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Su K, Liu J, Ren X, Huo Y, Du G, Zhao W, Wang X, Liang B, Li D, Liu PX. A fully autonomous robotic ultrasound system for thyroid scanning. Nat Commun 2024; 15:4004. [PMID: 38734697 DOI: 10.1038/s41467-024-48421-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
The current thyroid ultrasound relies heavily on the experience and skills of the sonographer and the expertise of the radiologist, and the process is physically and cognitively exhausting. In this paper, we report a fully autonomous robotic ultrasound system, which is able to scan thyroid regions without human assistance and identify malignant nod- ules. In this system, human skeleton point recognition, reinforcement learning, and force feedback are used to deal with the difficulties in locating thyroid targets. The orientation of the ultrasound probe is adjusted dynamically via Bayesian optimization. Experimental results on human participants demonstrated that this system can perform high-quality ultrasound scans, close to manual scans obtained by clinicians. Additionally, it has the potential to detect thyroid nodules and provide data on nodule characteristics for American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) calculation.
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Affiliation(s)
- Kang Su
- School of Computer Science and Engineering, South China University of Technology, Guangzhou, 510006, China
| | - Jingwei Liu
- School of Computer Science and Engineering, South China University of Technology, Guangzhou, 510006, China
| | - Xiaoqi Ren
- School of Future Technology, South China University of Technology, Guangzhou, 511442, China
- Peng Cheng Laboratory, Shenzhen, 518000, China
| | - Yingxiang Huo
- School of Future Technology, South China University of Technology, Guangzhou, 511442, China
- Peng Cheng Laboratory, Shenzhen, 518000, China
| | - Guanglong Du
- School of Computer Science and Engineering, South China University of Technology, Guangzhou, 510006, China.
| | - Wei Zhao
- Division of Vascular and Interventional Radiology, Nanfang Hospital Southern Medical University, Guangzhou, 510515, China
| | - Xueqian Wang
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, China.
| | - Bin Liang
- Department of Automation, Tsinghua University, 100854, Beijing, China.
| | - Di Li
- School of Mechanical and Automotive Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Peter Xiaoping Liu
- Department of Systems and Computer Engineering, Carleton University, Ottawa, ON, K1S 5B6, Canada.
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Ochitwa Z, Fotouhi R, Adams SJ, Noguera Cundar AP, Obaid H. MSK-TIM: A Telerobotic Ultrasound System for Assessing the Musculoskeletal System. SENSORS (BASEL, SWITZERLAND) 2024; 24:2368. [PMID: 38610578 PMCID: PMC11013981 DOI: 10.3390/s24072368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/21/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024]
Abstract
The aim of this paper is to investigate technological advancements made to a robotic tele-ultrasound system for musculoskeletal imaging, the MSK-TIM (Musculoskeletal Telerobotic Imaging Machine). The hardware was enhanced with a force feedback sensor and a new controller was introduced. Software improvements were developed which allowed the operator to access ultrasound functions such as focus, depth, gain, zoom, color, and power Doppler controls. The device was equipped with Wi-Fi network capability which allowed the master and slave stations to be positioned in different locations. A trial assessing the system to scan the wrist was conducted with twelve participants, for a total of twenty-four arms. Both the participants and radiologist reported their experience. The images obtained were determined to be of satisfactory quality for diagnosis. The system improvements resulted in a better user and patient experience for the radiologist and participants. Latency with the VPN configuration was similar to the WLAN in our experiments. This research explores several technologies in medical telerobotics and provides insight into how they should be used in future. This study provides evidence to support larger-scale trials of the MSK-TIM for musculoskeletal imaging.
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Affiliation(s)
- Zachary Ochitwa
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada; (Z.O.); (A.P.N.C.)
| | - Reza Fotouhi
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada; (Z.O.); (A.P.N.C.)
| | - Scott J. Adams
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK S7N 0W8, Canada; (S.J.A.); (H.O.)
| | - Adriana Paola Noguera Cundar
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada; (Z.O.); (A.P.N.C.)
| | - Haron Obaid
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK S7N 0W8, Canada; (S.J.A.); (H.O.)
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Liang WH, Chan SC, Lee HH, Hung SC, Lin CC, Chen CJ, Chen MJ, Lai JH. Feasibility and Safety of 5G-Based Telerobotic Abdominal Ultrasonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:355-360. [PMID: 37916293 DOI: 10.1002/jum.16368] [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: 10/15/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Telemedicine can offer services to remote patients regardless of the distance. Fifth-generation (5G) mobile networks may make telemedicine practical because of their low latency. This study aimed to evaluate the feasibility and safety of a novel 5G robot-assisted remote abdominal ultrasound (AUS) telemedicine technology in clinical applications in distant locations. METHODS We performed 5G-based telerobotic AUS in patients who were located more than 100 km away from the physicians. RESULTS The telerobotic AUS had a longer examination time than the conditional bedside AUS; however, the complete examination rate was not inferior. None of the volunteers experienced discomfort during the examination and the examination time was acceptable for all. CONCLUSION Our findings confirm the feasibility and safety of 5G-based telerobotic AUS in clinical practice.
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Affiliation(s)
- Wei-Hsin Liang
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Sean-Chen Chan
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ho-Hsin Lee
- Service Systems Technology Center, Industrial Technology Research Institute, Hsinchu City, Taiwan
| | - Shang-Chih Hung
- Service Systems Technology Center, Industrial Technology Research Institute, Hsinchu City, Taiwan
| | - Ching-Chung Lin
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Medical College, New Taipei, Taiwan
| | - Chih-Jen Chen
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ming-Jen Chen
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Medical College, New Taipei, Taiwan
| | - Jian-Han Lai
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Medical College, New Taipei, Taiwan
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Jiang Z, Salcudean SE, Navab N. Robotic ultrasound imaging: State-of-the-art and future perspectives. Med Image Anal 2023; 89:102878. [PMID: 37541100 DOI: 10.1016/j.media.2023.102878] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 04/27/2023] [Accepted: 06/22/2023] [Indexed: 08/06/2023]
Abstract
Ultrasound (US) is one of the most widely used modalities for clinical intervention and diagnosis due to the merits of providing non-invasive, radiation-free, and real-time images. However, free-hand US examinations are highly operator-dependent. Robotic US System (RUSS) aims at overcoming this shortcoming by offering reproducibility, while also aiming at improving dexterity, and intelligent anatomy and disease-aware imaging. In addition to enhancing diagnostic outcomes, RUSS also holds the potential to provide medical interventions for populations suffering from the shortage of experienced sonographers. In this paper, we categorize RUSS as teleoperated or autonomous. Regarding teleoperated RUSS, we summarize their technical developments, and clinical evaluations, respectively. This survey then focuses on the review of recent work on autonomous robotic US imaging. We demonstrate that machine learning and artificial intelligence present the key techniques, which enable intelligent patient and process-specific, motion and deformation-aware robotic image acquisition. We also show that the research on artificial intelligence for autonomous RUSS has directed the research community toward understanding and modeling expert sonographers' semantic reasoning and action. Here, we call this process, the recovery of the "language of sonography". This side result of research on autonomous robotic US acquisitions could be considered as valuable and essential as the progress made in the robotic US examination itself. This article will provide both engineers and clinicians with a comprehensive understanding of RUSS by surveying underlying techniques. Additionally, we present the challenges that the scientific community needs to face in the coming years in order to achieve its ultimate goal of developing intelligent robotic sonographer colleagues. These colleagues are expected to be capable of collaborating with human sonographers in dynamic environments to enhance both diagnostic and intraoperative imaging.
