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Tanaka T, Imai R, Takeshima H. Split-based elevational localization of photoacoustic guidewire tip by 1D array probe using spatial impulse response. Phys Med Biol 2024; 69:065013. [PMID: 38344935 DOI: 10.1088/1361-6560/ad27fe] [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: 09/27/2023] [Accepted: 02/09/2024] [Indexed: 03/20/2024]
Abstract
Objective. Photoacoustic emitters on the tip of a therapeutic device have been intensively studied for echo-guided intervention purposes. In this study, a novel method for localizing the guidewire tip emitter in the elevation direction using a 1D array probe is proposed to resolve the issue of the tip potentially deviating from the ultrasound-imaged plane.Approach. Our method uses the 'interference split' that appears when the emitter is off-plane. Here, a point source from the emitter splits into two points in images. Based on the split, 'split-based elevation localization (SEL)' is introduced to estimate the absolute elevation position of the emitter. Additionally, 'Signed SEL' incorporates an asymmetric feature into the 1D probe to obtain the sign of the elevation localization. An attenuative coupler is attached to the half side of the probe to control the interference split. In SEL and Signed SEL, we propose a modeled split matching (MSM) algorithm to localize the tip position. MSM performs pattern matching of a measured split waveform with modeled split waveforms corresponding to all emitter positions in a region of interest. The modeled waveforms are precalculated using the spatial impulse response. The proposed method is numerically and experimentally validated.Main results. Numerical simulations for time-domain wave propagation clearly demonstrated the interference split phenomena. In the experimental validation with a vessel-mimicking phantom, the proposed methods successfully estimated the elevation positions,yb.SEL exhibited a root-mean-squared error (RMSE) of 2.0 mm for the range of 0 mm ≤yb≤ 30 mm, while Signed SEL estimated the absolute position with an RMSE of 2.4 mm and the sign with an accuracy of 80.8% for the range of -30 mm ≤yb≤ 30 mm.Significance.These results suggest that the proposed method could provide approximate tip positions and help sonographers track it by fanning the probe.
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Affiliation(s)
- Tomohiko Tanaka
- Innovative Technology Laboratory, FUJIFILM Healthcare Corporation, Tokyo, Japan
| | - Ryo Imai
- Research & Development Group, Hitachi, Ltd, Tokyo, Japan
| | - Hirozumi Takeshima
- Innovative Technology Laboratory, FUJIFILM Healthcare Corporation, Tokyo, Japan
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2
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Fusco P, Pascarella G, Stecco C, Blanco R, Forero M, Pawa A, Tulgar S, Strumia A, Remore LM, DE Cassai A, Colantonio LB, Del Buono R, Fattorini F, Sepolvere G, Tedesco M, Petroni GM, Ciaschi W, Crassiti M, Costa F. Factors to consider for fascial plane blocks' success in acute and chronic pain management. Minerva Anestesiol 2024; 90:87-97. [PMID: 38197590 DOI: 10.23736/s0375-9393.23.17866-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
The outcome of fascial plane blocks (FPBs) has a certain variability that may depend on many factors, which can be divided into three main categories: operator-related, patient-related and drug-related. Operator-related factors include personal skills, choice of needle and injection modalities. Patient variables include anthropometric features, the type of targeted fascia, anatomical variants, patient positioning, muscle tone and breathing. Ultimately, efficacy, onset, and duration of fascial blocks may be affected by characteristics of the injected solution, including the type of local anesthetic, volume, concentration, pH, temperature and the use of adjuvants. In this article, we investigated all the factors that may influence the outcome of FPBs from a generic perspective, without focusing on any specific technique. Also, we provided suggestions to optimize techniques for everyday practitioners and insights to researchers for future studies.
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Affiliation(s)
- Pierfrancesco Fusco
- Unit of Anesthesia and Intensive Care, SS Filippo e Nicola Hospital, Avezzano, L'Aquila, Italy
| | - Giuseppe Pascarella
- Unit of Anesthesia and Intensive Care, Campus Bio-Medico University Hospital, Rome, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, Padua, Italy
| | - Rafael Blanco
- Unit of Anesthesia and Intensive Care, King's College Hospital Dubai, Abu Dhabi, United Arab Emirates
| | - Mauricio Forero
- Faculty of Anesthesia and Pain Medicine, McMaster University, Hamilton, ON, Canada
| | - Amit Pawa
- Department of Anesthesia and Perioperative Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Serkan Tulgar
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Samsun Training and Research Hospital, Samsun University, Samsun, Türkiye
| | - Alessandro Strumia
- Unit of Anesthesia and Intensive Care, Campus Bio-Medico University Hospital, Rome, Italy
| | - Luigi M Remore
- Unit of Anesthesia and Intensive Care, Campus Bio-Medico University Hospital, Rome, Italy
| | - Alessandro DE Cassai
- Unit of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy
| | | | - Romualdo Del Buono
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy
| | | | - Giuseppe Sepolvere
- Intensive Care Unit, Department of Anesthesia and Cardiac Surgery, San Michele Hospital, Maddaloni, Caserta, Italy
| | - Mario Tedesco
- Department of Anesthesia, Intensive Care and Pain Therapy, Mater Day Hospital, Bari, Italy
| | - Gian M Petroni
- Unit of Anesthesia and Intensive Care, S. Maria Hospital, Terni, Italy -
| | - Walter Ciaschi
- Unit of Anesthesia and Intensive Care, F. Spaziani Hospital, Frosinone, Italy
| | - Massimiliano Crassiti
- Unit of Anesthesia and Intensive Care, Campus Bio-Medico University Hospital, Rome, Italy
| | - Fabio Costa
- Unit of Anesthesia and Intensive Care, Campus Bio-Medico University Hospital, Rome, Italy
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Malamal G, Schwab HM, Panicker MR. Enhanced Needle Visualization With Reflection Tuned Apodization Based on the Radon Transform for Ultrasound Imaging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:1482-1493. [PMID: 37721881 DOI: 10.1109/tuffc.2023.3316284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
In ultrasound (US)-guided interventions, accurately tracking and visualizing needles during in-plane insertions are significant challenges due to strong directional specular reflections. These reflections violate the geometrical delay and apodization estimations in the conventional delay and sum beamforming (DASB) degrading the visualization of needles. This study proposes a novel reflection tuned apodization (RTA) to address this issue and facilitate needle enhancement through DASB. The method leverages both temporal and angular information derived from the Radon transforms of the radio frequency (RF) data from plane-wave imaging to filter the specular reflections from the needle and their directivity. The directivity information is translated into apodization center maps through time-to-space mapping in the Radon domain, which is subsequently integrated into DASB. We assess the influence of needle angulations, projection angles in the Radon transform, needle gauge sizes, and the presence of multiple specular interfaces on the approach. The analysis shows that the method surpasses conventional DASB in enhancing the image quality of needle interfaces while preserving the diffuse scattering from the surrounding tissues without significant computational overhead. The work offers promising prospects for improved outcomes in US-guided interventions and better insights into characterizing US reflections with Radon transforms.
