Simulating Ultrasound Tissue Deformation Using Inverse Mapping

Abstract Ultrasound guidance is used for a variety of surgical needle insertion procedures, but there is currently no standard for the teaching of ultrasound skills. Recently, computer ultrasound simulation has been introduced as an alternative teaching method to traditional manikin and cadaver training because of its ability to provide diverse scenario training, quantitative feedback, and objective assessment. Current computer ultrasound training simulation is limited in its ability to image tissue deformation caused by needle insertions, even though tissue deformation identification is a critical skill in performing an ultrasound-guided needle insertion. To fill this need for improved simulation, a novel method of simulating ultrasound tissue–needle deformation is proposed and evaluated. First, a cadaver study is conducted to obtain ultrasound video of a peripheral nerve block. Then, optical flow analysis is conducted on this video to characterize the tissue movement due to the needle insertion. Tissue movement is characterized into three zones of motion: tissue near the needle being pulled, and zones above and below the needle where the tissue rolls. The rolling zones were centered 1.34 mm above and below the needle and 4.53 mm behind the needle. Using this characterization, a vector field is generated mimicking these zones. This vector field is then applied to an ultrasound image using inverse mapping to simulate tissue movement. The resulting simulation can be processed at 3.1 frames per second. This methodology can be applied through future optimized graphical processing to allow for accurate real time needle tissue simulation.

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Haptic Communication to Support Biopsy Procedures Learning in Virtual Environments

Presence Teleoperators & Virtual Environments ◽

10.1162/pres_a_00128 ◽

2012 ◽

Vol 21 (4) ◽

pp. 470-489 ◽

Cited By ~ 19

Author(s):

Amine Chellali ◽

Cedric Dumas ◽

Isabelle Milleville-Pennel

Keyword(s):

Teaching Method ◽

Skills Training ◽

Needle Insertion ◽

Learning System ◽

Fine Motor ◽

Skills Acquisition ◽

Surgical Skill ◽

Biopsy Procedure ◽

Haptic Communication ◽

Procedure Learning

In interventional radiology, physicians require high haptic sensitivity and fine motor skills development because of the limited real-time visual feedback of the surgical site. The transfer of this type of surgical skill to novices is a challenging issue. This paper presents a study on the design of a biopsy procedure learning system. Our methodology, based on a task-centered design approach, aims to bring out new design rules for virtual learning environments. A new collaborative haptic training paradigm is introduced to support human-haptic interaction in a virtual environment. The interaction paradigm supports haptic communication between two distant users to teach a surgical skill. In order to evaluate this paradigm, a user experiment was conducted. Sixty volunteer medical students participated in the study to assess the influence of the teaching method on their performance in a biopsy procedure task. The results show that to transfer the skills, the combination of haptic communication with verbal and visual communications improves the novices’ performance compared to conventional teaching methods. Furthermore, the results show that, depending on the teaching method, participants developed different needle insertion profiles. We conclude that our interaction paradigm facilitates expert-novice haptic communication and improves skills transfer; and new skills acquisition depends on the availability of different communication channels between experts and novices. Our findings indicate that the traditional fellowship methods in surgery should evolve to an off-patient collaborative environment that will continue to support visual and verbal communication, but also haptic communication, in order to achieve a better and more complete skills training.

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An Analysis of Soft Tissue Deformation by Needle Insertion

Proceedings of the 1992 Annual Meeting of JSME/MMD ◽

10.1299/jsmezairiki.2003.0_641 ◽

2003 ◽

Vol 2003 (0) ◽

pp. 641-642

Author(s):

Toshikatsu Washio ◽

Kiyoshi Yoshinaka ◽

Kiyoyuki Chinzei ◽

Kazuyuki Mizuhara

Keyword(s):

Soft Tissue ◽

Needle Insertion ◽

Tissue Deformation ◽

Soft Tissue Deformation

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Feasibility of Real-Time Angiographic Perfusion Imaging in the Treatment of Cerebral Vasospasm

Interventional Neurology ◽

10.1159/000468157 ◽

2017 ◽

Vol 6 (3-4) ◽

pp. 163-169 ◽

Cited By ~ 3

Author(s):

Christopher Donaldson ◽

Anthea H. O'Neill ◽

Lee-Anne Slater ◽

Winston Chong ◽

Leon T. Lai ◽

...

