Horvath Samantha, Arikatla Sreekanth, Cleary Kevin, Sharma Karun, Rosenberg Avi, Enquobahrie Andinet
Kitware, Inc.
Childrens National Medical Center.
Proc SPIE Int Soc Opt Eng. 2019 Feb;10951. doi: 10.1117/12.2512871. Epub 2019 Mar 12.
Ultrasound (US)-guided renal biopsy is a critically important tool in the evaluation and management of non-malignant renal pathologies with diagnostic and prognostic significance. It requires a good biopsy technique and skill to safely and consistently obtain high yield biopsy samples for tissue analysis. This project aims to develop a virtual trainer to help clinicians to improve procedural skill competence in real-time ultrasound-guided renal biopsy. This paper presents a cost-effective, high-fidelity trainer built using low-cost hardware components and open source visualization and interactive simulation libraries: interactive medical simulation toolkit (iMSTK) and 3D Slicer. We used a physical mannequin to simulate the tactile feedback that trainees experience while scanning a real patient and to provide trainees with spatial awareness of the US scanning plane with respect to the patient's anatomy. The ultrasound probe and biopsy needle were modeled using commonly used clinical tools and were instrumented to communicate with the simulator. 3D Slicer was used to visualize an image sliced from a pre-acquired 3-D ultrasound volume based on the location of the probe, with a realistic needle rendering. The simulation engine in iMSTK modeled the interaction between the needle and the virtual tissue to generate visual deformations on the tissue and tactile forces on the needle which are transmitted to the needle that the user holds. Initial testing has shown promising results with respect to quality of simulated images and system responsiveness. Further evaluation by clinicians is planned for the next stage.
超声（US）引导下的肾活检是评估和管理具有诊断和预后意义的非恶性肾脏疾病的一项至关重要的工具。它需要良好的活检技术和技能，以便安全且持续地获取用于组织分析的高质量活检样本。本项目旨在开发一种虚拟训练器，以帮助临床医生提高实时超声引导下肾活检的操作技能水平。本文介绍了一种使用低成本硬件组件以及开源可视化和交互式模拟库构建的经济高效、高保真的训练器：交互式医学模拟工具包（iMSTK）和3D Slicer。我们使用了一个物理人体模型来模拟学员在扫描真实患者时所体验到的触觉反馈，并为学员提供关于超声扫描平面相对于患者解剖结构的空间感知。超声探头和活检针使用常用临床工具进行建模，并配备了与模拟器通信的装置。3D Slicer用于根据探头位置可视化从预先获取的三维超声容积中切片得到的图像，并进行逼真的针渲染。iMSTK中的模拟引擎对针与虚拟组织之间的相互作用进行建模，以在组织上产生视觉变形，并在针上产生触觉力，这些力会传递到用户手持的针上。初步测试在模拟图像质量和系统响应性方面已显示出有希望的结果。计划在下一阶段由临床医生进行进一步评估。