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Rahaman A, Tang Y, Gao S, Ma X, Sorokin I, Zhang HK. Needle Aligned Ultrasound Image-Guided Access Through Dual-Segment Array. IEEE Trans Biomed Eng 2023; 70:2645-2654. [PMID: 37030673 PMCID: PMC10590177 DOI: 10.1109/tbme.2023.3260735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Ultrasound (US) guided access for percutaneous nephrolithotomy (PCNL) is gaining popularity in the urology community as it reduces radiation risk. The most popular technique involves manual image-needle alignment. A misaligned needle however needs to be retracted and reinserted, resulting in a lengthened operation time and complications such as bleeding. These limitations can be mitigated through the co-registration between the US array and needle. The through-hole array concept provides the primary solution, including a hole at the center of the array. Because of the central opening, the image-needle alignment is achieved inherently. Previous literature has described applications that are limited to superficial and intravascular procedures, suggesting that developing a through-hole array for deeper target applications would be a new breakthrough. OBJECTIVE Here, we present a dual-segment array with a central opening. As the prototype development, two segments of 32-element arrays are combined with an open space of 10 mm in length in between them. METHOD We conducted phantom and ex-vivo studies considering the target depth of the 80-100 mm range. The image quality and needle visibility are evaluated by comparing the signal-to-noise ratio (SNR), full width at half maximum (FWHM), and contrast-to-noise ratio (CNR) results measured with a no-hole linear array under equivalent conditions. An ex-vivo study is performed using porcine kidneys with ceramic balls embedded to evaluate the needle access accuracy. RESULTS AND CONCLUSION The mean needle access error of 20 trials is found to be 2.94 ±1.09 mm, suggesting its potential impact on realizing a simple and intuitive deep US image-guided access.
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Brasileiro ACL, Silva AVCGE, Garcia AL, Furtado BRCDM, Araújo FAP, Diniz LN, Silva LCME, Lima LADC. Needle visualization during ultrasound-guided puncture: image optimization. J Vasc Bras 2023; 22:e20230038. [PMID: 37576736 PMCID: PMC10421575 DOI: 10.1590/1677-5449.202300382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/01/2023] [Indexed: 08/15/2023] Open
Abstract
Background Obtaining an adequate image of the needle by ultrasound reduces complications resulting from punctures, increasing patient safety and reducing hospitalization costs. Objectives To verify human perception in relation to number of pixels, while also identifying the best puncture angle and which needle should be used, and to evaluate whether there is a difference if needle visualization software is used. Methods 20 images were analyzed by 103 students who classified them as being sufficient or insufficient and were compared with the quality observed using photoshop. We evaluated whether there were differences between puncture angles of less than 45º and more than 45º, between IV catheter and introducer needles, and between images obtained with and without visualization software. Results There was a higher percentage of sufficient ratings for images those that had more than 60 pixels and when the puncture angle was less than 45º, with significant associations between students' evaluations and each of these groups (p < 0.001). The percentages of images classified as sufficient were higher for images in which a IV catheter was used and also higher for those using the needle visualization software, with significant associations between the results for students' classifications and each of these groups (p < 0.001). Conclusions The human eye classifies an image as sufficient according to higher numbers of pixels. Images of punctures at angles smaller than 45º in relation to the surface, of punctures performed with a IV catheter, and when using specific visualization software are also better detected by the human eye.
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6
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Malamal G, Panicker MR. On the physics of ultrasound transmission for in-plane needle tracking in guided interventions. Biomed Phys Eng Express 2023; 9. [PMID: 36898145 DOI: 10.1088/2057-1976/acc338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/10/2023] [Indexed: 03/12/2023]
Abstract
Objective.In ultrasound (US) guided interventions, the accurate visualization and tracking of needles is a critical challenge, particularly during in-plane insertions. An inaccurate identification and localization of needles lead to severe inadvertent complications and increased procedure times. This is due to the inherent specular reflections from the needle with directivity depending on the angle of incidence of the US beam, and the needle inclination.Approach.Though several methods have been proposed for improved needle visualization, a detailed study emphasizing the physics of specular reflections resulting from the interaction of transmitted US beam with the needle remains to be explored. In this work, we discuss the properties of specular reflections from planar and spherical wave US transmissions respectively through multi-angle plane wave (PW) and synthetic transmit aperture (STA) techniques for in-plane needle insertion angles between 15°-50°.Main Results.The qualitative and quantitative results from simulations and experiments reveal that the spherical waves enable better visualization and characterization of needles than planar wavefronts. The needle visibility in PW transmissions is severely degraded by the receive aperture weighting during image reconstruction than STA due to greater deviation in reflection directivity. It is also observed that the spherical wave characteristics starts to alter to planar characteristics due to wave divergence at large needle insertion depths.Significance.The study highlights that synergistic transmit-receive imaging schemes addressing the physical properties of reflections from the transmit wavefronts are imperative for the precise imaging of needle interfaces and hence have strong potential in elevating the quality of outcomes from US guided interventional practices.
