Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology

Purpose Comparison of puncture deviation and puncture duration between computed tomography (CT)- and C-arm CT (CACT)-guided puncture performed by residents in training (RiT). Methods In a cohort of 25 RiTs enrolled in a research training program either CT- or CACT-guided puncture was performed on a phantom. Prior to the experiments, the RiT’s level of training, experience playing a musical instrument, video games, and ball sports, and self-assessed manual skills and spatial skills were recorded. Each RiT performed two punctures. The first puncture was performed with a transaxial or single angulated needle path and the second with a single or double angulated needle path. Puncture deviation and puncture duration were compared between the procedures and were correlated with the self-assessments. Results RiTs in both the CT guidance and CACT guidance groups did not differ with respect to radiologic experience (p = 1), angiographic experience (p = 0.415), and number of ultrasound-guided puncture procedures (p = 0.483), CT-guided puncture procedures (p = 0.934), and CACT-guided puncture procedures (p = 0.466). The puncture duration was significantly longer with CT guidance (without navigation tool) than with CACT guidance with navigation software (p < 0.001). There was no significant difference in the puncture duration between the first and second puncture using CT guidance (p = 0.719). However, in the case of CACT, the second puncture was significantly faster (p = 0.006). Puncture deviations were not different between CT-guided and CACT-guided puncture (p = 0.337) and between the first and second puncture of CT-guided and CACT-guided puncture (CT: p = 0.130; CACT: p = 0.391). The self-assessment of manual skills did not correlate with puncture deviation (p = 0.059) and puncture duration (p = 0.158). The self-assessed spatial skills correlated positively with puncture deviation (p = 0.011) but not with puncture duration (p = 0.541). Conclusion The RiTs achieved a puncture deviation that was clinically adequate with respect to their level of training and did not differ between CT-guided and CACT-guided puncture. The puncture duration was shorter when using CACT. CACT guidance with navigation software support has a potentially steeper learning curve. Spatial skills might accelerate the learning of image-guided puncture. Key Points: Citation Format

Method to Identify Accessory Root Canals using a New CBCT Software

This study describes a methodology to identify accessory root canals using the e-Vol DX software in CBCT scans. Accessory root canals are strategic shelters for microorganisms present in root canal infections. The identification of these small canals in periapical radiographic exams has limitations, besides being markedly limited accessibility to the action of endodontic instruments and to the antimicrobial agents. A significant number of accessory canals have sufficient diameters to be visible on cone-beam computed tomography (CBCT) images of high spatial resolution. Therefore, it may go unnoticed or even confused when there is no specific training for this type of diagnosis. The methodology consists in establishing thin slices (0.1mm or smaller) obtained from coronal, sagittal and axial slices. The method consists of the following steps: during navigation along the long axis of a root canal when finding a possible hypodense line of main root canal in a tomographic section (axial, sagittal or coronal), the navigation software lines of the multiplanar reconstruction (MPR) must be adjusted so that they are parallel and perpendicular to the hypodense line (parallax correction). Then, after judiciously adjusted, the accessory canal image will invariably appear as a line on one of the MPR tomographic slices, another line on another slice, and a dot on the third slice. The three sections of the MPR present images with the “line-line-dot” sequence. In this way, it is possible to identify an accessory root canal and also visualize it in volumetric reconstruction in a specific filter. The application of this method is easy to employed and may benefit the diagnosis when you want to visualize accessory root canals and distinguish it from root fracture line.

Natural language understanding of map navigation queries in Roman Urdu by joint entity and intent determination

Navigation based task-oriented dialogue systems provide users with a natural way of communicating with maps and navigation software. Natural language understanding (NLU) is the first step for a task-oriented dialogue system. It extracts the important entities (slot tagging) from the user’s utterance and determines the user’s objective (intent determination). Word embeddings are the distributed representations of the input sentence, and encompass the sentence’s semantic and syntactic representations. We created the word embeddings using different methods like FastText, ELMO, BERT and XLNET; and studied their effect on the natural language understanding output. Experiments are performed on the Roman Urdu navigation utterances dataset. The results show that for the intent determination task XLNET based word embeddings outperform other methods; while for the task of slot tagging FastText and XLNET based word embeddings have much better accuracy in comparison to other approaches.