Keyword(s):

Real Time ◽

Cerebral Vasospasm ◽

Cerebral Artery ◽

Perfusion Imaging ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Mean Transit Time ◽

Objective Assessment ◽

Arterial Intervention ◽

Flow Analysis ◽

Treatment Procedures

Background: Objective assessment and quantification of the severity of cerebral vasospasm following aneurysmal subarachnoid hemorrhage is not routinely utilized. We investigated the feasibility of angiographic perfusion imaging derived from digital subtraction angiography (DSA) following endovascular vasospasm treatment procedures. Methodology: Real-time blood flow analysis was performed using parametric color coding on pre- and postintervention DSA. Semiquantitative parenchymal perfusion parameters (arrival time [AT] of contrast, time to peak [TTP] opacification, and mean transit time [MTT] of contrast) were calculated across 3 vascular territories (anterior cerebral artery [ACA], middle cerebral artery [MCA], and lenticulostriate arteries) using standard 2-D angiographic perfusion software. The pre- and postintervention arterial vessel diameters were compared. Results: Twelve endovascular vasospasm treatments in 6 patients were performed. All patients received intra-arterial vasodilator therapy with either nimodipine, milrinone, or both. Following intra-arterial intervention, parenchymal flow analysis showed improvement in TTP and MTT across all vascular territories (p < 0.002) and improvement in AT in the ACA and MCA territories (p < 0.03). Improvement in parenchymal perfusion parameters was associated with improvement in vessel diameters in all territories following treatment (p < 0.05). Conclusion: Real-time parenchymal perfusion imaging during endovascular vasospasm treatment procedures is feasible and provides reliable semiquantitative measurement of angiographic treatment response.

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Tissue Deformation and Insertion Force of Bee-Stinger Inspired Surgical Needles

Journal of Medical Devices ◽

10.1115/1.4040637 ◽

2018 ◽

Vol 12 (3) ◽

Author(s):

Mohammad Sahlabadi ◽

Parsaoran Hutapea

Keyword(s):

Three Dimensional ◽

Needle Insertion ◽

The Body ◽

Image Correlation ◽

Tissue Deformation ◽

Insertion Force ◽

Needle Path ◽

Percutaneous Procedures ◽

Target Locations ◽

Path Deviation

Surgical needles are commonly used to reach target locations inside of the body for percutaneous procedures. The major issues in needle steering in tissues are the insertion force which causes tissue damage and tissue deformation that causes the needle path deviation (i.e., tip deflection) resulting in the needle missing the intended target. In this study, honeybee-inspired needle prototypes were proposed and studied to decrease the insertion force and to reduce the tissue deformation. Three-dimensional (3D) printing technology was used to manufacture scaled-up needle prototypes. Needle insertion tests on tissue-mimicking polyvinyl chloride (PVC) gel were performed to measure the insertion force and the tip deflection. Digital image correlation (DIC) study was conducted to determine the tissue deformation during the insertion. It was demonstrated that the bioinspired needles can be utilized to decrease the insertion force by 24% and to minimize the tip deflection. It was also observed that the bioinspired needles decrease the tissue deformation by 17%. From this study, it can be concluded that the proposed bee-inspired needle design can be used to develop and manufacture innovative surgical needles for more effective and less invasive percutaneous procedures.

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Partial estimation of needle tip orientation in generalized coordinates in ultrasound image-guided needle insertion

2016 IEEE International Conference on Advanced Intelligent Mechatronics (AIM) ◽

10.1109/aim.2016.7576999 ◽

2016 ◽

Cited By ~ 4

Author(s):

Bita Fallahi ◽

Carlos Rossa ◽

Ronald Sloboda ◽

Nawaid Usmani ◽

Mahdi Tavakoli

Keyword(s):

Ultrasound Image ◽

Needle Insertion ◽

Generalized Coordinates ◽

Image Guided

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A novel tool for objective assessment of femorotibial rotation: a cadaver study

International Orthopaedics ◽

10.1007/s00264-010-1159-5 ◽

2010 ◽

Vol 35 (11) ◽

pp. 1611-1620 ◽

Cited By ~ 6

Author(s):

Philipp Ahrens ◽

Chlodwig Kirchhoff ◽

Florian Fischer ◽

Petra Heinrich ◽

Rüdiger von Eisenhart-Rothe ◽

...

Keyword(s):

Objective Assessment ◽

Cadaver Study

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Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study

BMC Anesthesiology ◽

10.1186/s12871-021-01444-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Youngwon Kim ◽

Seokha Yoo ◽

Sun-Kyung Park ◽

Hansu Bae ◽

Young-Jin Lim ◽

...