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Affiliation(s)
- Zhongliang Jiang
- Computer Aided Medical Procedures, Technical University of Munich, Munich, Germany.
| | - Septimiu E Salcudean
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Nassir Navab
- Computer Aided Medical Procedures, Technical University of Munich, Munich, Germany; Computer Aided Medical Procedures, Johns Hopkins University, Baltimore, MD, USA
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Tan J, Li B, Leng Y, Li Y, Peng J, Wu J, Luo B, Chen X, Rong Y, Fu C. Fully Automatic Dual-Probe Lung Ultrasound Scanning Robot for Screening Triage. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:975-988. [PMID: 36191095 DOI: 10.1109/tuffc.2022.3211532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Two-dimensional lung ultrasound (LUS) has widely emerged as a rapid and noninvasive imaging tool for the detection and diagnosis of coronavirus disease 2019 (COVID-19). However, image differences will be magnified due to changes in ultrasound (US) imaging experience, such as US probe attitude control and force control, which will directly affect the diagnosis results. In addition, the risk of virus transmission between sonographer and patients is increased due to frequent physical contact. In this study, a fully automatic dual-probe US scanning robot for the acquisition of LUS images is proposed and developed. Furthermore, the trajectory was optimized based on the velocity look-ahead strategy, the stability of contact force of the system and the scanning efficiency were improved by 24.13% and 29.46%, respectively. Also, the control ability of the contact force of robotic automatic scanning was 34.14 times higher than that of traditional manual scanning, which significantly improves the smoothness of scanning. Importantly, there was no significant difference in image quality obtained by robotic automatic scanning and manual scanning. Furthermore, the scanning time for a single person is less than 4 min, which greatly improves the efficiency of screening triage of group COVID-19 diagnosis and suspected patients and reduces the risk of virus exposure and spread.
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Sai H, Xu Z, Xia C, Wang L, Zhang J. Lightweight Force-Controlled Device for Freehand Ultrasound Acquisition. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:944-960. [PMID: 37028093 DOI: 10.1109/tuffc.2023.3252015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
This study investigates a force-controlled auxiliary device for freehand ultrasound (US) examinations. The designed device allows sonographers to maintain a steady target pressure on the US probe, thereby improving the US image quality and reproducibility. The use of a screw motor to power the device and a Raspberry Pi as the system controller results in a lightweight and portable device, while a screen enhances user-interactivity. Using gravity compensation, error compensation, an adaptive proportional-integral-derivative algorithm, and low-pass signal filtering, the designed device provides highly accurate force control. Several experiments using the developed device, including clinical trials relating to the jugular and superficial femoral veins, validate its utility in ensuring the desired pressure in response to varying environments and prolonged US examinations, enabling low or high pressures to be maintained and lowering the threshold of clinical experience. Moreover, the experimental results show that the designed device effectively relieves the stress on the sonographer's hand joints during US examinations and enables rapid assessment of the tissue elasticity characteristics. With automatic pressure tracking between probe and patient, the proposed device offers potentially significant benefits for the reproducibility and stability of US images and the health of sonographers.
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Ren JY, Lei YM, Lei BS, Peng YX, Pan XF, Ye HR, Cui XW. The feasibility and satisfaction study of 5G-based robotic teleultrasound diagnostic system in health check-ups. Front Public Health 2023; 11:1149964. [PMID: 37497023 PMCID: PMC10366591 DOI: 10.3389/fpubh.2023.1149964] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/10/2023] [Indexed: 07/28/2023] Open
Abstract
Objective Regular check-up with ultrasound in underserved rural and/or remote areas is hampered due to the limited availability of sonologists and ultrasound devices. This study aimed to assess the feasibility and satisfaction of health check-ups with a 5G-based robotic teleultrasound diagnostic system. Methods In this prospective study, sonologists from two hospitals manipulated the telerobotic ultrasound system to perform teleultrasound check-ups of the liver, gallbladder, pancreas, spleen, kidneys, bladder, prostate (male), uterus and ovaries (female) for the subjects. The feasibility and satisfaction of health check-ups with a 5G-based robotic teleultrasound diagnostic system were evaluated in terms of examination results, examination duration, and satisfaction questionnaire survey. Results A total of 546 subjects were included with the most frequently diagnosed being abdominal disorders (n = 343) and male reproductive illnesses (n = 97), of which fatty liver (n = 204) and prostatic calcification (n = 54) were the most. The median teleultrasound examination duration (interquartile range) for men and women was 9 (9-11) min and 9 (7-11) min (p = 0.236), respectively. All the subjects were satisfied with this new type of telerobotic ultrasound check-ups and 96% reported no fear of the robotic arm during the examination. Conclusion The 5G-based teleultrasound robotic diagnostic system in health check-ups is feasible and satisfactory, indicating that this teleultrasound robot system may have significant application value in underserved rural and/or remote areas to mitigate disparity in achieving health equity.
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Affiliation(s)
- Jia-Yu Ren
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu-Meng Lei
- Department of Medical Ultrasound, China Resources & Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Bing-Song Lei
- Department of Medical Ultrasound, China Resources & Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Yue-Xiang Peng
- Department of Ultrasound, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
| | - Xiao-Fang Pan
- Health Medical Department, Dalian Municipal Central Hospital, Dalian, China
| | - Hua-Rong Ye
- Department of Medical Ultrasound, China Resources & Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Chen YL, Chiang HK. Development of Single-Channel Dual-Element Custom-Made Ultrasound Scanner with Miniature Optical Position Tracker for Freehand Imaging. BIOSENSORS 2023; 13:bios13040431. [PMID: 37185505 PMCID: PMC10136573 DOI: 10.3390/bios13040431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 05/17/2023]
Abstract
Handheld ultrasound has great potential in resource-limited areas, and can improve healthcare for rural populations. Single-channel ultrasound has been widely used in many clinical ultrasound applications, and optical tracking is considered accurate and reliable. In this study, we developed a 10 MHz lead magnesium niobate-lead titanate (PMN-PT) dual-element ultrasound transducer combined with a miniature optical position tracker, and then measured the rectus femoris of the thigh, upper arm, and cheek muscles. Compared to single-element transducers, dual-element transducers improve the contrast of near-field signals, effectively reduce noise, and are suitable for measuring curved surfaces. The purpose of position tracking is to calculate the location of the ultrasound transducer during the measurement process. By utilizing positioning information, 2D ultrasound imaging can be achieved while maintaining structural integrity. The dual-element ultrasound scanner presented in this study can enable continuous scanning over a large area without a scanning width limitation. The custom-made dual-element ultrasound scanner has the advantage of being a portable, reliable, and low-cost ultrasound device, and is helpful in popularizing medical care for remote villages.