Is the Greater Trochanter the Ideal Freehand Landmark for the S2AI Screw Angle in the Caudal Direction? Commentary on “Extra-articular Portion of the Sacroiliac Joint—Between the Sacral and Pelvic Tuberosities: An Anatomical Guide for the S2-Alar-Iliac Screw Trajectory” by Tatara et al

The author introduced a novel freehand technique for S2-Alar-Iliac screw placement Which demonstrated good clinical safety. However the optimal anatomical landmarks of the screw angle in the caudal direction have not been unified. The tip of the greater trochanter(TGT) was one of the most frequently chosen landmark in fluoroscopic or navigation guidance technique. Additional adjustments are always needed according to these studies. The freehand technique of the present study also choose the TGT as the as the landmark of the S2AI screw angle in the caudal direction, whether it also need any adjustment? We hope the author could explain more about this issue. Besides, the relationship between TGT and the sacral iliac bone is not static, which will make the reliability of the pre-surgery navigation software simulation doubtful.

An Optics-guided Robotic System for Dental Implant Surgery

At present, dental implant surgery mainly relies on the clinical experience of the doctor and the assistance of preoperative medical imaging. However, there are some problems in dental implant surgery, such as narrow space, sight obstruction, inaccurate positioning, and high requirements of doctors' proficiency. Therefore, a dental implant robot system (DIRS) guided by optical navigation is developed in this study, with an x-shaped tool and an irregular pentagonal tracer are designed for spatial registration and needle tip positioning strategy respectively. The coordinate system of each unit in DIRS is unified through system calibration, spatial registration, and needle tip positioning strategy. Then the surgical path is planned on the Computed Tomography (CT) images in the navigation software before operation. The automatic positioning method and the auxiliary positioning method can be used in the operation to achieve accurate positioning and assist doctors to complete the operation. The errors of spatial registration, needle tip positioning strategy, and the overall accuracy of the system were evaluated respectively, and the results showed that they all met the needs of clinical surgery. This study preliminarily verified the feasibility of the precise positioning method for dental surgery robots and provided certain ideas for subsequent related research.

Hardware in the Loop Topology for an Omnidirectional Mobile Robot Using Matlab in a Robot Operating System Environment

The symmetry of the omnidirectional robot motion abilities around its central vertical axis is an important advantage regarding its driveability for the flexible interoperation with fixed conveyor systems. The paper illustrates a Hardware in the Loop architectural approach for integrated development of an Ominidirectional Mobile Robot that is designed to serve in a dynamic logistic environment. Such logistic environments require complex algorithms for autonomous navigation between different warehouse locations, that can be efficiently developed using Robot Operating System nodes. Implementing path planning nodes benefits from using Matlab-Simulink, which provides a large selection of algorithms that are easily integrated and customized. The proposed solution is deployed for validation on a NVIDIA Jetson Nano, the embedded computer hosted locally on the robot, that runs the autonomous navigation software. The proposed solution permits the live connection to the omnidirectional prototype platform, allowing to deploy algorithms and acquire data for debugging the location, path planning and the mapping information during real time autonomous navigation experiments, very useful in validating different strategies.

Time-saving Effects Using Helicopter Transportation: Comparison to a Ground Transportation Time Predicted Using a Social Navigation Software

IntroductionPrevious comparison studies regarding two types of transportation, helicopter (HEMS) versus ground emergency medical services (GEMS), have shown underlying heterogeneity as these options have completely different routes and consequent times with reference to one patient. To compare the two types of transportation on a case-by-case basis, we analyzed the retrospectively reviewed HEMS and predicted GEMS data using an open-source navigation software.MethodsPatients transferred by military HEMS from 2016 to 2019 were retrospectively enrolled. The HEMS records on the time of notification, injury point and destination address, and time required were reviewed. The GEMS data on distance and the predicted time required were acquired using open-source social navigation systems. Comparison analyses between the two types of transportation were conducted. Further, linear logistic regression analyses were performed on the distance and time of the two options.ResultsA total of 183 patients were enrolled. There was no statistical difference (p=0.3021) in the distance between the two types of transportation, and the HEMS time was significantly shorter than that of GEMS (61.31 vs. 116.92 minutes, p<0.001). The simple linear curves for HEMS and GEMS were separately secured, and two graphs presented the statistical significance (p) as well as reasonable goodness-of-fit (R2). In general, the HEMS graph demonstrates a more gradual slope and narrow distribution compared to that of GEMS. ConclusionIdeally, HEMS is identified as a better transportation modality because it has a shorter transportation time (56 minutes saved) and a low possibility of potential time delays (larger R2).Running tileHelicopter vs. navigation-based ground ambulance