found the head phantom useful for mastering some of the early skills required for neonatal brain ultrasound examinations, which in turn improved their confidence and reduced anxiety.
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Affiliation(s)
- Antonio La Torre
- Department of Neonatology, AOU Careggi Hospital, Florence, Italy
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Mackle EC, Shapey J, Maneas E, Saeed SR, Bradford R, Ourselin S, Vercauteren T, Desjardins AE. Patient-Specific Polyvinyl Alcohol Phantom Fabrication with Ultrasound and X-Ray Contrast for Brain Tumor Surgery Planning. J Vis Exp 2020. [PMID: 32744524 PMCID: PMC7610642 DOI: 10.3791/61344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Phantoms are essential tools for clinical training, surgical planning and the development of novel medical devices. However, it is challenging to create anatomically accurate head phantoms with realistic brain imaging properties because standard fabrication methods are not optimized to replicate any patient-specific anatomical detail and 3D printing materials are not optimized for imaging properties. In order to test and validate a novel navigation system for use during brain tumor surgery, an anatomically accurate phantom with realistic imaging and mechanical properties was required. Therefore, a phantom was developed using real patient data as input and 3D printing of molds to fabricate a patient-specific head phantom comprising the skull, brain and tumor with both ultrasound and X-ray contrast. The phantom also had mechanical properties that allowed the phantom tissue to be manipulated in a similar manner to how human brain tissue is handled during surgery. The phantom was successfully tested during a surgical simulation in a virtual operating room. The phantom fabrication method uses commercially available materials and is easy to reproduce. The 3D printing files can be readily shared, and the technique can be adapted to encompass many different types of tumor.
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Affiliation(s)
- Eleanor C Mackle
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London;
| | - Jonathan Shapey
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London; Department of Neurosurgery, National Hospital for Neurology and Neurosurgery; School of Biomedical Engineering & Imaging Sciences, King's College London
| | - Efthymios Maneas
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London
| | - Shakeel R Saeed
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery; The Ear Institute, University College London; The Royal National Throat, Nose and Ear Hospital, London
| | - Robert Bradford
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London
| | - Tom Vercauteren
- School of Biomedical Engineering & Imaging Sciences, King's College London
| | - Adrien E Desjardins
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London
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Mohammad K, Murthy P, Aguinaga F, Fajardo C, Eguiguren L, Castro Y, Guzman V, Scott JN, Chan S, Soraisham A, Stritzke A, Al Awad E, Kamaluddeen M, Thomas S. Simulation-Based Structured Education Supports Focused Neonatal Cranial Ultrasound Training. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1195-1201. [PMID: 31876319 DOI: 10.1002/jum.15207] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Brain injury in preterm neonates may cause clinical deterioration and requires timeous bedside diagnosis. Teaching cranial ultrasound (US) skills using fragile preterm neonates is challenging. The purpose of this study was to test the effectiveness and feasibility of using task-trainer computer-based simulators and US-suitable cranial phantoms in combination with teaching sessions in teaching novices to perform focused cranial US evaluations for identifying substantial intraventricular hemorrhage. METHODS This was a prospective interventional educational study targeting participants with no prior skills in neonatal cranial US. Participants attended a 2-day training workshop, with didactic and hands-on interactive sessions using computer-based and 3-dimensional printed phantom simulators. Participants then performed a cranial US scan on a healthy neonate to assess the diagnostic quality of the images acquired. Individual precourse and postcourse knowledge tests were compared. To test recall, participants also submitted US images acquired on neonates within 3 and 6 months of attending the course. RESULTS Forty-five participants completed the training modules. Mean knowledge scores increased significantly (in brain anatomy, brain physiology, intracranial disorders, and US physics domains). Thirty-eight cranial US scans were acquired during the course, 22 within 3 months after completion, and 34 within 6 months after completion. Thirty-two (84%) of the initial 38 case images, 17 (77%) of 22 images submitted within 3 months, and 32 (94%) of 34 images submitted within 6 months after course completion were of diagnostic quality. CONCLUSIONS A structured training module with didactic and hand-on training sessions using simulators and phantoms is feasible and supports training of clinicians to perform focused cranial US examinations.