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Affiliation(s)
- Yen-Lung Chen
- Department of BioMedical Engineering, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Huihua Kenny Chiang
- Department of BioMedical Engineering, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
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Tsumura R, Umezawa A, Morishima Y, Iwata H, Yoshinaka K. Suppression of Clothing-Induced Acoustic Attenuation in Robotic Auscultation. SENSORS (BASEL, SWITZERLAND) 2023; 23:2260. [PMID: 36850859 PMCID: PMC9959155 DOI: 10.3390/s23042260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
For patients who are often embarrassed and uncomfortable when exposing their breasts and having them touched by physicians of different genders during auscultation, we are developing a robotic system that performs auscultation over clothing. As the technical issue, the sound obtained through the clothing is often attenuated. This study aims to investigate clothing-induced acoustic attenuation and develop a suppression method for it. Because the attenuation is due to the loss of energy as sound propagates through a medium with viscosity, we hypothesized that the attenuation is improved by compressing clothing and shortening the sound propagation distance. Then, the amplitude spectrum of the heart sound was obtained over clothes of different thicknesses and materials in a phantom study and human trial at varying contact forces with a developed passive-actuated end-effector. Our results demonstrate the feasibility of the attenuation suppression method by applying an optimum contact force, which varied according to the clothing condition. In the phantom experiments, the attenuation rate was improved maximumly by 48% when applying the optimal contact force (1 N). In human trials, the attenuation rate was under the acceptable attenuation (40%) when applying the optimal contact force in all combinations in each subject. The proposed method promises the potential of robotic auscultation toward eliminating gender bias.
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Affiliation(s)
- Ryosuke Tsumura
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba 305-8564, Japan
| | - Akihiro Umezawa
- Department of Creative Science and Engineering, Waseda University, Tokyo 162-0042, Japan
| | - Yuko Morishima
- Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Hiroyasu Iwata
- Department of Creative Science and Engineering, Waseda University, Tokyo 162-0042, Japan
| | - Kiyoshi Yoshinaka
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba 305-8564, Japan
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Tsumura R, Koseki Y, Nitta N, Yoshinaka K. Towards fully automated robotic platform for remote auscultation. Int J Med Robot 2023; 19:e2461. [PMID: 36097703 DOI: 10.1002/rcs.2461] [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: 12/01/2021] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Since most developed countries are facing an increase in the number of patients per healthcare worker due to a declining birth rate and an ageing population, relatively simple and safe diagnosis tasks may need to be performed using robotics and automation technologies, without specialists and hospitals. This study presents an automated robotic platform for remote auscultation, which is a highly cost-effective screening tool for detecting abnormal clinical signs. METHOD The developed robotic platform is composed of a 6-degree-of-freedom cooperative robotic arm, LiDAR camera, and a spring-based mechanism holding an electric stethoscope. The platform enables autonomous stethoscope positioning based on external body information acquired using the LiDAR camera-based multi-way registration; the platform also ensures safe and flexible contact, maintaining the contact force within a certain range through the passive-actuated mechanism. RESULTS Our preliminary results confirm that the robotic platform enables estimation of the landing positions required for cardiac examinations based on the depth and landmark information of the body surface. It also handles the stethoscope while maintaining the contact force without relying on the push-in displacement by the robotic arm. CONCLUSION The developed robotic platform enables the estimation of the landing positions and handling the stethoscope while maintaining the contact force, which promises the potential of automatic remote auscultation.
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Affiliation(s)
- Ryosuke Tsumura
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Yoshihiko Koseki
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Naotaka Nitta
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Kiyoshi Yoshinaka
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
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Chai HH, Ye RZ, Xiong LF, Xu ZN, Chen X, Xu LJ, Hu X, Jiang LF, Peng CZ. Successful Use of a 5G-Based Robot-Assisted Remote Ultrasound System in a Care Center for Disabled Patients in Rural China. Front Public Health 2022; 10:915071. [PMID: 35923952 PMCID: PMC9339711 DOI: 10.3389/fpubh.2022.915071] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/22/2022] [Indexed: 12/07/2022] Open
Abstract
Background Disability has become a global population health challenge. Due to difficulties in self-care or independent living, patients with disability mainly live in community-based care centers or institutions for long-term care. Nonetheless, these settings often lack basic medical resources, such as ultrasonography. Thus, remote ultrasonic robot technology for clinical applications across wide regions is imperative. To date, few experiences of remote diagnostic systems in rural care centers have been reported. Objective To assess the feasibility of a fifth-generation cellular technology (5G)-based robot-assisted remote ultrasound system in a care center for disabled patients in rural China. Methods Patients underwent remote robot-assisted and bedside ultrasound examinations of the liver, gallbladder, spleen, and kidneys. We compared the diagnostic consistency and differences between the two modalities and evaluated the examination duration, image quality, and safety. Results Forty-nine patients were included (21 men; mean age: 61.0 ± 19.0 [range: 19–91] years). Thirty-nine and ten had positive and negative results, respectively; 67 lesions were detected. Comparing the methods, 41 and 8 patients had consistent and inconsistent diagnoses, respectively. The McNemar and kappa values were 0.727 and 0.601, respectively. The mean duration of remote and bedside examinations was 12.2 ± 4.5 (range: 5–26) min and 7.5 ± 1.8 (range: 5–13) min (p < 0.001), respectively. The median image score for original images on the patient side and transmitted images on the doctor side was 5 points (interquartile range: [IQR]: 4.7–5.0) and 4.7 points (IQR: 4.5–5.0) (p = 0.176), respectively. No obvious complications from the examination were reported. Conclusions A 5G-based robot-assisted remote ultrasound system is feasible and has comparable diagnostic efficiency to traditional bedside ultrasound. This system may provide a unique solution for basic ultrasound diagnostic services in primary healthcare settings.
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Affiliation(s)
- Hui-hui Chai
- Department of Medical Ultrasound, Shanghai Tenth People' Hospital, Tongji University School of Medicine, Shanghai, China
| | - Rui-zhong Ye
- Emergency and Critical Care Center, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Lin-fei Xiong
- Department of Engineering, BGI Life Science Research Institution, Shenzhen, China
| | - Zi-ning Xu
- Emergency and Critical Care Center, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Xuan Chen
- Department of Engineering, BGI Life Science Research Institution, Shenzhen, China
| | - Li-juan Xu
- Department of General Practice, Yuanshu Disabled Care Center, Huzhou, China
| | - Xin Hu
- Department of General Practice, Yuanshu Disabled Care Center, Huzhou, China
| | - Lian-feng Jiang
- Department of General Practice, Yuanshu Disabled Care Center, Huzhou, China
| | - Cheng-zhong Peng
- Department of Medical Ultrasound, Shanghai Tenth People' Hospital, Tongji University School of Medicine, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Tongji University School of Medicine, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China
- *Correspondence: Cheng-zhong Peng
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Kliewer M, Walker T, Bagley AR. Toward Ergonomic Design in Ultrasound Scanning: Strategies to Mitigate Injurious Forces. Ultrasound Q 2022; 38:65-71. [PMID: 35239630 DOI: 10.1097/ruq.0000000000000564] [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: 11/26/2022]
Abstract
ABSTRACT Sonographers experience stress-related musculoskeletal injuries at alarming rates. The magnitude of the problem has resulted in substantial economic and human costs. Early efforts, such as the transposition of office ergonomic models to the ultrasound suite, have been only marginally successful because of the vast difference between clerical and sonography work demands. In addition, although the issue has attracted the attention of professional sonographer societies, equipment manufacturers, and governmental agencies, such as the OSHA (Occupational Safety and Health), the causative mechanisms by which sonographers are injured remain inadequately addressed. A definitive ergonomic solution has been elusive.With the help of occupational therapists and biomechanical engineers, we have developed a number of possible ergonomic modifications of ultrasound equipment. We explain the rationale behind these approaches to transducer design and assess the strengths and deficiencies of each.
