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 通过获得和评估急性肾功能不全患者的肾活检， 肾损伤（AKI）和慢性肾病（CKD）。作为这项努力的一部分，需要 新技术提高了人类肾脏活检的安全性以及质量， 诊断产量，使得活检组织产生有用的研究或临床信息。 超声引导下肾活检是一个非常重要的工具，在评估和管理 肾脏病理学第一阶段SBIR提案的目标是开发一个虚拟模拟器， 培训临床医生，以提高实时超声引导肾活检的操作技能 活检 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能是持续获得高产量肾组织的关键 活检样本此外，较差的肾活检技术可能导致显著的 并发症和不利的致命后果。本项目提出的模拟器将 加速在无风险环境中进行超声引导肾活检的培训， 提高肾活检的安全性并确保活检程序产生高质量 可以提供有用临床信息的标本。 所提出的系统将有利于放射科医生，肾脏科医生，和介入 放射科医生在两个方面：（a）改进三维和动态超声成像 和（B）改进的手动灵活性， 在触觉反馈的帮助下进行针头操作。该项目是Kitware与 Inc.儿童国家医疗中心Kitware是创建和支持 先进的软件和技术，拥有超过15年的图像引导经验 干预措施。儿童国家医疗中心（CNMC）是国际公认的 在肾脏病理临床管理方面具有丰富专业知识的儿科医院。的 两个机构已经成功地合作了几个项目， 引导活检项目。第一期工程的目标是建立虚拟仿真系统 并通过与儿科放射科医生、肾脏科医生和 CNMC的介入放射科医生第一阶段工作的顺利完成将导致 我们的模拟器系统的概念证明，并为进一步的系统奠定基础 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.