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Affiliation(s)
- Khorshid Mohammad
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Prashanth Murthy
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Fernando Aguinaga
- Department of Pediatrics, Universidad San Francisco de Quito, Quito, Ecuador
| | - Carlos Fajardo
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Luis Eguiguren
- Department of Pediatrics, Universidad San Francisco de Quito, Quito, Ecuador
| | - Yessi Castro
- Department of Pediatrics, Universidad San Francisco de Quito, Quito, Ecuador
| | - Veronica Guzman
- Department of Pediatrics, Universidad San Francisco de Quito, Quito, Ecuador
| | - James N Scott
- Radiology, University of Calgary, Calgary, Alberta, Canada
- Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Sonny Chan
- Computer Science, University of Calgary, Calgary, Alberta, Canada
| | - Amuchou Soraisham
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Amelie Stritzke
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Essa Al Awad
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | | | - Sumesh Thomas
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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Bradley K, Quinton A, Aziz A. Determining if simulation is effective for training in ultrasound: A narrative review. SONOGRAPHY 2019. [DOI: 10.1002/sono.12208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Kate Bradley
- IRIS ImagingIntegrated Radiology and Imaging Services Brisbane Queensland Australia
- Nepean Clinical SchoolUniversity of Sydney Sydney New South Wales Australia
| | - Ann Quinton
- School of Health, Medical and Applied Sciences, Medical SonographyCQUniversity Sydney New South Wales Australia
- Nepean Clinical SchoolUniversity of Sydney Sydney New South Wales Australia
| | - Aamer Aziz
- School of Health, Medical and Applied Sciences, Medical SonographyCQUniversity Mackay Queensland Australia
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Elvira L, Durán C, Higuti RT, Tiago MM, Ibáñez A, Parrilla M, Valverde E, Jiménez J, Bassat Q. Development and Characterization of Medical Phantoms for Ultrasound Imaging Based on Customizable and Mouldable Polyvinyl Alcohol Cryogel-Based Materials and 3-D Printing: Application to High-Frequency Cranial Ultrasonography in Infants. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2226-2241. [PMID: 31128769 DOI: 10.1016/j.ultrasmedbio.2019.04.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/29/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
This work presents an affordable and easily customizable methodology for phantom manufacturing, which can be used to mimic different anatomic organs and structures. This methodology is based on the use of polyvinyl alcohol-based cryogels as a physical substitute for biologic soft tissues and of 3-D printed polymers for hard tissues, moulding and supporting elements. Thin and durable soft-tissue mimicking layers and multilayer arrangements can be obtained using these materials. Special attention was paid to the acoustic properties (sound speed, attenuation coefficient and mechanical impedance) of the materials developed to simulate soft tissues. These properties were characterized as a function of the additives concentration (propylene-glycol and alumina particles). The polyvinyl alcohol formulation proposed in this work is stable over several freeze-thaw cycles, allowing the manufacturing of multilayer materials with controlled properties. The manufacturing methodology presented was applied to the development of a phantom for high-frequency cranial ultrasonography in infants. This phantom was able to reproduce the main characteristics of the ultrasound images obtained in neonates through the anterior fontanel, down to 8-mm depth.
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Affiliation(s)
- Luis Elvira
- Instituto de Tecnologías Físicas y de la Información, CSIC, Madrid, Spain.
| | - Carmen Durán
- Instituto de Tecnologías Físicas y de la Información, CSIC, Madrid, Spain
| | - Ricardo T Higuti
- Univ Estadual Paulista, Campus of Ilha Solteira, Departament of Electrical Engineering, São Paulo, Brazil
| | - Marcelo M Tiago
- Federal University of Ouro Preto (UFOP), Department of Electrical Engineering, João Monlevade, Minas Gerais, Brazil
| | - Alberto Ibáñez
- Instituto de Tecnologías Físicas y de la Información, CSIC, Madrid, Spain
| | | | - Eva Valverde
- Unidad de Neonatología, Hospital La Paz, Madrid, Spain
| | - Javier Jiménez
- New Born Solutions, Barcelona Scientific Park, Barcelona, Spain
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; ICREA, Pg. Lluís Companys 23, Barcelona, Spain; Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain
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Gunabushanam G, Nautsch F, Mills I, Scoutt LM. Accessible Personal Ultrasound Training Simulator. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1425-1432. [PMID: 30208244 DOI: 10.1002/jum.14820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/11/2018] [Accepted: 08/14/2018] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Ultrasound simulators are increasingly used for teaching and training purposes, but development has been limited by the need for dedicated and often expensive hardware. The objective of this study was to develop and deploy an accessible and very low-cost personal ultrasound training simulator and obtain trainee feedback. METHODS An ultrasound simulator software program that uses a smartphone as a "mock-probe" and a laptop computer as a "mock ultrasound machine" was created. Spatial positional data is acquired from the smartphone's inbuilt accelerometer and gyroscope and transmitted to the laptop computer for processing and display of simulated ultrasound images in real time by the software program. After obtaining institutional review board approval and informed consent, all first-year radiology residents at our institution were provided access to the simulator program during the "bootcamp" introductory conference series, and a written survey was conducted to obtain feedback. RESULTS A personal ultrasound training simulator software program (Persimus) that reliably performs motion sensing along 2 axes and displays simulated ultrasound images was developed. Nine of 12 (75%) first-year residents at our institution participated in the written survey. Residents' scored values were 8.44 ± 1.33 and 8.44 ± 1.33 (mean + standard deviation) for perceived utility and overall impression and satisfaction, respectively, of the simulator on the Likert scale (1-10, with 10 being the highest score). CONCLUSION Personal ultrasound simulators are technically feasible. These are well received by first-year radiology residents and perceived as useful to their education.