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Affiliation(s)
- Mark Kliewer
- Department of Radiology, University of Wisconsin School of Medicine, Madison, WI
| | - Tim Walker
- Department of Radiology, University of Wisconsin School of Medicine, Madison, WI
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Remote Ultrasound Scan Procedures with Medical Robots: Towards New Perspectives between Medicine and Engineering. Appl Bionics Biomech 2022; 2022:1072642. [PMID: 35154375 PMCID: PMC8832154 DOI: 10.1155/2022/1072642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/10/2021] [Accepted: 02/01/2022] [Indexed: 12/13/2022] Open
Abstract
Background This review explores state-of-the-art teleoperated robots for medical ultrasound scan procedures, providing a comprehensive look including the recent trends arising from the COVID-19 pandemic. Methods Physicians' experience is included to indicate the importance of their role in the design of improved medical robots. From this perspective, novel classes of equipment for remote diagnostics based on medical robotics are discussed in terms of innovative engineering technologies. Results Relevant literature is reviewed under the system engineering point of view, organizing the discussion on the basis of the main technological focus of each contribution. Conclusions This contribution is aimed at stimulating new research to obtain faster results on teleoperated robotics for ultrasound diagnostics in response to the high demand raised by the ongoing pandemic.
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De Raeymaekers L, Illemann NM, Als TJ, Skjødt MG, Tvergaard MS, Andreasen Struijk LNS. Preliminary examination of the potential of robot-assisted sonography - An ergonomic tool for obstetric sonographers. APPLIED ERGONOMICS 2021; 96:103479. [PMID: 34126571 DOI: 10.1016/j.apergo.2021.103479] [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: 04/11/2019] [Revised: 03/14/2021] [Accepted: 05/23/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study was to explore the ergonomic challenges, the needs and reservations related to robot-assisted ultrasound for obstetric sonographers and thereby to provide information for the design of robotic solutions. A mixed-method design was used, where data from the obstetric sonographers and their immediate managers from 18 out of a Danish total of 20 obstetric departments was collected. The data was collected through a survey and interviews. 98.1% of the obstetric sonographers experienced ache, pain or discomfort related to scans. The most frequent cause for the sonographers' ergonomic challenges were the patients' physique (93,52%) and the need to obtain good image quality (83,33%). These reasons are non-controllable parameters for the obstetric sonographers and requires a solution, which ergonomically supports the sonographers in these situations. All of the interviewed obstetric sonographers (n = 8) and immediate managers (n = 3) claimed they were interested in testing a solution based on robot-assisted ultrasound.
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Affiliation(s)
- Liv De Raeymaekers
- Students at Master of Clinical Science and Technology, Aalborg University, Aalborg, Denmark
| | - Nanna Martens Illemann
- Students at Master of Clinical Science and Technology, Aalborg University, Aalborg, Denmark
| | - Tine Juul Als
- Students at Master of Clinical Science and Technology, Aalborg University, Aalborg, Denmark
| | - Martin Glud Skjødt
- Students at Master of Clinical Science and Technology, Aalborg University, Aalborg, Denmark
| | - Marie Steen Tvergaard
- Students at Master of Clinical Science and Technology, Aalborg University, Aalborg, Denmark
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15
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Ma X, Zhang Z, Zhang HK. Autonomous Scanning Target Localization for Robotic Lung Ultrasound Imaging. PROCEEDINGS OF THE ... IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS. IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS 2021; 2021:9467-9474. [PMID: 35965637 PMCID: PMC9373068 DOI: 10.1109/iros51168.2021.9635902] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Under the ceaseless global COVID-19 pandemic, lung ultrasound (LUS) is the emerging way for effective diagnosis and severeness evaluation of respiratory diseases. However, close physical contact is unavoidable in conventional clinical ultrasound, increasing the infection risk for health-care workers. Hence, a scanning approach involving minimal physical contact between an operator and a patient is vital to maximize the safety of clinical ultrasound procedures. A robotic ultrasound platform can satisfy this need by remotely manipulating the ultrasound probe with a robotic arm. This paper proposes a robotic LUS system that incorporates the automatic identification and execution of the ultrasound probe placement pose without manual input. An RGB-D camera is utilized to recognize the scanning targets on the patient through a learning-based human pose estimation algorithm and solve for the landing pose to attach the probe vertically to the tissue surface; A position/force controller is designed to handle intraoperative probe pose adjustment for maintaining the contact force. We evaluated the scanning area localization accuracy, motion execution accuracy, and ultrasound image acquisition capability using an upper torso mannequin and a realistic lung ultrasound phantom with healthy and COVID-19-infected lung anatomy. Results demonstrated the overall scanning target localization accuracy of 19.67 ± 4.92 mm and the probe landing pose estimation accuracy of 6.92 ± 2.75 mm in translation, 10.35 ± 2.97 deg in rotation. The contact force-controlled robotic scanning allowed the successful ultrasound image collection, capturing pathological landmarks.
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Affiliation(s)
- Xihan Ma
- Department of Robotics Engineering, Worcester Polytechnic Institute, Worcester, MA, 01609 USA
| | - Ziming Zhang
- Department of Electrical and Computer Engineering, Worcester Polytechnic Institute, Worcester, MA, 01609 USA
| | - Haichong K Zhang
- Department of Robotics Engineering, Worcester Polytechnic Institute, Worcester, MA, 01609 USA
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, 01609 USA
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16
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Obaid M, Zhang Q, Adams SJ, Fotouhi R, Obaid H. Development and assessment of a telesonography system for musculoskeletal imaging. Eur Radiol Exp 2021; 5:29. [PMID: 34312733 PMCID: PMC8313647 DOI: 10.1186/s41747-021-00227-z] [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: 02/13/2021] [Accepted: 06/02/2021] [Indexed: 11/25/2022] Open
Abstract
Background Telesonography systems have been developed to overcome barriers to accessing diagnostic ultrasound for patients in rural and remote communities. However, most previous telesonography systems have been designed for performing only abdominal and obstetrical exams. In this paper, we describe the development and assessment of a musculoskeletal (MSK) telesonography system. Methods We developed a 4-degrees-of-freedom (DOF) robot to manipulate an ultrasound probe. The robot was remotely controlled by a radiologist operating a joystick at the master site. The telesonography system was used to scan participants’ forearms, and all participants were conventionally scanned for comparison. Participants and radiologists were surveyed regarding their experience. Images from both scanning methods were independently assessed by an MSK radiologist. Results All ten ultrasound exams were successfully performed using our developed MSK telesonography system, with no significant delay in movement. The duration (mean ± standard deviation) of telerobotic and conventional exams was 4.6 ± 0.9 and 1.4 ± 0.5 min, respectively (p = 0.039). An MSK radiologist rated quality of real-time ultrasound images transmitted over an internet connection as “very good” for all telesonography exams, and participants rated communication with the radiologist as “very good” or “good” for all exams. Visualisation of anatomic structures was similar between telerobotic and conventional methods, with no statistically significant differences. Conclusions The MSK telesonography system developed in this study is feasible for performing soft tissue ultrasound exams. The advancement of this system may allow MSK ultrasound exams to be performed over long distances, increasing access to ultrasound for patients in rural and remote communities.