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Affiliation(s)
- Gayathri Malamal
- Center for Computational Imaging, Dept. of Electrical Engineering, Indian Institute of Technology Palakkad, India
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7
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Baker C, Xochicale M, Lin FY, Mathews S, Joubert F, Shakir DI, Miles R, Mosse CA, Zhao T, Liang W, Kunpalin Y, Dromey B, Mistry T, Sebire NJ, Zhang E, Ourselin S, Beard PC, David AL, Desjardins AE, Vercauteren T, Xia W. Intraoperative Needle Tip Tracking with an Integrated Fibre-Optic Ultrasound Sensor. SENSORS (BASEL, SWITZERLAND) 2022; 22:9035. [PMID: 36501738 PMCID: PMC9739176 DOI: 10.3390/s22239035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
Ultrasound is an essential tool for guidance of many minimally-invasive surgical and interventional procedures, where accurate placement of the interventional device is critical to avoid adverse events. Needle insertion procedures for anaesthesia, fetal medicine and tumour biopsy are commonly ultrasound-guided, and misplacement of the needle may lead to complications such as nerve damage, organ injury or pregnancy loss. Clear visibility of the needle tip is therefore critical, but visibility is often precluded by tissue heterogeneities or specular reflections from the needle shaft. This paper presents the in vitro and ex vivo accuracy of a new, real-time, ultrasound needle tip tracking system for guidance of fetal interventions. A fibre-optic, Fabry-Pérot interferometer hydrophone is integrated into an intraoperative needle and used to localise the needle tip within a handheld ultrasound field. While previous, related work has been based on research ultrasound systems with bespoke transmission sequences, the new system-developed under the ISO 13485 Medical Devices quality standard-operates as an adjunct to a commercial ultrasound imaging system and therefore provides the image quality expected in the clinic, superimposing a cross-hair onto the ultrasound image at the needle tip position. Tracking accuracy was determined by translating the needle tip to 356 known positions in the ultrasound field of view in a tank of water, and by comparison to manual labelling of the the position of the needle in B-mode US images during an insertion into an ex vivo phantom. In water, the mean distance between tracked and true positions was 0.7 ± 0.4 mm with a mean repeatability of 0.3 ± 0.2 mm. In the tissue phantom, the mean distance between tracked and labelled positions was 1.1 ± 0.7 mm. Tracking performance was found to be independent of needle angle. The study demonstrates the performance and clinical compatibility of ultrasound needle tracking, an essential step towards a first-in-human study.
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Affiliation(s)
- Christian Baker
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Miguel Xochicale
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Fang-Yu Lin
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Sunish Mathews
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Francois Joubert
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Dzhoshkun I. Shakir
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Richard Miles
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Charles A. Mosse
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Tianrui Zhao
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Weidong Liang
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Yada Kunpalin
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 74 Huntley Street, London WC1E 6AU, UK
| | - Brian Dromey
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 74 Huntley Street, London WC1E 6AU, UK
| | - Talisa Mistry
- NIHR Great Ormond Street BRC and Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Neil J. Sebire
- NIHR Great Ormond Street BRC and Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Edward Zhang
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Paul C. Beard
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Anna L. David
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 74 Huntley Street, London WC1E 6AU, UK
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Wenfeng Xia
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
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Shi M, Bodian S, West SJ, Sathasivam S, Gordon RJ, Collier P, Vercauteren T, Desjardins AE, Noimark S, Xia W. Enhanced Photoacoustic Visualisation of Clinical Needles by Combining Interstitial and Extracorporeal Illumination of Elastomeric Nanocomposite Coatings. SENSORS (BASEL, SWITZERLAND) 2022; 22:6417. [PMID: 36080876 PMCID: PMC9460224 DOI: 10.3390/s22176417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Ultrasound (US) image guidance is widely used for minimally invasive procedures, but the invasive medical devices (such as metallic needles), especially their tips, can be poorly visualised in US images, leading to significant complications. Photoacoustic (PA) imaging is promising for visualising invasive devices and peripheral tissue targets. Light-emitting diodes (LEDs) acting as PA excitation sources facilitate the clinical translation of PA imaging, but the image quality is degraded due to the low pulse energy leading to insufficient contrast with needles at deep locations. In this paper, photoacoustic visualisation of clinical needles was enhanced by elastomeric nanocomposite coatings with superficial and interstitial illumination. Candle soot nanoparticle-polydimethylsiloxane (CSNP-PDMS) composites with high optical absorption and large thermal expansion coefficients were applied onto the needle exterior and the end-face of an optical fibre placed in the needle lumen. The excitation light was delivered at the surface by LED arrays and through the embedded optical fibre by a pulsed diode laser to improve the visibility of the needle tip. The performance was validated using an ex-vivo tissue model. An LED-based PA/US imaging system was used for imaging the needle out-of-plane and in-plane insertions over approach angles of 20 deg to 55 deg. The CSNP-PDMS composite conferred substantial visual enhancements on both the needle shaft and the tip, with an average of 1.7- and 1.6-fold improvements in signal-to-noise ratios (SNRs), respectively. With the extended light field involving extracorporeal and interstitial illumination and the highly absorbing coatings, enhanced visualisation of the needle shaft and needle tip was achieved with PA imaging, which could be helpful in current US-guided minimally invasive surgeries.
