Advanced virtual simulator for real-time ultrasound-guided renal biopsy training

摘要 肾脏精准医学项目(KPMP)的目标是创建一个 肾脏组织图谱，定义疾病亚组，并确定关键细胞、途径和靶点 通过获取和评估急性肾功能衰竭患者的肾脏活检来寻找新的治疗方法 肾损伤(AKI)和慢性肾脏疾病(CKD)。作为这一努力的一部分，有必要 提高人类肾脏活检安全性以及质量和质量的新技术 诊断率，以便活检组织产生有用的研究或临床信息。 超声引导下的肾活检是评估和处理肾脏病变的重要工具。 肾脏的病理变化。此第一阶段SBIR提案的目标是开发一个虚拟模拟器，以 培训临床医生提高实时超声引导下肾脏手术的操作技能 活组织检查。 尽管针设计和超声成像的改进是有帮助的， 优秀的活检技术和技巧是持续获得高产量肾脏的关键。 活组织检查样本。此外，糟糕的肾活检技术可能会导致显著的 并发症和不利的致命后果。本项目中提出的模拟器将 在无风险的环境中加快超声引导肾活检的培训，最终 提高肾活检的安全性，确保肾活检的质量 可以提供有用的临床信息的标本。 拟议的系统将使放射科医生、肾科医生和介入医生受益。 放射科医生在两个方面：(A)改进了三维和动态超声成像 专门进行针吸活组织检查的解释和(B)提高了手工操作的灵活性 在触觉反馈的帮助下处理针头。该项目是Kitware之间的合作 Inc.和国家儿童医疗中心。Kitware是创建和支持 最先进的软件和技术，在图像引导领域拥有超过15年的经验 干预措施。国家儿童医学中心(CNMC)是国际公认的 儿科医院在肾脏病理的临床管理方面拥有广泛的专业知识。这个 两家机构已经在包括IMAGE在内的几个项目上成功合作 有指导的活组织检查项目。一期工程的目标是建立虚拟模拟器系统 并通过与儿科放射科医生、肾科医生和 CNMC的介入放射科医生。第一阶段工作的成功完成将导致 验证了我们的模拟器系统的概念，并为进一步的系统奠定了基础 第二阶段的开发和验证。

ABSTRACT The objectives of the Kidney Precision Medicine Project (KPMP) project are to create a kidney tissue atlas, define disease subgroups, and identify critical cells, pathways and targets for novel therapies by obtaining and evaluating kidney biopsies from participants with acute kidney injury (AKI) and chronic kidney disease (CKD). As part of this effort, there is a need for new technologies that improve the safety of the human kidney biopsy as well as the quality and diagnostic yield so that the biopsy tissue yields useful research or clinical information. Ultrasound-guided kidney biopsy is a critically important tool in the evaluation and management of renal pathologies. The goal of this Phase I SBIR proposal is to develop a virtual simulator to train clinicians to improve procedural skill competence in real-time ultrasound-guided renal biopsy. Although improvements in needle design and ultrasound imaging have been helpful, excellent biopsy technique and skill are essential to consistently obtaining high yield renal biopsy samples. Furthermore, poor renal biopsy technique can potentially lead to significant complications and adverse lethal outcomes. The simulator proposed in this project will accelerate the training of ultrasound-guided renal biopsy in a risk-free environment, ultimately improving the safety of kidney biopsy and ensuring that the biopsy procedure yields high quality specimen that can provide useful clinical information. The proposed system will benefit radiologists, nephrologists, and interventional radiologists in two ways: (a) Improved three dimensional and dynamic ultrasound imaging interpretation specific to performing a needle biopsy and (b) Improved manual dexterity in needle handling with the aid of tactile feedback. This project is a collaboration between Kitware Inc. and Children's National Medical Center. Kitware is a leader in the creation and support of state-of-the-art software and technology with more than 15 years of experience in image-guided interventions. Children's National Medical Center (CNMC) is an internationally recognized pediatric hospital with extensive expertise in the clinical management of renal pathologies. The two institutions have already collaborated successfully on several projects including image guided biopsy projects. The aims of the Phase I project are to build the virtual simulator system and evaluate it by conducting a study with pediatric radiologists, nephrologists, and interventional radiologists at CNMC. The successful completion of the Phase I work will result in a proof of concept of our simulator system and lay the groundwork for further system development and validation in Phase II.