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Affiliation(s)
- Mohammed Obaid
- Department of Physics and Astronomy, Faculty of Science, University of British Columbia, 6224 Agricultural Road, Vancouver, BC, V6T 1Z1, Canada
| | - Qianwei Zhang
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
| | - Scott J Adams
- Department of Medical Imaging, College of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada.
| | - Reza Fotouhi
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
| | - Haron Obaid
- Department of Medical Imaging, College of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
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Adams SJ, Burbridge B, Obaid H, Stoneham G, Babyn P, Mendez I. Telerobotic Sonography for Remote Diagnostic Imaging: Narrative Review of Current Developments and Clinical Applications. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:1287-1306. [PMID: 33058242 DOI: 10.1002/jum.15525] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/08/2020] [Accepted: 09/12/2020] [Indexed: 05/23/2023]
Abstract
Access to sonographers and sonologists is limited in many communities around the world. Telerobotic sonography (robotic ultrasound) is a new technology to increase access to sonography, providing sonographers and sonologists the ability to manipulate an ultrasound probe from a distant location and remotely perform ultrasound examinations. This narrative review discusses the development of telerobotic ultrasound systems, clinical studies evaluating the feasibility and diagnostic accuracy of telerobotic sonography, and emerging use of telerobotic sonography in clinical settings. Telerobotic sonography provides an opportunity to provide real-time ultrasound examinations to underserviced rural and remote communities to increase equity in the delivery of diagnostic imaging.
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Affiliation(s)
- Scott J Adams
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Brent Burbridge
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Haron Obaid
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Grant Stoneham
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Paul Babyn
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ivar Mendez
- Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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18
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Tsumura R, Hardin JW, Bimbraw K, Grossestreuer AV, Odusanya OS, Zheng Y, Hill JC, Hoffmann B, Soboyejo W, Zhang HK. Tele-Operative Low-Cost Robotic Lung Ultrasound Scanning Platform for Triage of COVID-19 Patients. IEEE Robot Autom Lett 2021; 6:4664-4671. [PMID: 34532570 PMCID: PMC8442628 DOI: 10.1109/lra.2021.3068702] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/23/2021] [Indexed: 12/21/2022]
Abstract
Novel severe acute respiratory syndrome coronavirus 2 (COVID-19) has become a pandemic of epic proportions, and global response to prepare health systems worldwide is of utmost importance. 2-dimensional (2D) lung ultrasound (LUS) has emerged as a rapid, noninvasive imaging tool for diagnosing COVID-19 infected patients. Concerns surrounding LUS include the disparity of infected patients and healthcare providers, and importantly, the requirement for substantial physical contact between the patient and operator, increasing the risk of transmission. New variants of COVID-19 will continue to emerge; therefore, mitigation of the virus's spread is of paramount importance. A tele-operative robotic ultrasound platform capable of performing LUS in COVID-19 infected patients may be of significant benefit, especially in low- and middle-income countries. The authors address the issues mentioned above surrounding the use of LUS in COVID-19 infected patients and the potential for extension of this technology in a resource-limited environment. Additionally, first-time application, feasibility, and safety were validated in healthy subjects. Preliminary results demonstrate that our platform allows for the successful acquisition and application of robotic LUS in humans.
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Affiliation(s)
- Ryosuke Tsumura
- Department of Biomedical EngineeringWorcester Polytechnic InstituteWorcesterMA01609USA
| | - John W. Hardin
- Department of Emergency MedicineBeth Israel Deaconess Medical CenterBostonMA02215USA
| | - Keshav Bimbraw
- Department of Biomedical EngineeringWorcester Polytechnic InstituteWorcesterMA01609USA
| | - Anne V. Grossestreuer
- Department of Emergency MedicineBeth Israel Deaconess Medical CenterBostonMA02215USA
| | | | - Yihao Zheng
- Department of Mechanical EngineeringWorcester Polytechnic InstituteWorcesterMA01609USA
| | - Jeffrey C. Hill
- Department of Diagnostic Medical Sonography, School of Medical Imaging and TherapeuticsMCPHS UniversityWorcesterMA01608USA
| | - Beatrice Hoffmann
- Department of Emergency MedicineBeth Israel Deaconess Medical CenterBostonMA02215USA
| | - Winston Soboyejo
- Department of Mechanical EngineeringWorcester Polytechnic InstituteWorcesterMA01609USA
| | - Haichong K. Zhang
- Department of Biomedical EngineeringWorcester Polytechnic InstituteWorcesterMA01609USA
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Ipsen S, Wulff D, Kuhlemann I, Schweikard A, Ernst F. Towards automated ultrasound imaging-robotic image acquisition in liver and prostate for long-term motion monitoring. Phys Med Biol 2021; 66. [PMID: 33770768 DOI: 10.1088/1361-6560/abf277] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/26/2021] [Indexed: 11/12/2022]
Abstract
Real-time volumetric (4D) ultrasound has shown high potential for diagnostic and therapy guidance tasks. One of the main drawbacks of ultrasound imaging to date is the reliance on manual probe positioning and the resulting user dependence. Robotic assistance could help overcome this issue and facilitate the acquisition of long-term image data to observe dynamic processesin vivoover time. The aim of this study is to assess the feasibility of robotic probe manipulation and organ motion quantification during extended imaging sessions. The system consists of a collaborative robot and a 4D ultrasound system providing real-time data access. Five healthy volunteers received liver and prostate scans during free breathing over 30 min. Initial probe placement was performed with real-time remote control with a predefined contact force of 10 N. During scan acquisition, the probe position was continuously adjusted to the body surface motion using impedance control. Ultrasound volumes, the pose of the end-effector and the estimated contact forces were recorded. For motion analysis, one anatomical landmark was manually annotated in a subset of ultrasound frames for each experiment. Probe contact was uninterrupted over the entire scan duration in all ten sessions. Organ drift and imaging artefacts were successfully compensated using remote control. The median contact force along the probe's longitudinal axis was 10.0 N with maximum values of 13.2 and 21.3 N for liver and prostate, respectively. Forces exceeding 11 N only occurred in 0.3% of the time. Probe and landmark motion were more pronounced in the liver, with median interquartile ranges of 1.5 and 9.6 mm, compared to 0.6 and 2.7 mm in the prostate. The results show that robotic ultrasound imaging with dynamic force control can be used for stable, long-term imaging of anatomical regions affected by motion. The system facilitates the acquisition of 4D image datain vivoover extended scanning periods for the first time and holds the potential to be used for motion monitoring for therapy guidance as well as diagnostic tasks.
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Affiliation(s)
- Svenja Ipsen
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany.,Fraunhofer Research Institution for Individualized and Cell-Based Medical Engineering IMTE, Luebeck, Germany
| | - Daniel Wulff
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany
| | - Ivo Kuhlemann
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany
| | - Achim Schweikard
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany
| | - Floris Ernst
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany
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20
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Wang KJ, Chen CH, Chen JJ(J, Ciou WS, Xu CB, Du YC. An Improved Sensing Method of a Robotic Ultrasound System for Real-Time Force and Angle Calibration. SENSORS (BASEL, SWITZERLAND) 2021; 21:2927. [PMID: 33922012 PMCID: PMC8122492 DOI: 10.3390/s21092927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/07/2021] [Accepted: 04/17/2021] [Indexed: 01/08/2023]
Abstract
An ultrasonic examination is a clinically universal and safe examination method, and with the development of telemedicine and precision medicine, the robotic ultrasound system (RUS) integrated with a robotic arm and ultrasound imaging system receives increasing attention. As the RUS requires precision and reproducibility, it is important to monitor the real-time calibration of the RUS during examination, especially the angle of the probe for image detection and its force on the surface. Additionally, to speed up the integration of the RUS and the current medical ultrasound system (US), the current RUSs mostly use a self-designed fixture to connect the probe to the arm. If the fixture has inconsistencies, it may cause an operating error. In order to improve its resilience, this study proposed an improved sensing method for real-time force and angle calibration. Based on multichannel pressure sensors, an inertial measurement unit (IMU), and a novel sensing structure, the ultrasonic probe and robotic arm could be simply and rapidly combined, which rendered real-time force and angle calibration at a low cost. The experimental results show that the average success rate of the downforce position identification achieved was 88.2%. The phantom experiment indicated that the method could assist the RUS in the real-time calibration of both force and angle during an examination.