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Affiliation(s)
- Mengjie Shi
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Semyon Bodian
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Simeon J. West
- Department of Anaesthesia, University College Hospital, London NW1 2BU, UK
| | - Sanjayan Sathasivam
- Department of Chemistry, University College London, London WC1H 0AJ, UK or
- School of Engineering, London South Bank University, London SE1 0AA, UK
| | | | - Paul Collier
- Johnson Matthey Technology Centre, Reading RG4 9NH, UK
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Sacha Noimark
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Wenfeng Xia
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
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9
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Daoud MI, Abu-Hani AF, Shtaiyat A, Ali MZ, Alazrai R. Needle detection using ultrasound B-mode and power Doppler analyses. Med Phys 2022; 49:4999-5013. [PMID: 35608237 DOI: 10.1002/mp.15725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/31/2022] [Accepted: 04/13/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Ultrasound is employed in needle interventions to visualize the anatomical structures and track the needle. Nevertheless, needle detection in ultrasound images is a difficult task, specifically at steep insertion angles. PURPOSE A new method is presented to enable effective needle detection using ultrasound B-mode and power Doppler analyses. METHODS A small buzzer is used to excite the needle and an ultrasound system is utilized to acquire B-mode and power Doppler images for the needle. The B-mode and power Doppler images are processed using Radon transform and local phase analysis to initially detect the axis of the needle. The detection of the needle axis is improved by processing the power Doppler image using alpha shape analysis to define a region of interest (ROI) that contains the needle. Also, a set of feature maps are extracted from the ROI in the B-mode image. The feature maps are processed using a machine learning classifier to construct a likelihood image that visualizes the posterior needle likelihoods of the pixels. Radon transform is applied to the likelihood image to achieve an improved needle axis detection. Additionally, the region in the B-mode image surrounding the needle axis is analyzed to identify the needle tip using a custom-made probabilistic approach. Our method was utilized to detect needles inserted in ex vivo animal tissues at shallow [20° -40°), moderate [40° -60°), and steep [60° -85°] angles. RESULTS Our method detected the needles with failure rates equal to 0% and mean angle, axis, and tip errors less than or equal to 0.7°, 0.6 mm, and 0.7 mm, respectively. Additionally, our method achieved favorable results compared to two recently introduced needle detection methods. CONCLUSIONS The results indicate the potential of applying our method to achieve effective needle detection in ultrasound images. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Mohammad I Daoud
- Department of Computer Engineering, German Jordanian University, Amman, 11180, Jordan
| | - Ayah F Abu-Hani
- Department of Electrical and Computer Engineering, Technical University of Munich, Munich, 80333, Germany
| | - Ahmad Shtaiyat
- Department of Computer Engineering, German Jordanian University, Amman, 11180, Jordan
| | - Mostafa Z Ali
- Department of Computer Information Systems, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Rami Alazrai
- Department of Computer Engineering, German Jordanian University, Amman, 11180, Jordan
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10
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Zhang S, Liu T, Liu Y, Mei W. Effect of ultrasound angle for radial artery cannulation in adults: a randomized controlled trial. Minerva Anestesiol 2022; 88:230-237. [PMID: 35164488 DOI: 10.23736/s0375-9393.22.16090-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although the first attempt success rate of radial artery cannulation has been significantly improved by using dynamic needle tip positioning (DNTP) method, there are still problems with long cannulation time. We hereby observe the effect of ultrasound angle for radial artery cannulation in adult patients. METHODS Adult patients scheduled to undergo elective surgeries with continuous invasive blood pressure monitoring were included and randomly allocated into either a U-P-artery (ultrasound probe perpendicular to the artery) or U-P-needle (ultrasound probe perpendicular to the needle) group. The primary outcome measure was cannulation time at the first attempt, the secondary outcome measures included the first attempt success rate, number of attempts and the total puncture procedure duration. In addition, the incidence of complications was included as secondary outcomes. RESULTS Fifty-nine patients were evaluated finally. The cannulation time at the first attempt in U-P-needle group (N.=28) was significantly lower than that in U-P-artery group (N.=31; median [IQR]: 16 [13.5-20] seconds vs. 41 [25.5-54.5] seconds, P<0.001). The total puncture procedure duration in group U-P-needle was also shorter than that in the group U-P-artery (median [IQR]: 17.4 [13.5-20] seconds vs. 52.2 [25.5-54.5] seconds, P<0.001). No significant difference was observed with respect to first-attempt success rate (96.4% vs. 93.5%, relative risk: 0.97, 95% CI: 0.863-1.0907, P=0.615). The number of attempts showed no statistical difference as well. CONCLUSIONS The usage of the U-P-needle approach could remarkably reduce radial arterial cannulation time at the first attempt as well as total puncture procedure duration, comparing with the U-P-artery approach.
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Affiliation(s)
- Shuang Zhang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Tianzhu Liu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Liu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Mei
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China -
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Hovgesen CH, Wilhjelm JE, Vilmann P, Kalaitzakis E. Echogenic Surface Enhancements for Improving Needle Visualization in Ultrasound: A PRISMA Systematic Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:311-325. [PMID: 33870532 DOI: 10.1002/jum.15713] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 05/12/2023]
Abstract
Optimal visualization of needles in clinical ultrasound imaging is important and challenging, especially at steep angles. Improvement of visualization has been attempted with various techniques, for example, coatings and dimples. This systematic review summarizes enhancement techniques and identifies superior echogenic surface enhancements. Twenty-four papers were identified providing visibility measures for 33 different echogenic needles. These were grouped according to surface characteristics and ranked. Echogenic needles ranked higher than standard needles especially at steeper angles. Among the echogenic needles, coated needles were seemingly better visualized "in vivo" than noncoated needles, despite heterogeneity in study conditions. No unambiguous comparison revealed which needle was best visualized.
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Affiliation(s)
- Caroline Harder Hovgesen
- Biomedical Engineering, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Jens E Wilhjelm
- Biomedical Engineering, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Peter Vilmann
- Gastrounit, Herlev University Hospital, Herlev, Denmark
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12
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Sánchez-Margallo JA, Tas L, Moelker A, van den Dobbelsteen JJ, Sánchez-Margallo FM, Langø T, van Walsum T, van de Berg NJ. Block-matching-based registration to evaluate ultrasound visibility of percutaneous needles in liver-mimicking phantoms. Med Phys 2021; 48:7602-7612. [PMID: 34665885 PMCID: PMC9298012 DOI: 10.1002/mp.15305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To present a novel methodical approach to compare visibility of percutaneous needles in ultrasound images. Methods A motor‐driven rotation platform was used to gradually change the needle angle while capturing image data. Data analysis was automated using block‐matching‐based registration, with a tracking and refinement step. Every 25 frames, a Hough transform was used to improve needle alignments after large rotations. The method was demonstrated by comparing three commercial needles (14G radiofrequency ablation, RFA; 18G Trocar; 22G Chiba) and six prototype needles with different sizes, materials, and surface conditions (polished, sand‐blasted, and kerfed), within polyvinyl alcohol phantom tissue and ex vivo bovine liver models. For each needle and angle, a contrast‐to‐noise ratio (CNR) was determined to quantify visibility. CNR values are presented as a function of needle type and insertion angle. In addition, the normalized area under the (CNR‐angle) curve was used as a summary metric to compare needles. Results In phantom tissue, the first kerfed needle design had the largest normalized area of visibility and the polished 1 mm diameter stainless steel needle the smallest (0.704 ± 0.199 vs. 0.154 ± 0.027, p < 0.01). In the ex vivo model, the second kerfed needle design had the largest normalized area of visibility, and the sand‐blasted stainless steel needle the smallest (0.470 ± 0.190 vs. 0.127 ± 0.047, p < 0.001). As expected, the analysis showed needle visibility peaks at orthogonal insertion angles. For acute or obtuse angles, needle visibility was similar or reduced. Overall, the variability in needle visibility was considerably higher in livers. Conclusion The best overall visibility was found with kerfed needles and the commercial RFA needle. The presented methodical approach to quantify ultrasound visibility allows comparisons of (echogenic) needles, as well as other technological innovations aiming to improve ultrasound visibility of percutaneous needles, such as coatings, material treatments, and beam steering approaches.
