Intuitive Guidance for Intervention and Diagnosis with Enhanced Ultrasound (i-Guide-U)

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Spinal needle injections are widely applied for anesthetic purposes: for surgery, for the relief of back pain, and for epidurals in obstetrics. More than two million North Americans undergo these procedures each year. However, about 60,000 patients per year experience complications associated with inaccurate placement of the needle. These complications have three consequences: (1) an increase in pain, anxiety and the length of hospital stay, (2) a small number of patients will suffer temporary or permanent neurologic deficit, and (3) the perceived risk inhibits more widespread use of spinal needle injections. To improve patient outcomes, several ultrasound-guided techniques have been proposed for more accurate placement of the needle. However, anesthesiologists experience poor quality depiction of anatomical features and difficulty in interpreting images, preventing ultrasound from becoming the standard-of-care.My proposal introduces intuitive guidance for intervention and diagnosis with enhanced ultrasound (i-Guide-U) technologies that augment computer models derived from other imaging modalities to improve the quality of ultrasound images and enhance interpretations. For the first time, it combines medical image registration and ultrasound tissue typing to dramatically improve ultrasound image formation quality based on the knowledge of the underlying anatomy. These methods will be integrated and evaluated in the context of spinal needle injection for improved visibility of critical anatomical structures and targeting. This program will train two PhD, five MSc and five undergraduate students in leading edge biomedical engineering research.