Individualized Ultrasound-Guided Intervention Phantom Development, Fabrication, and Proof of Concept.

Journal: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
Published Date: Jul 1, 2023

Abstract

Commercial ultrasound vascular phantoms lack the anatomic diversity required for robust pre-clinical interventional device testing. We fabricated individualized phantoms to test an artificial intelligence enabled ultrasound-guided surgical robotic system (AI-GUIDE) which allows novices to cannulate deep vessels. After segmenting vessels on computed tomography scans, vessel cores, bony anatomy, and a mold tailored to the skin contour were 3D-printed. Vessel cores were coated in silicone, surrounded in tissue-mimicking gel tailored for ultrasound and needle insertion, and dissolved with water. One upper arm and four inguinal phantoms were constructed. Operators used AI-GUIDE to deploy needles into phantom vessels. Two groin phantoms were tested due to imaging artifacts in the other two phantoms. Six operators (medical experience: none, 3; 1-5 years, 2; 5+ years, 1) inserted 27 inguinal needles with 81% (22/27) success in a median of 48 seconds. Seven operators performed 24 arm injections, without tuning the AI for arm anatomy, with 71% (17/24) success. After excluding failures due to motor malfunction and a defective needle, success rate was 100% (22/22) in the groin and 85% (17/20) in the arm. Individualized 3D-printed phantoms permit testing of surgical robotics across a large number of operators and different anatomic sites. AI-GUIDE operators rapidly and reliably inserted a needle into target vessels in the upper arm and groin, even without prior medical training. Virtual device trials in individualized 3-D printed phantoms may improve rigor of results and expedite translation.Clinical Relevance- Individualized phantoms enable rigorous and efficient evaluation of interventional devices and reduce the need for animal and human subject testing.

Authors

  • Theodore T Pierce
    Department of Radiology, Massachusetts General Hospital, White 270, 55 Fruit Street, Boston, MA, 02114, USA.
  • Mark P Ottensmeyer
    Medical Device & Simulation Laboratory, Department of Radiology, Massachusetts General Hospital; Harvard Medical School.
  • Avik Som
  • Laura J Brattain
    MIT Lincoln Laboratory, 244 Wood St, Lexington, MA, 02420, USA. brattainl@ll.mit.edu.
  • Joshua S Werblin
  • Patrick D Sutphin
  • Scott Schoen
  • Matthew R Johnson
    University of Nebraska-Lincoln, Lincoln, NE, USA.
  • Lars Gjesteby
    Biomedical Imaging Center, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, 12180, United States of America.
  • Brian A Telfer
    MIT Lincoln Laboratory, 244 Wood St, Lexington, MA, 02420, USA.
  • Anthony E Samir
    Division of Ultrasound, Department of Radiology, Center for Ultrasound Research & Translation, Massachusetts General Hospital, Boston, MA, 02114, USA.

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