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Affiliation(s)
- Juan A Sánchez-Margallo
- Bioengineering and Health Technologies Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Lisette Tas
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Adriaan Moelker
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | | | | | - Theo van Walsum
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Nick J van de Berg
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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13
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Jiang T, Zhu X, Jiao Y, Li X, Shen Z, Cui Y. Localization Accuracy of Ultrasound-Actuated Needle with Color Doppler Imaging. Diagnostics (Basel) 2020; 10:diagnostics10121020. [PMID: 33260712 PMCID: PMC7761225 DOI: 10.3390/diagnostics10121020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/13/2020] [Accepted: 11/24/2020] [Indexed: 11/30/2022] Open
Abstract
An ultrasonic needle-actuating device for tissue biopsy and regional anaesthesia offers enhanced needle visibility with color Doppler imaging. However, its specific performance is not yet fully determined. This work investigated the influence on needle visibility of the insertion angle and drive voltage, as well as determined the accuracy and agreement of needle tip localization by comparing color Doppler measurements with paired photographic and B-mode ultrasound measurements. Needle tip accuracy measurements in a gelatin phantom gave a regression trend, where the slope of trend is 0.8808; coefficient of determination (R2) is 0.8877; bias is −0.50 mm; and the 95% limits of agreement are from −1.31 to 0.31 mm when comparing color Doppler with photographic measurements. When comparing the color Doppler with B-mode ultrasound measurements, the slope of the regression trend is 1.0179; R2 is 0.9651; bias is −0.16 mm; and the 95% limits of agreement are from −1.935 to 1.605 mm. The results demonstrate the accuracy of this technique and its potential for application to biopsy and ultrasound guided regional anaesthesia.
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Affiliation(s)
- Tingyi Jiang
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215010, China; (X.Z.); (Y.J.); (X.L.); (Z.S.)
- Correspondence: (T.J.); (Y.C.)
| | - Xinle Zhu
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215010, China; (X.Z.); (Y.J.); (X.L.); (Z.S.)
| | - Yang Jiao
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215010, China; (X.Z.); (Y.J.); (X.L.); (Z.S.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xinze Li
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215010, China; (X.Z.); (Y.J.); (X.L.); (Z.S.)
| | - Zhitian Shen
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215010, China; (X.Z.); (Y.J.); (X.L.); (Z.S.)
- Department of Electronic Engineering and Information Science, University of Science and Technology of China, Hefei 230031, China
| | - Yaoyao Cui
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215010, China; (X.Z.); (Y.J.); (X.L.); (Z.S.)
- Correspondence: (T.J.); (Y.C.)
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14
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Beigi P, Salcudean SE, Ng GC, Rohling R. Enhancement of needle visualization and localization in ultrasound. Int J Comput Assist Radiol Surg 2020; 16:169-178. [PMID: 32995981 DOI: 10.1007/s11548-020-02227-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/06/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE This scoping review covers needle visualization and localization techniques in ultrasound, where localization-based approaches mostly aim to compute the needle shaft (and tip) location while potentially enhancing its visibility too. METHODS A literature review is conducted on the state-of-the-art techniques, which could be divided into five categories: (1) signal and image processing-based techniques to augment the needle, (2) modifications to the needle and insertion to help with needle-transducer alignment and visibility, (3) changes to ultrasound image formation, (4) motion-based analysis and (5) machine learning. RESULTS Advantages, limitations and challenges of representative examples in each of the categories are discussed. Evaluation techniques performed in ex vivo, phantom and in vivo studies are discussed and summarized. CONCLUSION Greatest limitation of the majority of the literature is that they rely on original visibility of the needle in the static image. Need for additional/improved apparatus is the greatest limitation toward clinical utility in practice. SIGNIFICANCE Ultrasound-guided needle placement is performed in many clinical applications, including biopsies, treatment injections and anesthesia. Despite the wide range and long history of this technique, an ongoing challenge is needle visibility in ultrasound. A robust technique to enhance ultrasonic needle visibility, especially for steeply inserted hand-held needles, and while maintaining clinical utility requirements is needed.
