Portable Ultrasound System for Automated Detection of Abdominal Free-Fluid

项目摘要/摘要 创伤超声重点评估(FAST)检查是重视快速发现的标准 急诊医疗和创伤重症监护中的腹部游离液体。这是一种临终关怀的超声波检查 包含腹部的四个视图。在创伤中，在证实之前，腹部游离液体被认为是血液。 否则的话。及时检测至关重要，因为如果不进行治疗，腹部出血可能会迅速导致 失血性休克和死亡。执行和口译快速考试需要适当的培训和 练习一下。在社区医院，由于接触医生的机会有限，快速检查没有得到充分利用 能够进行检查(通常是急诊医生或创伤外科医生)。此外，低成本和 超声波的便携性使其成为院前设置的理想分诊工具。在这些设置中，检测 腹部自由液体将影响医疗运输的轻重缓急和有限资源的分配。 BioSensics与波士顿大学医学院合作，提议开发一种便携式 超声波系统，使受过最低程度培训的操作员能够进行快速检查。该系统将引导 操作者通过图像采集过程，自动计算出腹部自由液体的概率。 一个根本的创新是超声探头相对于患者的位置和方向将是 测量并用于通知图像处理系统和操作员引导系统。可行性 该系统的图像处理组件已通过两项回顾研究进行了演示 肝周(如右上腹)腹部超声图。在第一个研究中(在我们的第一阶段SBIR之前) 在20个快速检查的队列中，腹部游离液体被鉴定为100%的敏感性和90%的特异性。 由腹水等腹水引起的内科原因。在第二项研究中(本项目第一阶段) 在47例腹水患者中，腹水诊断的敏感性为81%，特异性为88%。 腹膜积血和51例阴性对照(腹膜积血，尤其是外伤性腹膜积血分类较多 因为自由液体体积通常较小，所以很困难)。此外，在第一阶段，我们建立了一个超声波系统 它记录了图像采集过程中探头的位置和方向。 第二阶段SBIR项目的目标如下：1)开发有效的图像处理算法 要计算在所有四个快速检查视图中存在腹部自由液体的概率，请展开 之前为肝周切面所做的工作；以及2)开发和测试软件以使受过最低程度培训的用户能够 通过提供基于探头位置和方向的实时指导来执行快速检查。建议数 技术具有巨大的商业化潜力。我们的首要目标市场是急救医疗服务。 (EMS)包括民用救护车公司和美国军方。我们的第二个目标市场是紧急市场 特别注重农村和社区医院的科室。更广泛地说，这项技术可能有助于 许多需要对腹部游离液体进行非创伤性评估的环境。

PROJECT SUMMARY / ABSTRACT The Focused Assessment with Sonography in Trauma (FAST) exam is the standard of care for rapid detection of abdominal free fluid in emergency medicine and trauma critical care. It is a point-of-care ultrasound exam that incorporates four views of the abdomen. In trauma, abdominal free fluid is assumed to be blood until proven otherwise. Timely detection is critical because if untreated abdominal hemorrhage can rapidly lead to hemorrhagic shock and death. Performing and interpreting a FAST exam requires appropriate training and practice. In community hospitals the FAST exam is underutilized due to limited access to physicians who are able to perform the exam (typically an emergency physician or trauma surgeon). In addition, the low cost and portability of ultrasound make it an ideal triage tool for pre-hospital settings. In these settings, detection of abdominal free fluid would impact medical transport prioritization and aid in the distribution of limited resources. BioSensics, in collaboration with Boston University School of Medicine, proposes to develop a portable ultrasound system to enable a minimally trained operator to perform a FAST exam. The system will guide the operator through the image acquisition process and automatically compute a probability for abdominal free fluid. A fundamental innovation is that ultrasound probe position and orientation, with respect to the patient, will be measured and used to inform both the image processing system and the operator guidance system. Feasibility of the image processing component of the system has been demonstrated through two retrospective studies of perihepatic (e.g., right upper quadrant) abdominal ultrasound views. In the first study (prior to our Phase I SBIR) abdominal free fluid was identified with 100% sensitivity and 90% specificity in a cohort of 20 FAST exams mostly from medical causes of abdominal free fluid, such as ascites. In the second study (during Phase I of this project) abdominal free fluid was identified with 81% sensitivity and 88% specificity in a cohort of 47 cases of hemoperitoneum and 51 negative controls (classification of hemoperitoneum, especially from trauma, is more difficult because the free fluid volume is often smaller). In addition, during Phase I we built an ultrasound system that records the position and orientation of the probe during the image acquisition process. The objectives of this Phase II SBIR project are the following: 1) develop validate image processing algorithms to compute a probability for the presence of abdominal free fluid in all four FAST exam views by expanding on the prior work done for the perihepatic view; and 2) develop and test software to enable a minimally trained user to perform a FAST exam by providing real-time guidance based on probe position and orientation. The proposed technology has significant commercialization potential. Our first target market is emergency medical services (EMS) including civilian ambulance companies and the US military. Our second target market is emergency departments with a particular focus on rural and community hospitals. More broadly, the technology could aid in many settings where non-trauma assessment of abdominal free fluid is necessary.