Robotic Lung Ultrasound for Triage of COVID-19 Patients in a Resource-Limited Environment

在资源有限的环境中使用机器人肺部超声对 COVID-19 患者进行分类

• 批准号: 10199160
• 负责人: John Hardin
• 金额: $ 38.65万
• 依托单位: WORCESTER POLYTECHNIC INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10199160
• 关键词: 2019-nCoV; Acoustics; Acute; Affect; Area; Body Surface; COVID-19; Chest; Clinical Trials; Computational algorithm; Computer-Assisted Diagnosis; Conduct Clinical Trials; Control Groups; Country; Coupling; Data Collection; Data Set; Detection; Diagnosis; Diagnostic; Diagnostic Imaging; Diagnostic tests; Disease; Electronics; Engineering; Ensure; Environment; Goals; Guidelines; Health Personnel; Health system; Healthcare; Hospitals; Human; Hybrids; Image; Institutional Review Boards; International; Intuition; Lead; Lung; Manuals; Mechanics; Mission; Monitor; Neonatal; Nigeria; Patient Triage; Patients; Performance; Phase I Clinical Trials; Physicians; Play; Procedures; Protocols documentation; Radiation; Reproducibility; Research; Resources; Respiratory Signs and Symptoms; Respiratory distress; Risk; Robot; Robotics; Roentgen Rays; Role; Safety; Scanning; Scientist; Severities; Side; Structure; System; Thoracic Radiography; Time; Tissues; Training; Triage; Ultrasonography; Validation; X-Ray Film; accurate diagnosis; base; chest computed tomography; clinical efficacy; contagion; cost; data standards; design; diagnostic accuracy; experimental study; health care delivery; healthy volunteer; imaging modality; improved; interest; kinematics; lung basal segment; novel; operation; pandemic disease; patient safety; point of care; portability; pressure; rapid diagnosis; response; risk minimization; robot assistance; robot control; transmission process; virtual; visual information

PROJECT SUMMARY Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already taken on a pandemic of epic proportions, affecting over 8 million humans in an estimated 100 countries. A global response to prepare health systems worldwide is of utmost importance. Respiratory symptoms are the primary manifestation of COVID-19, and the disease caused by SARS-CoV-2 can range from mild illness to severe, acute and fulminant respiratory distress. This varying severity in the face of a worldwide pandemic necessitates rapid diagnosis to provide the proper triage and disposition of patients. Diagnostic testing such as plain-film radiography (x-ray) and chest computed tomography (CT) are considered the mainstay of diagnostic imaging in the detection of lung-related disease. Lung ultrasound (LUS) has emerged as an alternative to x-ray and chest CT for rapid diagnosis of COVID-19 affected patients with major advantages include safety, absence of radiation, low cost, and its portability for ease of bedside diagnosis. Guidelines for LUS imaging in COVID-19 patients have been proposed. However, LUS imaging is highly operator dependent. In resource-limited areas, the accessibility is limited by the small number of physicians and sonographers who are properly trained in providing accurate diagnosis. Additionally, LUS imaging requires close physical proximity between the operator and patient, which could lead to an increased risk of COVID-19 transmission. Therefore, there is a unmet need to develop a more accessible LUS system for COVID-19 patients, whereby reducing physical contact between the operator and patient. In this proposal, we aim to develop a safe, low-cost, and easy-to-use robotic LUS platform to 1) maximize the accessibility in a resource-limited environment and 2) minimize the risk of COVID-19 transmission between patients and healthcare workers. This robotic platform will be designed to conduct LUS procedures following established diagnostic workflows, while ensuring adequate safety. The proposed gantry-based robot platform allows the operator to tele-operatively manipulate the ultrasound probe based on visual information from cameras. Thus, the operator is not required to be present with the patient, improving accessibility. An optimal tissue-probe contact pressure will be maintained by an electronics-free passive mechanical configuration to avoid excessive contact forces and ensure patient safety. The gantry system is structurally simple, low-cost, and easy to implement in a research-limited environment. Specifically, we propose to evaluate the robotic LUS platform with the active-passive hybrid control (Aim 1), demonstrate the safety and cross-validation in healthy volunteers (Aim 2), and demonstrate the system reliability and performance in COVID19 patients (Aim 3). This proposed robotic LUS platform (1) makes the LUS procedure more accessible in a resource-limited environment, (2) minimizes the risk of contagion between patients and healthcare workers and, (3) establishes standardized data collection of LUS to improve the efficacy. The proposed system has the potential to play a critical role in maximizing healthcare function via triaging of patients suspected to or have been diagnosed with COVID-19.

项目摘要 新型严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）已经呈现出史诗般的大流行， 比例，影响到估计100个国家的800多万人。全球应对措施， 世界范围内的系统至关重要。呼吸道症状是COVID-19的主要表现， SARS-CoV-2引起的疾病范围从轻度疾病到严重、急性和爆发性呼吸道疾病 痛苦面对世界范围内的大流行，这种不同的严重程度需要快速诊断，以提供 对病人进行适当的分类和处置。诊断测试，如平片X线摄影（X光）和胸部 计算机断层扫描（CT）被认为是检测肺部相关疾病的诊断成像的支柱 疾病肺部超声（LUS）已成为X射线和胸部CT的替代方法，用于快速诊断肺结核。 受COVID-19影响的患者的主要优势包括安全，无辐射，成本低， 便携性，便于床边诊断。COVID-19患者LUS成像指南已经提出。 然而，LUS成像高度依赖于操作者。在资源有限的地区， 在提供准确诊断方面接受过适当培训的医生和超声技师人数较少。 此外，LUS成像需要操作者和患者之间的紧密物理接近，这可能导致 COVID-19传播的风险增加。因此，需要开发一种更容易获得的 LUS系统用于COVID-19患者，从而减少操作员与患者之间的身体接触。 在这项提案中，我们的目标是开发一个安全，低成本，易于使用的机器人LUS平台，以1）最大限度地提高 在资源有限的环境中的可达性，以及2）最大限度地降低COVID-19在 患者和医护人员。该机器人平台将被设计用于执行LUS程序， 建立诊断工作流程，同时确保足够的安全性。所提出的基于龙门架的机器人平台 允许操作者基于来自超声探头的视觉信息 相机因此，操作者不需要与患者在一起，提高了可达性。最佳 组织探针接触压力将由无电子的无源机械配置保持， 避免接触力过大，确保患者安全。该门架系统结构简单、成本低， 易于在研究受限的环境中实现。具体来说，我们建议评估机器人LUS 平台与主被动混合控制（目标1），证明了安全性和交叉验证，在健康 志愿者（目标2），并证明系统在COVID 19患者中的可靠性和性能（目标3）。这 所提出的机器人LUS平台（1）使得LUS过程在资源有限的环境中更容易获得， (2)最大限度地减少病人和医护人员之间的传染风险，（3）建立标准化的 LUS的数据收集，以提高疗效。拟议的系统有可能在以下方面发挥关键作用： 通过对疑似或已确诊COVID-19的患者进行分诊，最大限度地发挥医疗保健功能。