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Affiliation(s)
- Kuan-Ju Wang
- Department of Biomedical Engineering, National Cheng Kung University, No.1, University Road, Tainan 70101, Taiwan; (K.-J.W.); (J.-J.C.); (C.-B.X.)
- Brain Navi Biotechnology Co., Ltd., No.66-1, Shengyi 5th Rd. Zhubei City, Hsinchu County 302041, Taiwan; (C.-H.C.); (W.-S.C.)
| | - Chieh-Hsiao Chen
- Brain Navi Biotechnology Co., Ltd., No.66-1, Shengyi 5th Rd. Zhubei City, Hsinchu County 302041, Taiwan; (C.-H.C.); (W.-S.C.)
- China Medical University Beigang Hospital, No.123, Xinde Road, Xinjia Village, Beigang Township, Yunlin County 65152, Taiwan
| | - Jia-Jin (Jason) Chen
- Department of Biomedical Engineering, National Cheng Kung University, No.1, University Road, Tainan 70101, Taiwan; (K.-J.W.); (J.-J.C.); (C.-B.X.)
| | - Wei-Siang Ciou
- Brain Navi Biotechnology Co., Ltd., No.66-1, Shengyi 5th Rd. Zhubei City, Hsinchu County 302041, Taiwan; (C.-H.C.); (W.-S.C.)
| | - Cheng-Bin Xu
- Department of Biomedical Engineering, National Cheng Kung University, No.1, University Road, Tainan 70101, Taiwan; (K.-J.W.); (J.-J.C.); (C.-B.X.)
| | - Yi-Chun Du
- Department of Biomedical Engineering, National Cheng Kung University, No.1, University Road, Tainan 70101, Taiwan; (K.-J.W.); (J.-J.C.); (C.-B.X.)
- Medical Device Innovation Center, National Cheng Kung University, No.1, University Road, Tainan 70101, Taiwan
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21
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Ivashchenko OV, Kuhlmann KFD, van Veen R, Pouw B, Kok NFM, Hoetjes NJ, Smit JN, Klompenhouwer EG, Nijkamp J, Ruers TJM. CBCT-based navigation system for open liver surgery: Accurate guidance toward mobile and deformable targets with a semi-rigid organ approximation and electromagnetic tracking of the liver. Med Phys 2021; 48:2145-2159. [PMID: 33666243 PMCID: PMC8251891 DOI: 10.1002/mp.14825] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 12/21/2022] Open
Abstract
Purpose The surgical navigation system that provides guidance throughout the surgery can facilitate safer and more radical liver resections, but such a system should also be able to handle organ motion. This work investigates the accuracy of intraoperative surgical guidance during open liver resection, with a semi‐rigid organ approximation and electromagnetic tracking of the target area. Methods The suggested navigation technique incorporates a preoperative 3D liver model based on diagnostic 4D MRI scan, intraoperative contrast‐enhanced CBCT imaging and electromagnetic (EM) tracking of the liver surface, as well as surgical instruments, by means of six degrees‐of‐freedom micro‐EM sensors. Results The system was evaluated during surgeries with 35 patients and resulted in an accurate and intuitive real‐time visualization of liver anatomy and tumor's location, confirmed by intraoperative checks on visible anatomical landmarks. Based on accuracy measurements verified by intraoperative CBCT, the system’s average accuracy was 4.0 ± 3.0 mm, while the total surgical delay due to navigation stayed below 20 min. Conclusions The electromagnetic navigation system for open liver surgery developed in this work allows for accurate localization of liver lesions and critical anatomical structures surrounding the resection area, even when the liver was manipulated. However, further clinically integrating the method requires shortening the guidance‐related surgical delay, which can be achieved by shifting to faster intraoperative imaging like ultrasound. Our approach is adaptable to navigation on other mobile and deformable organs, and therefore may benefit various clinical applications.
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Affiliation(s)
- Oleksandra V Ivashchenko
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Koert F D Kuhlmann
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Ruben van Veen
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Bas Pouw
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Niels F M Kok
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Nikie J Hoetjes
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Jasper N Smit
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Elisabeth G Klompenhouwer
- Department of Radiology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Jasper Nijkamp
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Theodoor J M Ruers
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Faculty of Science and Technology (TNW), University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands
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22
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Housden J, Wang S, Bao X, Zheng J, Skelton E, Matthew J, Noh Y, Eltiraifi O, Singh A, Singh D, Rhode K. Towards Standardized Acquisition with a Dual-probe Ultrasound Robot for Fetal Imaging. IEEE Robot Autom Lett 2021; 6:1059-1065. [PMID: 33912664 PMCID: PMC7610692 DOI: 10.1109/lra.2021.3056033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Standardized acquisitions and diagnoses using robots and AI would potentially increase the general usability and reliability of medical ultrasound. Working towards this prospect, this paper presents the recent developments of a standardized acquisition workflow using a novel dual-probe ultrasound robot, for a project known as intelligent Fetal Imaging and Diagnosis (iFIND). The workflow includes an abdominal surface mapping step to obtain a non-parametric spline surface, a rule-based end-point calculation method to position each individual joint, and a motor synchronization method to achieve a smooth motion towards a target point. The design and implementation of the robot are first presented in this paper and the proposed workflow is then explained in detail with simulation and volunteer experiments performed and analyzed. The closed-form analytical solution to the specific motion planning problem has demonstrated a reliable performance controlling the robot to move towards the expected scanning areas and the calculated proximity of the robot to the surface shows that the robot maintains a safe distance while moving around the abdomen. The volunteer study has successfully demonstrated the reliable working and controllability of the robot in terms of acquiring desired ultrasound views. Our future work will focus on improving the motion planning, and on integrating the proposed standardized acquisition workflow with newly- developed ultrasound image processing methods to obtain diagnostic results in an accurate and consistent way.
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Affiliation(s)
- James Housden
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Shuangyi Wang
- State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Xianqiang Bao
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Jia Zheng
- School of General Engineering, Beihang University, Beijing 100191, China
| | - Emily Skelton
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Jacqueline Matthew
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Yohan Noh
- Department of Mechanical and Aerospace Engineering, Brunel University, London UB8 3PH, UK
| | - Olla Eltiraifi
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | | | | | - Kawal Rhode
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
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Huang Y, Xiao W, Wang C, Liu H, Huang R, Sun Z. Towards Fully Autonomous Ultrasound Scanning Robot With Imitation Learning Based on Clinical Protocols. IEEE Robot Autom Lett 2021; 6:3671-3678. [DOI: 10.1109/lra.2021.3064283] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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24
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von Haxthausen F, Böttger S, Wulff D, Hagenah J, García-Vázquez V, Ipsen S. Medical Robotics for Ultrasound Imaging: Current Systems and Future Trends. ACTA ACUST UNITED AC 2021; 2:55-71. [PMID: 34977593 PMCID: PMC7898497 DOI: 10.1007/s43154-020-00037-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/17/2022]
Abstract
Abstract
Purpose of Review
This review provides an overview of the most recent robotic ultrasound systems that have contemporary emerged over the past five years, highlighting their status and future directions. The systems are categorized based on their level of robot autonomy (LORA).
