Towards an Advanced Virtual Ultrasound-guided Renal Biopsy Trainer.
Towards an Advanced Virtual Ultrasound-guided Renal Biopsy Trainer.
复制标题
迈向先进的虚拟超声引导肾活检训练器。
DOI：
10.1117/12.2512871
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Enquobahrie,Andinet
中科院分区：
文献类型：
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作者：
Horvath,Samantha;Arikatla,Sreekanth;Cleary,Kevin;Sharma,Karun;Rosenberg,Avi;Enquobahrie,Andinet
超声(US)引导下的肾脏活检是评估和处理具有诊断和预后意义的非恶性肾脏病变的重要工具。要安全而稳定地获得用于组织分析的高产量活检样本，需要良好的活检技术和技能。本项目旨在开发一个虚拟培训器，以帮助临床医生提高实时超声引导肾活检的操作技能能力。本文介绍了一种低成本、高保真的训练器，该训练器使用低成本的硬件组件和开源的可视化和交互模拟库：交互式医学模拟工具包(IMSTK)和3D Slicer。我们使用了一个物理模型来模拟受训者在扫描真实患者时所经历的触觉反馈，并为受训者提供关于患者解剖的US扫描平面的空间感知。超声探头和活检针使用常用的临床工具建模，并安装仪器以与模拟器进行通信。3D切片器用于根据探头的位置对从预先获取的3-D超声体积切片的图像进行可视化，并提供逼真的针状渲染。IMSTK中的模拟引擎模拟了针和虚拟组织之间的相互作用，以在组织上产生视觉变形，并在针上产生触觉作用力，这些力传递到用户手中的针上。初步测试表明，在模拟图像质量和系统响应性方面，结果令人振奋。下一阶段计划由临床医生进行进一步评估。
Ultrasound (US)-guided renal biopsy is a critically important tool in the evaluation and management of non-malignant renal pathologies with diagnostic and prognostic significance. It requires a good biopsy technique and skill to safely and consistently obtain high yield biopsy samples for tissue analysis. This project aims to develop a virtual trainer to help clinicians to improve procedural skill competence in real-time ultrasound-guided renal biopsy. This paper presents a cost-effective, high-fidelity trainer built using low-cost hardware components and open source visualization and interactive simulation libraries: interactive medical simulation toolkit (iMSTK) and 3D Slicer. We used a physical mannequin to simulate the tactile feedback that trainees experience while scanning a real patient and to provide trainees with spatial awareness of the US scanning plane with respect to the patient’s anatomy. The ultrasound probe and biopsy needle were modeled using commonly used clinical tools and were instrumented to communicate with the simulator. 3D Slicer was used to visualize an image sliced from a pre-acquired 3-D ultrasound volume based on the location of the probe, with a realistic needle rendering. The simulation engine in iMSTK modeled the interaction between the needle and the virtual tissue to generate visual deformations on the tissue and tactile forces on the needle which are transmitted to the needle that the user holds. Initial testing has shown promising results with respect to quality of simulated images and system responsiveness. Further evaluation by clinicians is planned for the next stage.