Keyword(s):

Spinal Anesthesia ◽

Ultrasound Image ◽

Image Data ◽

Needle Insertion ◽

Oblique View ◽

Optimal Angle ◽

Link Type ◽

Upper Level ◽

Positive Angle ◽

Lumbar Spondylolisthesis

Abstract Background Spondylolisthesis is a common degenerative spinal deformity. At the level of spondylolisthesis, the anatomy of the interlaminar space may differ from normal spine, in which case optimal angle of the needle insertion for spinal anesthesia may change. This study compared the optimal angle of needle insertion during spinal anesthesia in patients with and without lumbar spondylolisthesis using ultrasound. Methods We recruited 40 patients, 20 with and 20 without lumbar spondylolisthesis (group S and N, respectively). Ultrasonography was performed in the transverse midline and parasagittal oblique views at the spondylolisthesis level and the adjacent upper level. We measured the probe application angle with the longest interlaminar height of the ligamentum flavum-dura mater complex (LFD), depth from the skin to the LFD, depth from the skin to the anterior complex, and intrathecal space width. A positive angle represented a cephalad angulation. Results The optimal needle insertion angle in the transverse midline view at the spondylolisthesis level was (-) 2.7 ± 3.4° in group S and 0.8 ± 2.5° in group N (P$$<$$ < 0.001). In the parasagittal oblique view, it was (-) 2.7 ± 4.5° in group S and 1.0 ± 3.2° in group N (P = 0.004). There were no between-group differences in the angles at the upper level, with all cephalad angles in both views. Other ultrasound image data were comparable between groups. Conclusion In patients with spondylolisthesis, caudad angulation of the spinal needle can aid successful spinal puncture at spondylolisthesis level, both in the midline and paramedian approaches. Trial registration www.ClinicalTrials.gov (NCT04426916); registered 11 June 2020.

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Experimental study on needle insertion force to minimize tissue deformation in tongue tissue.

Medical Engineering & Physics ◽

10.1016/j.medengphy.2021.10.003 ◽

2021 ◽

Author(s):

Y. Aaboubout ◽

M.R. Nunes Soares ◽

E.M. Barroso ◽

L.C. van der Sar ◽

A. Bocharnikov ◽

...

Keyword(s):

Experimental Study ◽

Needle Insertion ◽

Tissue Deformation ◽

Insertion Force ◽

Needle Insertion Force

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A Review of Pneumatic Actuators Used for the Design of Medical Simulators and Medical Tools

Multimodal Technologies and Interaction ◽

10.3390/mti3030047 ◽

2019 ◽

Vol 3 (3) ◽

pp. 47 ◽

Cited By ~ 1

Author(s):

Thibault Sénac ◽

Arnaud Lelevé ◽

Richard Moreau ◽

Cyril Novales ◽

Laurence Nouaille ◽

...

Keyword(s):

Joint Venture ◽

Low Cost ◽

Objective Assessment ◽

Variable Stiffness ◽

Medical Specialty ◽

Needle Insertion ◽

Epidural Needle ◽

Body Parts ◽

Pneumatic Actuation ◽

Assisted Delivery

Simulators have been traditionally used for centuries during medical gestures training. Nowadays, mechatronic technologies have opened the way to more evolved solutions enabling objective assessment and dedicated pedagogic scenarios. Trainees can now practice in virtual environments representing various kind of patient and body parts including physio-pathologies issues. Gestures, to be mastered, vary according to each medical specialty (e.g., ultrasound probe orientations, or forceps installation during assisted delivery). Hence, medical students need kinesthetic feedback in order to significantly improve their learning capabilities. Gesture simulators require haptic devices with variable stiffness actuators. Existing solutions do not always fit the requirements because of their significant size. Contrary to electric actuators, pneumatic technology is low-cost, available off-the-shelf and offers a better mass–power ratio. However, it presents two main drawbacks: nonlinear dynamics and need for a compressed air supply. During the last decade, we have developed several haptic solutions based on pneumatic actuation (e.g., birth simulator, epidural needle insertion simulator) and, recently, in a joint venture with Prisme laboratory, a pneumatic probe master device for remote ultrasonography. This paper recalls literature scientific approaches on pneumatic actuation developed in the medical context and illustrated with the aforementioned applications to highlight the benefits.

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