Recent Findings
Teleoperating systems show the highest level of technical maturity. Collaborative assisting and autonomous systems are still in the research phase, with a focus on ultrasound image processing and force adaptation strategies. However, missing key factors are clinical studies and appropriate safety strategies. Future research will likely focus on artificial intelligence and virtual/augmented reality to improve image understanding and ergonomics.
Summary
A review on robotic ultrasound systems is presented in which first technical specifications are outlined. Hereafter, the literature of the past five years is subdivided into teleoperation, collaborative assistance, or autonomous systems based on LORA. Finally, future trends for robotic ultrasound systems are reviewed with a focus on artificial intelligence and virtual/augmented reality.
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Affiliation(s)
- Felix von Haxthausen
- Institute for Robotics and Cognitive Systems, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Sven Böttger
- Institute for Robotics and Cognitive Systems, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Daniel Wulff
- Institute for Robotics and Cognitive Systems, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Jannis Hagenah
- Institute for Robotics and Cognitive Systems, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Verónica García-Vázquez
- Institute for Robotics and Cognitive Systems, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Svenja Ipsen
- Institute for Robotics and Cognitive Systems, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
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25
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Kaschwich M, Dell A, Matysiak F, Bouchagiar J, Bayer A, Scharfschwerdt M, Ernst F, Kleemann M, Horn M. Development of an ultrasound-capable phantom with patient-specific 3D-printed vascular anatomy to simulate peripheral endovascular interventions. Ann Anat 2020; 232:151563. [DOI: 10.1016/j.aanat.2020.151563] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/19/2022]
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Abstract
Zusammenfassung
Hintergrund
Die periphere endovaskuläre Chirurgie ist nach wie vor durch die Anwendung von Röntgenstrahlen und Röntgenkontrastmittel für die intraprozedurale Navigation der Instrumentarien ein Verfahren mit potenziellen Risiken und Nebenwirkungen.
Projektziel
Ziel des RoGUS-PAD (Robotic-Guided Ultrasound System for Peripheral Arterial Disease)-Projektes ist die Entwicklung eines roboterbasierten ultraschallgesteuerten Assistenzsystems für periphere endovaskuläre Interventionen zur Verringerung und ggf. Vermeidung von Röntgenstrahlung und Röntgenkontrastmittel sowie Verbesserung der Echtzeitvisualisierung.
Material und Methoden
Für die Bildgebung wurde ein 2‑D-Ultraschall-Lineartastkopf (L12‑3, Philips Healthcare, Best, Niederlande) am Endeffektor eines Roboterarms (LBR iiwa 7 R800, KUKA, Augsburg, Deutschland) montiert. Die ersten Versuche wurden an einem eigens für dieses Projekt entwickelten ultraschallfähigen Phantom durchgeführt. Die Bildverarbeitung und Robotersteuerung erfolgten durch ein speziell entwickeltes Programm in C++.
Ergebnisse
Zur Testung der technischen Umsetzbarkeit des Projektes konnten wir einen semiautomatischen 2‑D-Ultraschallscan einer peripheren Arterie am Phantom durchführen. In 27 von 30 Durchläufen zeigte sich ein erfolgreicher Scanvorgang.
Schlussfolgerung
Unsere ersten Ergebnisse bestätigten, dass die Entwicklung eines roboterbasierten Assistenzsystems für ultraschallgesteuerte periphere endovaskuläre Interventionen technisch umsetzbar ist. Dies stützt unsere Ambitionen einer Translation des Systems in die tägliche klinische Praxis.
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27
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Abstract
In this contribution, we approached a new aspect in robotic applications. We investigated human–machine modeling for remote ultrasound scan equipment. While robotic systems for ultrasound scan applications with remote operations have been widely studied, in this research, remote force-feedback control was tested. The goal is for the human operator to receive, as physical input, the correct force perception transmitted by the remote ultrasound scan equipment in analyzing the body of the patient. Two principal aspects were investigated. The first was an artificial body model to receive the control signals from the remote equipment. The second aspect was to study a suitable feedback control law that attempts to compensate for the uncertainty between the artificial body and the patient’s body, while also taking into account the transmission delay. Therefore, the task was to give the operator relevant information while considering the force effect; thus, providing a reliable and efficient platform in order to work in remote conditions with ultrasound scan equipment.
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Salerno A, Tupchong K, Verceles AC, McCurdy MT. Point-of-Care Teleultrasound: A Systematic Review. Telemed J E Health 2020; 26:1314-1321. [PMID: 32302520 DOI: 10.1089/tmj.2019.0177] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: Telemedicine and point-of-care ultrasound have merged to create a field known as teleultrasound (TUS). Real-time TUS involves the transmission of bedside ultrasound (US) images with direct feedback from an US expert. In this review, we summarize the current uses of real-time TUS and discuss its potential future uses. Methods: We performed a literature search (PubMed and EMBase) to assess articles related to real-time TUS. Data were extracted using a standardized collection form, and relevant articles were separated into feasibility or clinical studies. Results: Our search yielded 45 articles, with most of the reports taking place in resource-constrained settings. A large portion of the studies discussed the use of the focused assessment with sonography in trauma exam. Others included musculoskeletal, vascular, and echocardiography. Conclusion: Real-time TUS allows for rapid access to diagnostic imaging in various clinical settings. This technology is poised to expand with many uses on the horizon.
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Affiliation(s)
- Alexis Salerno
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Keegan Tupchong
- Division of Critical Care Medicine, Department of Emergency Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Avelino C Verceles
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Michael T McCurdy
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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29
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Wang S, Housden RJ, Noh Y, Singh A, Lindenroth L, Liu H, Althoefer K, Hajnal J, Singh D, Rhode K. Analysis of a Customized Clutch Joint Designed for the Safety Management of an Ultrasound Robot. APPLIED SCIENCES (BASEL, SWITZERLAND) 2019; 9:1900. [PMID: 32754346 PMCID: PMC7115904 DOI: 10.3390/app9091900] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Robotic systems have great potential to assist ultrasound (US) examination. Currently, the safety management method to limit the force that a US robot can apply mostly relies on force sensing and software-based algorithms. This causes the concern that the potential failure of sensors, electrical systems, or software could lead to patient injuries. In this paper, we investigated a customized spring-loaded ball clutch joint designed for a newly developed US robot to passively limit the force applied. The working mechanism of the clutch was modelled and the kinematic-based analysis was performed to understand the variation of the limited force at different postures of the robot. The triggering torque of the clutch was found to be 3928 N·mm, which results in the mean limited force 22.10 ± 1.76 N at the US probe end based on potential postures. The real measurement of the implemented design indicated that the limited force could be set between 17 and 24 N at the neutral posture depending on the preload. With the maximum preload, the mean limited force was found to be 21.98 ± 0.96 N based on 30 repeated measurements. The practically measured results meet the expectation from the theoretical calculation, and the resulting small variation has indicated a good repeatability of the clutch. Based on this evidence, it is concluded that the proposed clutch meets the design aim that it can limit the force applied within a safe range while at the same time ensuring that the required force is applied at different postures.