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Affiliation(s)
- Parmida Beigi
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada.
| | - Septimiu E Salcudean
- Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada
| | - Gary C Ng
- Philips Ultrasound, Bothell, WA, USA
| | - Robert Rohling
- Electrical and Computer Engineering Department and Mechanical Engineering Department, University of British Columbia, Vancouver, BC, Canada
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15
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Kim HJ, Chin KJ, Kim H, Jang HY, Bin SI, Ro YJ, Koh WU. Ultrasound-Guided Anterior Approach to a Sciatic Nerve Block: Influence of Lower Limb Positioning on the Visibility and Depth of the Sciatic Nerve. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1641-1647. [PMID: 32124994 DOI: 10.1002/jum.15258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/05/2020] [Accepted: 02/17/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES We aimed to identify the optimal lower limb position for an ultrasound (US)-guided anterior approach to a sciatic nerve block. METHODS We included 45 patients who met the following criteria: American Society of Anesthesiologists physical status of 1 to 3, age between 18 and 80 years, and scheduled to undergo knee surgery that required a sciatic nerve block. The lower limbs of each patient were placed in the following 4 positions: N, neutral; ER, external rotation of the hip (angle, 45°); ER/F15, ER (angle, 45°) and flexion (angle, 15°) of the hip; and ER/F45, ER (angle, 45°) and F (angle, 45°) of the hip. An investigator acquired US scans of the sciatic nerve in each position, and the visibility score and depth of the sciatic nerve from the skin were analyzed. RESULTS The visibility scores were significantly higher in positions ER/F15 and ER/F45 than in positions ER and N (P < .0001). However, there was no difference between the visibility scores in positions ER/F15 and ER/F45 (P = .0959). The depth of the sciatic nerve from the skin decreased with ER and an increase in the F angle of the hip (overall P < .0001). CONCLUSIONS Based on the visibility score and depth from the skin, ER of the hip to 45° with a greater F angle (45° versus 15°) of the hip appears to be the optimal position for an US-guided anterior approach to a sciatic nerve block.
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Affiliation(s)
- Ha-Jung Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Ki Jinn Chin
- Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Hyungtae Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Hwa-Young Jang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Seong-Il Bin
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Young-Jin Ro
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Won Uk Koh
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea
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16
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Lee MG, Choi SU, Lim JK, Lee MJ, Hong JS, Baek MO, Yoon SZ, Park HY, Shin HJ. Ultrasound-guided sciatic nerve block at the midthigh level in a porcine model: A descriptive study. Vet Med Sci 2020; 6:543-549. [PMID: 32281259 PMCID: PMC7397899 DOI: 10.1002/vms3.265] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/21/2020] [Accepted: 03/08/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVE There are a growing number of porcine models being used for orthopaedic experiments for human beings. Therefore, pain management of those research pigs using ultrasound (US)-guided nerve block can be usefully performed. The aim of this study is to determine optimal US approaches for accessing and localizing the sciatic nerve at the midthigh level, a relevant block site for hindlimb surgery in female Yorkshire pigs. METHODS As a first step, we dissected the intubated, blood-washed out pigs (n = 3) and confirmed the anatomical position of the sciatic nerve at midthigh level. After dissection, we found the sciatic nerve, connected with nerve stimulator, and checked the dorsiflexion or plantar flexion of the hindlimb. We matched the sciatic nerve location with the US image. After the pigs were euthanized, the neural structures of the sciatic nerve were confirmed by histological examination with H&E staining. In second step, a main US-guided sciatic nerve block study was done in the intubated, live pigs (n = 8) based on the above study. RESULTS In lateral position, the effective US-guided nerve block site was about 6 cm from the patella crease level; immediately proximal to the bifurcation of the sciatic nerve into the tibial nerve and common peroneal nerve. The distal femur was selected as the landmark. There were no vessels or other nerves surrounding the sciatic nerve. The needle-tip was positioned less than 1 cm lateral from the distal femur and about 2 cm deep to skin. 'Donut sign' in US images was confirmed in all 16 nerves. CONCLUSIONS Midthigh level sciatic nerve is located superficially, which enables nerve block to be easily performed using US. This is the first study to describe midthigh sciatic nerve block in the lateral position under US guidance in a porcine model from a clinical perspective.
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Affiliation(s)
- Mi Geum Lee
- Department of Anesthesiology and Pain medicine, Gachon University College of Medicine, Incheon, South Korea
| | - Sung Uk Choi
- Department of Anesthesiology and Pain medicine, Korea University College of Medicine, Seoul, South Korea
| | - Jae Kwan Lim
- Korea Artificial Organ Center, Korea University College of Medicine, Seoul, South Korea
| | - Mee Ju Lee
- Department of Anesthesiology and Pain medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ji Su Hong
- Department of Anesthesiology and Pain medicine, Korea University College of Medicine, Seoul, South Korea
| | - Mi Ok Baek
- Korea Artificial Organ Center, Korea University College of Medicine, Seoul, South Korea
| | - Seung Zhoo Yoon
- Department of Anesthesiology and Pain medicine, Korea University College of Medicine, Seoul, South Korea
| | - Hee Yeon Park
- Department of Anesthesiology and Pain medicine, Gachon University College of Medicine, Incheon, South Korea
| | - Hyeon Ju Shin
- Department of Anesthesiology and Pain medicine, Korea University College of Medicine, Seoul, South Korea
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17
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Daoud MI, Abu-Hani AF, Alazrai R. Reliable and accurate needle localization in curvilinear ultrasound images using signature-based analysis of ultrasound beamformed radio frequency signals. Med Phys 2020; 47:2356-2379. [PMID: 32160309 DOI: 10.1002/mp.14126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/30/2019] [Accepted: 02/21/2020] [Indexed: 01/26/2023] Open
Abstract
PURPOSE Ultrasound imaging is used in many minimally invasive needle insertion procedures to track the advancing needle, but localizing the needle in ultrasound images can be challenging, particularly at steep insertion angles. Previous methods have been introduced to localize the needle in ultrasound images, but the majority of these methods are based on ultrasound B-mode image analysis that is affected by the needle visibility. To address this limitation, we propose a two-phase, signature-based method to achieve reliable and accurate needle localization in curvilinear ultrasound images based on the beamformed radio frequency (RF) signals that are acquired using conventional ultrasound imaging systems. METHODS In the first phase of our proposed method, the beamformed RF signals are divided into overlapping segments and these segments are processed to extract needle-specific features to identify the needle echoes. The features are analyzed using a support vector machine classifier to synthesize a quantitative image that highlights the needle. The quantitative image is processed using the Radon transform to achieve a reliable and accurate signature-based estimation of the needle axis. In the second phase, the accuracy of the needle axis estimation is improved by processing the RF samples located around the signature-based estimation of the needle axis using local phase analysis combined with the Radon transform. Moreover, a probabilistic approach is employed to identify the needle tip. The proposed method is used to localize needles with two different sizes inserted in ex vivo animal tissue specimens at various insertion angles. RESULTS Our proposed method achieved reliable and accurate needle localization for an extended range of needle insertion angles with failure rates of 0% and mean angle, axis, and tip errors smaller than or equal to 0 . 7 ∘ , 0.6 mm, and 0.7 mm, respectively. Moreover, our proposed method outperformed a recently introduced needle localization method that is based on B-mode image analysis. CONCLUSIONS These results suggest the potential of employing our signature-based method to achieve reliable and accurate needle localization during ultrasound-guided needle insertion procedures.
