A Computerized Tutor Prototype for Prostate Cryotherapy: Key Building Blocks and System Evaluation.
A Computerized Tutor Prototype for Prostate Cryotherapy: Key Building Blocks and System Evaluation.
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前列腺冷冻治疗的计算机化导师原型：关键构建模块和系统评估。
DOI：
10.1117/12.2257151
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
McCormick,JamesT
中科院分区：
文献类型：
--
作者：
Rabin,Yoed;Shimada,Kenji;Joshi,Purva;Sehrawat,Anjali;Keelan,Robert;Wilfong,DonaM;McCormick,JamesT
本文着重于评估的原型，基于计算机的辅导系统的前列腺冷冻手术，同时审查其关键的积木和基准性能。辅导系统列出冷冻探针放置的几何约束，显示前列腺的渲染形状，模拟冷冻探针插入，实现距离测量，模拟对应的热历史，并评估目标区域形状与预先选择的计划等温线之间的失配。学员规划的质量是衡量比较与计算机生成的计划，创建了一个以前开发的规划算法，称为气泡包装的每个案例研究。虽然本研究中的辅导水平仅针对冷冻探针放置的几何约束和由此产生的热历史，但它创造了一个独特的机会来深入了解手术室外的过程。导师的系统验证已经通过收集来自外科住院医师的培训数据来进行，这些住院医师没有先前的经验或冷冻治疗的先进知识。此外，该系统已被没有受过正规医学教育的工程专业研究生评估。在规划等温线和目标区域形状之间的匹配方面，结果表明，在50分钟的培训过程中，医疗居民的表现从前测的4.4%提高到后测的37.8%（计算机优化计划的10%范围内）。将这些结果与工程专业学生的表现进行比较，结果相似，表明冷冻探针布局的规划基本上围绕几何考虑。
This paper focuses on the evaluation of a prototype for a computer-based tutoring system for prostate cryosurgery, while reviewing its key building blocks and their benchmark performance. The tutoring system lists geometrical constraints of cryoprobe placement, displays a rendered shape of the prostate, simulates cryoprobe insertion, enables distance measurements, simulates the corresponding thermal history, and evaluates the mismatch between the target region shape and a pre-selected planning isotherm. The quality of trainee planning is measured in comparison with a computergenerated plan, created for each case study by a previously developed planning algorithm, known as bubble-packing. While the tutoring level in this study aims only at geometrical constraints on cryoprobe placement and the resulting thermal history, it creates a unique opportunity to gain insight into the process outside of the operation room. System validation of the tutor has been performed by collecting training data from surgical residents, having no prior experience or advanced knowledge of cryotherapy. Furthermore, the system has been evaluated by graduate engineering students having no formal education in medicine. In terms of match between a planning isotherm and the target region shape, results demonstrate medical residents’ performance improved from 4.4% in a pretest to 37.8% in a posttest over a course of 50 minutes of training (within 10% margins from a computer-optimized plan). Comparing those results with the performance of engineering students indicates similar results, suggesting that planning of the cryoprobe layout essentially revolves around geometric considerations.
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