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Affiliation(s)
- Gowthaman Gunabushanam
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Felix Nautsch
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ian Mills
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Leslie M Scoutt
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
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A New Paradigm in Cleft Lip Procedural Excellence: Creation and Preliminary Digital Validation of a Lifelike Simulator. Plast Reconstr Surg 2019; 142:1300-1304. [PMID: 30511984 DOI: 10.1097/prs.0000000000004924] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Simulation is becoming an increasingly important tool for hands-on surgical education in a no-risk environment. Cleft lip repair is a common procedure where precise technique is needed to achieve optimal outcome, making it an ideal candidate for simulation. A digital simulated patient with a typical unilateral complete cleft lip and alveolus was constructed using existing three-dimensional imaging studies. Key surface and internal anatomical elements were characterized in detail. A prototype high-fidelity simulator was constructed with silicone and synthetic polymers over a supportive scaffold, piloted by three surgeons using multiple techniques, and digitally compared to real patients. All surgeons completed key steps of a cleft lip repair on the simulator and found it approximated the haptics and anatomy of a cleft lip. Surface change and anthropometric movements accomplished on the simulator were similar for all three surgeons. In digital comparison to analogous real patient data, the simulator anthropometric movements and topographic change were similar to real nasolabial movement. A high-fidelity cleft lip simulator provides "on-demand" opportunity to realistically practice all steps of a cleft lip repair, with implications for overcoming volume-outcome relationship challenges of diminishing operative experience for resident surgeons.
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Pessin YJ, Tang-Simmons J. Sonography Simulators: Use and Opportunities in CAAHEP-Accredited Programs. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2018. [DOI: 10.1177/8756479318799347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Concern for patient safety and increased demands on health professionals have resulted in challenges for the clinical training of sonography students. The purpose of this study was to examine simulation use in Commission on Accreditation of Allied Health Education Programs (CAAHEP)–accredited sonography programs. A prospective cross-sectional study was conducted. Program directors were sent a survey that addressed the use of simulation and the perception of simulation’s educational value. Of the 230 sonography programs identified, 137 responded, for a response rate of 60%. Of the respondents, 75% indicated they used simulation and 89% reported that it was a good teaching tool. The programs indicated that 81% recorded a positive student experience using simulation. Simulation was rated most useful for improved anatomic identification (55%) and transducer manipulation (64%). Simulation is commonly used for educational training in CAAHEP-accredited sonography programs and is perceived as a positive tool to enhance education of students. More research is needed to establish best use and educational practice.
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Affiliation(s)
- Yosefa J. Pessin
- Department of Diagnostic Medical Imaging, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Jason Tang-Simmons
- Department of Diagnostic Medical Imaging, SUNY Downstate Medical Center, Brooklyn, NY, USA
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Grillo FW, Souza VH, Matsuda RH, Rondinoni C, Pavan TZ, Baffa O, Machado HR, Carneiro AAO. Patient-specific neurosurgical phantom: assessment of visual quality, accuracy, and scaling effects. 3D Print Med 2018; 4:3. [PMID: 29782617 PMCID: PMC5954795 DOI: 10.1186/s41205-018-0025-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/26/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Training in medical education depends on the availability of standardized materials that can reliably mimic the human anatomy and physiology. One alternative to using cadavers or animal bodies is to employ phantoms or mimicking devices. Styrene-ethylene/butylene-styrene (SEBS) gels are biologically inert and present tunable properties, including mechanical properties that resemble the soft tissue. Therefore, SEBS is an alternative to develop a patient-specific phantom, that provides real visual and morphological experience during simulation-based neurosurgical training. RESULTS A 3D model was reconstructed and printed based on patient-specific magnetic resonance images. The fused deposition of polyactic acid (PLA) filament and selective laser sintering of polyamid were used for 3D printing. Silicone and SEBS materials were employed to mimic soft tissues. A neuronavigation protocol was performed on the 3D-printed models scaled to three different sizes, 100%, 50%, and 25% of the original dimensions. A neurosurgery team (17 individuals) evaluated the phantom realism as "very good" and "perfect" in 49% and 31% of the cases, respectively, and rated phantom utility as "very good" and "perfect" in 61% and 32% of the cases, respectively. Models in original size (100%) and scaled to 50% provided a quantitative and realistic visual analysis of the patient's cortical anatomy without distortion. However, reduction to one quarter of the original size (25%) hindered visualization of surface details and identification of anatomical landmarks. CONCLUSIONS A patient-specific phantom was developed with anatomically and spatially accurate shapes, that can be used as an alternative for surgical planning. Printed models scaled to sizes that avoided quality loss might save time and reduce medical training costs.
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Affiliation(s)
- Felipe Wilker Grillo
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Victor Hugo Souza
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Renan Hiroshi Matsuda
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Carlo Rondinoni
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Theo Zeferino Pavan
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Oswaldo Baffa
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
| | - Helio Rubens Machado
- Department of Surgery and Anatomy, Faculty of Medicine at Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, Brazil
| | - Antonio Adilton Oliveira Carneiro
- Department of Physics, Faculty of Philosophy, Science and Letters at Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP 14040-901 Brazil
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