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Affiliation(s)
- Mohammad I Daoud
- Department of Computer Engineering, German Jordanian University, Amman, 11180, Jordan
| | - Ayah F Abu-Hani
- Department of Computer Engineering, German Jordanian University, Amman, 11180, Jordan
| | - Rami Alazrai
- Department of Computer Engineering, German Jordanian University, Amman, 11180, Jordan
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18
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Daoud MI, Shtaiyat A, Zayadeen AR, Alazrai R. Accurate Needle Localization Using Two-Dimensional Power Doppler and B-Mode Ultrasound Image Analyses: A Feasibility Study. SENSORS (BASEL, SWITZERLAND) 2018; 18:E3475. [PMID: 30332743 PMCID: PMC6209937 DOI: 10.3390/s18103475] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/30/2018] [Accepted: 10/09/2018] [Indexed: 01/07/2023]
Abstract
Curvilinear ultrasound transducers are commonly used in various needle insertion interventions, but localizing the needle in curvilinear ultrasound images is usually challenging. In this paper, a new method is proposed to localize the needle in curvilinear ultrasound images by exciting the needle using a piezoelectric buzzer and imaging the excited needle using a curvilinear ultrasound transducer to acquire a power Doppler image and a B-mode image. The needle-induced Doppler responses that appear in the power Doppler image are analyzed to estimate the needle axis initially and identify the candidate regions that are expected to include the needle. The candidate needle regions in the B-mode image are analyzed to improve the localization of the needle axis. The needle tip is determined by analyzing the intensity variations of the power Doppler and B-mode images around the needle axis. The proposed method is employed to localize different needles that are inserted in three ex vivo animal tissue types at various insertion angles, and the results demonstrate the capability of the method to achieve automatic, reliable and accurate needle localization. Furthermore, the proposed method outperformed two existing needle localization methods.
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Affiliation(s)
- Mohammad I Daoud
- Department of Computer Engineering, German Jordanian University, Amman 11180, Jordan.
| | - Ahmad Shtaiyat
- Department of Computer Engineering, German Jordanian University, Amman 11180, Jordan.
| | - Adnan R Zayadeen
- Ultrasound Section, Jordanian Royal Medical Services, Amman 11180, Jordan.
| | - Rami Alazrai
- Department of Computer Engineering, German Jordanian University, Amman 11180, Jordan.
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Park BK. Ultrasound-guided genitourinary interventions: principles and techniques. Ultrasonography 2017; 36:336-348. [PMID: 28736429 PMCID: PMC5621800 DOI: 10.14366/usg.17026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 05/28/2017] [Accepted: 05/29/2017] [Indexed: 12/30/2022] Open
Abstract
Ultrasound (US) is often used to guide various interventional procedures in the genitourinary (GU) tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.
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Affiliation(s)
- Byung Kwan Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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20
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Rajasekaran S, Finnoff JT. The arcTOA Technique for Out-of-Plane Ultrasound-Guided Injections. PM R 2016; 8:713-5. [DOI: 10.1016/j.pmrj.2015.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/25/2015] [Indexed: 11/15/2022]
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Xia W, Ginsberg Y, West SJ, Nikitichev DI, Ourselin S, David AL, Desjardins AE. Coded excitation ultrasonic needle tracking: An in vivo study. Med Phys 2016; 43:4065. [PMID: 27370125 PMCID: PMC5207306 DOI: 10.1118/1.4953205] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 04/25/2016] [Accepted: 05/21/2016] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Accurate and efficient guidance of medical devices to procedural targets lies at the heart of interventional procedures. Ultrasound imaging is commonly used for device guidance, but determining the location of the device tip can be challenging. Various methods have been proposed to track medical devices during ultrasound-guided procedures, but widespread clinical adoption has remained elusive. With ultrasonic tracking, the location of a medical device is determined by ultrasonic communication between the ultrasound imaging probe and a transducer integrated into the medical device. The signal-to-noise ratio (SNR) of the transducer data is an important determinant of the depth in tissue at which tracking can be performed. In this paper, the authors present a new generation of ultrasonic tracking in which coded excitation is used to improve the SNR without spatial averaging. METHODS A fiber optic hydrophone was integrated into the cannula of a 20 gauge insertion needle. This transducer received transmissions from the ultrasound imaging probe, and the data were processed to obtain a tracking image of the needle tip. Excitation using Barker or Golay codes was performed to improve the SNR, and conventional bipolar excitation was performed for comparison. The performance of the coded excitation ultrasonic tracking system was evaluated in an in vivo ovine model with insertions to the brachial plexus and the uterine cavity. RESULTS Coded excitation significantly increased the SNRs of the tracking images, as compared with bipolar excitation. During an insertion to the brachial plexus, the SNR was increased by factors of 3.5 for Barker coding and 7.1 for Golay coding. During insertions into the uterine cavity, these factors ranged from 2.9 to 4.2 for Barker coding and 5.4 to 8.5 for Golay coding. The maximum SNR was 670, which was obtained with Golay coding during needle withdrawal from the brachial plexus. Range sidelobe artifacts were observed in tracking images obtained with Barker coded excitation, and they were visually absent with Golay coded excitation. The spatial tracking accuracy was unaffected by coded excitation. CONCLUSIONS Coded excitation is a viable method for improving the SNR in ultrasonic tracking without compromising spatial accuracy. This method provided SNR increases that are consistent with theoretical expectations, even in the presence of physiological motion. With the ultrasonic tracking system in this study, the SNR increases will have direct clinical implications in a broad range of interventional procedures by improving visibility of medical devices at large depths.