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Affiliation(s)
- Shuangyi Wang
- School of Biomedical Engineering & Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Richard James Housden
- School of Biomedical Engineering & Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Yohan Noh
- School of Biomedical Engineering & Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | | | - Lukas Lindenroth
- Department of Informatics, King’s College London, Strand, London WC2R 2LS, UK
| | - Hongbin Liu
- Department of Informatics, King’s College London, Strand, London WC2R 2LS, UK
| | - Kaspar Althoefer
- Faculty of Science & Engineering, Queen Mary University of London, Mile End Rd, London E1 4NS, UK
| | - Joseph Hajnal
- School of Biomedical Engineering & Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | | | - Kawal Rhode
- School of Biomedical Engineering & Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
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30
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Wang S, Housden J, Noh Y, Singh A, Back J, Lindenroth L, Liu H, Hajnal J, Althoefer K, Singh D, Rhode K. Design and Implementation of a Bespoke Robotic Manipulator for Extra-corporeal Ultrasound. J Vis Exp 2019. [PMID: 30663700 DOI: 10.3791/58811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
With the potential for high precision, dexterity, and repeatability, a self-tracked robotic system can be employed to assist the acquisition of real-time ultrasound. However, limited numbers of robots designed for extra-corporeal ultrasound have been successfully translated into clinical use. In this study, we aim to build a bespoke robotic manipulator for extra-corporeal ultrasound examination, which is lightweight and has a small footprint. The robot is formed by five specially shaped links and custom-made joint mechanisms for probe manipulation, to cover the necessary range of motion with redundant degrees of freedom to ensure the patient's safety. The mechanical safety is emphasized with a clutch mechanism, to limit the force applied to patients. As a result of the design, the total weight of the manipulator is less than 2 kg and the length of the manipulator is about 25 cm. The design has been implemented, and simulation, phantom, and volunteer studies have been performed, to validate the range of motion, the ability to make fine adjustments, mechanical reliability, and the safe operation of the clutch. This paper details the design and implementation of the bespoke robotic ultrasound manipulator, with the design and assembly methods illustrated. Testing results to demonstrate the design features and clinical experience of using the system are presented. It is concluded that the current proposed robotic manipulator meets the requirements as a bespoke system for extra-corporeal ultrasound examination and has great potential to be translated into clinical use.
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Affiliation(s)
- Shuangyi Wang
- School of Biomedical Engineering & Imaging Sciences, King's College London;
| | - James Housden
- School of Biomedical Engineering & Imaging Sciences, King's College London
| | - Yohan Noh
- School of Biomedical Engineering & Imaging Sciences, King's College London
| | | | | | | | - Hongbin Liu
- Department of Informatics, King's College London
| | - Joseph Hajnal
- School of Biomedical Engineering & Imaging Sciences, King's College London
| | - Kaspar Althoefer
- Faculty of Science & Engineering, Queen Mary University of London
| | | | - Kawal Rhode
- School of Biomedical Engineering & Imaging Sciences, King's College London
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31
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Hwang CL, Bishop J, Ching J, Elokda A, da Silva ALG, Laddu D, Phillips SA. Precision Measurements to Assess Baseline Status and Efficacy of Healthy Living Medicine. Prog Cardiovasc Dis 2019; 62:55-59. [PMID: 30610884 DOI: 10.1016/j.pcad.2018.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 12/28/2018] [Indexed: 01/07/2023]
Abstract
Precision medicine recently has gained popularity, calling for more individualized approaches to prevent and/or reduce chronic-disease risk and to reduce non-communicable diseases such as cardiovascular disease (CVD). Encompassed under Precision medicine initiatives is the concept of healthy living medicine (HLM), which emphasizes the promotion of lifestyle and behavioral practices including physical activity and healthy dietary pattern. Precision measurements have the potential to improve the understanding of how risk factors influence disease trajectory, and further inform on how to precisely tailor clinical strategies to manage risk factors to prevent disease manifestation, and refine therapies according the patient's demographic, environment, and disease etiology. The purpose of this review is to summarize the application of established and emerging measurements that may be used in HLM to manage and optimize care in CVD prevention.
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Affiliation(s)
- Chueh-Lung Hwang
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Jennifer Bishop
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Jerry Ching
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Ahmed Elokda
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL, United States of America
| | - Andréa Lúcia Gonçalves da Silva
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Department of Physical Education and Health, Physiotherapy` Course at University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Shane A Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America.
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32
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Use the force: deformation correction in robotic 3D ultrasound. Int J Comput Assist Radiol Surg 2018; 13:619-627. [DOI: 10.1007/s11548-018-1716-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 02/20/2018] [Indexed: 10/17/2022]
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33
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Du YC, Shih JB, Wu MJ, Chiou CY. Development of an AVF Stenosis Assessment Tool for Hemodialysis Patients Using Robotic Ultrasound System. MICROMACHINES 2018; 9:E51. [PMID: 30393327 PMCID: PMC6187484 DOI: 10.3390/mi9020051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/24/2018] [Accepted: 01/25/2018] [Indexed: 11/17/2022]
Abstract
With the aging population and lifestyle changes, the number of hemodialysis (HD) patients increases year by year. The arteriovenous fistula (AVF) is the gold standard vascular access used to access the blood for HD treatment. Since the status of stenosis affects HD efficiency, current clinical practices usually use a Doppler ultrasound imaging system to assess the parameters of the stenosis, such as the degree of stenosis (DOS). Unfortunately, this is a very time-consuming task. Furthermore, it is difficult to stably maintain the ultrasound probe for a prolonged period to give doctors clearer or reproducible images. In this study, a robotic ultrasound system (RUS) with ultrasound sequential imaging analysis was designed to evaluate the DOS of the AVF. The sequential imaging analysis was capable of image smoothing and vessel boundary detection. It enabled clinicians to mark the thickness of the plaque for further processing. Finally, the system was used to reconstruct 3D models of fistulas and calculated the DOS for clinical assessment. We also designed a pressure sensing module attached to the ultrasound probe to prevent the probe from coming loose, vibrating, and exerting abnormal pressure on the skin. In the phantom test, the results showed that the error of the DOS that was calculated by RUS was less than 3%. The results of clinical trials obtained from ten patients show that the error between the RUS and clinicians' measurement was about 10% and had a highly linear correlation (R Square > 0.95). In addition, the reproducibility error was about 3% and could effectively save about 46% of the time during clinical examinations.
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Affiliation(s)
- Yi-Chun Du
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, No. 1, Nan-Tai Street, Yungkang Dist., Tainan 71005, Taiwan.
| | - Jheng-Bang Shih
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, No. 1, Nan-Tai Street, Yungkang Dist., Tainan 71005, Taiwan.
| | - Ming-Jui Wu
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, No. 1, Nan-Tai Street, Yungkang Dist., Tainan 71005, Taiwan.
- Department of Internal Medicine, Kaohsiung Veterans General Hospital Tainan Branch, Tainan 71051, Taiwan.
| | - Chung-Yi Chiou
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, No. 1, Nan-Tai Street, Yungkang Dist., Tainan 71005, Taiwan.
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