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Affiliation(s)
- Wenfeng Xia
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Yuval Ginsberg
- Institute for Women’s Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, United Kingdom
| | - Simeon J. West
- Department of Anaesthesia, University College Hospital, Main Theaters, Maple Bridge Link Corridor, Podium 3, 235 Euston Road, London NW1 2BU, United Kingdom
| | - Daniil I. Nikitichev
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Sebastien Ourselin
- Center for Medical Imaging Computing, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Anna L. David
- Institute for Women’s Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, United Kingdom
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
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22
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Xia W, Mari JM, West SJ. In-plane ultrasonic needle tracking using a fiber-optic hydrophone. Med Phys 2015; 42:5983-91. [PMID: 26429273 PMCID: PMC5207301 DOI: 10.1118/1.4931418] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 09/01/2015] [Accepted: 09/03/2015] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Accurate and efficient guidance of needles to procedural targets is critically important during percutaneous interventional procedures. Ultrasound imaging is widely used for real-time image guidance in a variety of clinical contexts, but with this modality, uncertainties about the location of the needle tip within the image plane lead to significant complications. Whilst several methods have been proposed to improve the visibility of the needle, achieving accuracy and compatibility with current clinical practice is an ongoing challenge. In this paper, the authors present a method for directly visualizing the needle tip using an integrated fiber-optic ultrasound receiver in conjunction with the imaging probe used to acquire B-mode ultrasound images. METHODS Needle visualization and ultrasound imaging were performed with a clinical ultrasound imaging system. A miniature fiber-optic ultrasound hydrophone was integrated into a 20 gauge injection needle tip to receive transmissions from individual transducer elements of the ultrasound imaging probe. The received signals were reconstructed to create an image of the needle tip. Ultrasound B-mode imaging was interleaved with needle tip imaging. A first set of measurements was acquired in water and tissue ex vivo with a wide range of insertion angles (15°-68°) to study the accuracy and sensitivity of the tracking method. A second set was acquired in an in vivo swine model, with needle insertions to the brachial plexus. A third set was acquired in an in vivo ovine model for fetal interventions, with insertions to different locations within the uterine cavity. Two linear ultrasound imaging probes were used: a 14-5 MHz probe for the first and second sets, and a 9-4 MHz probe for the third. RESULTS During insertions in tissue ex vivo and in vivo, the imaged needle tip had submillimeter axial and lateral dimensions. The signal-to-noise (SNR) of the needle tip was found to depend on the insertion angle. With the needle tip in water, the SNR of the needle tip varied with insertion angle, attaining values of 284 at 27° and 501 at 68°. In swine tissue ex vivo, the SNR decreased from 80 at 15° to 16 at 61°. In swine tissue in vivo, the SNR varied with depth, from 200 at 17.5 mm to 48 at 26 mm, with a constant insertion angle of 40°. In ovine tissue in vivo, within the uterine cavity, the SNR varied from 46.4 at 25 mm depth to 18.4 at 32 mm depth, with insertion angles in the range of 26°-65°. CONCLUSIONS A fiber-optic ultrasound receiver integrated into the needle cannula in combination with single-element transmissions from the imaging probe allows for direct visualization of the needle tip within the ultrasound imaging plane. Visualization of the needle tip was achieved at depths and insertion angles that are encountered during nerve blocks and fetal interventions. The method presented in this paper has strong potential to improve the safety and efficiency of ultrasound-guided needle insertions.
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Affiliation(s)
- Wenfeng Xia
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Jean Martial Mari
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom and GePaSud, University of French Polynesia, Faa’a 98702, French Polynesia
| | - Simeon J. West
- Department of Anaesthesia, University College Hospital, Main Theatres, Maple Bridge Link Corridor, Podium 3, 235 Euston Road, London NW1 2BU, United Kingdom
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Mayoral V, Domingo-Rufes T, Casals M, Serrano A, Antonio Narváez J, Sabaté A. Myofascial trigger points: New insights in ultrasound imaging. ACTA ACUST UNITED AC 2013. [DOI: 10.1053/j.trap.2014.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Morillas-Sendin P, Ortega-Romero A, del-Olmo C. Basic considerations before injections and scanning techniques. ACTA ACUST UNITED AC 2013. [DOI: 10.1053/j.trap.2014.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Bloc S, Mercadal L, Dessieux T, Garnier T, Estebe JP, Le Naoures A, Komly B, Leclerc P, Morel B, Ecoffey C, Dhonneur G. The learning process of the hydrolocalization technique performed during ultrasound-guided regional anesthesia. Acta Anaesthesiol Scand 2010; 54:421-5. [PMID: 20085548 DOI: 10.1111/j.1399-6576.2009.02195.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Because poor echogenicity of the needle remains a safety issue, we decided to analyze the learning process of the hydrolocalization technique (Hloc) performed to continuously identify needle-tip anatomical position during many ultrasound-guided regional anesthesia procedures. METHODS Ten senior anesthesiologists naïve to the Hloc agreed to participate in the study. They were requested to perform 40 out-of-plane (OOP) approach ultrasound-guided axillary blocks (AB) each using the Hloc. The Hloc, which is a needle-tip localization principle, was performed by means of repetitive injections of a small amount of a local anesthetic solution (0.5-1 ml) under an ultrasound beam. Details of the learning process and skill acquisition of the Hloc were derived from the following parameters: the duration of block placement, a measure of the perceived difficulty of needle-tip visualization, a measure of block placement difficulty, and the amount of local anesthetics solution required for the technique. RESULTS Four hundred ABs were performed. The success rate of an ultrasound-guided AB was 98%. The Hloc was successful in all patients. Skill acquisition over time of the Hloc was associated with a significant reduction of both the duration and the perceived difficulty of ABs placement. Apprenticeship data revealed that 20 blocks were required to successfully place AB within 5 min in most cases using the Hloc. CONCLUSION The Hloc performed during the OOP approach of ultrasound-guided regional anesthesia is a simple technique with a relatively short learning process feasible for efficient placement of ABs.
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Affiliation(s)
- S Bloc
- Claude Galien Private Hospital, Quincy-Sous-Sénart, Paris, France
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