Kumar Avisha, Kempski Leadingham Kelley M, Kerensky Max J, Sankar Sriramana, Thakor Nitish V, Manbachi Amir
Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, United States.
HEPIUS Innovation Lab, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Front Med Technol. 2023 Oct 3;5:1238129. doi: 10.3389/fmedt.2023.1238129. eCollection 2023.
Tissue elasticity remains an essential biomarker of health and is indicative of irregularities such as tumors or infection. The timely detection of such abnormalities is crucial for the prevention of disease progression and complications that arise from late-stage illnesses. However, at both the bedside and the operating table, there is a distinct lack of tactile feedback for deep-seated tissue. As surgical techniques advance toward remote or minimally invasive options to reduce infection risk and hasten healing time, surgeons lose the ability to manually palpate tissue. Furthermore, palpation of deep structures results in decreased accuracy, with the additional barrier of needing years of experience for adequate confidence of diagnoses. This review delves into the current modalities used to fulfill the clinical need of quantifying physical touch. It covers research efforts involving tactile sensing for remote or minimally invasive surgeries, as well as the potential of ultrasound elastography to further this field with non-invasive real-time imaging of the organ's biomechanical properties. Elastography monitors tissue response to acoustic or mechanical energy and reconstructs an image representative of the elastic profile in the region of interest. This intuitive visualization of tissue elasticity surpasses the tactile information provided by sensors currently used to augment or supplement manual palpation. Focusing on common ultrasound elastography modalities, we evaluate various sensing mechanisms used for measuring tactile information and describe their emerging use in clinical settings where palpation is insufficient or restricted. With the ongoing advancements in ultrasound technology, particularly the emergence of micromachined ultrasound transducers, these devices hold great potential in facilitating early detection of tissue abnormalities and providing an objective measure of patient health.
组织弹性仍然是健康的重要生物标志物，可指示肿瘤或感染等异常情况。及时检测此类异常对于预防疾病进展以及晚期疾病引发的并发症至关重要。然而，在床边和手术台上，对于深部组织明显缺乏触觉反馈。随着手术技术朝着远程或微创方向发展以降低感染风险并加快愈合时间，外科医生失去了手动触诊组织的能力。此外，对深部结构的触诊准确性降低，还存在一个额外的障碍，即需要多年经验才能对诊断有足够的信心。本综述深入探讨了当前用于满足量化物理触觉临床需求的方法。它涵盖了涉及远程或微创手术触觉传感的研究工作，以及超声弹性成像通过对器官生物力学特性进行无创实时成像推动该领域发展的潜力。弹性成像监测组织对声能或机械能的反应，并重建代表感兴趣区域弹性轮廓的图像。这种对组织弹性的直观可视化超越了目前用于增强或补充手动触诊的传感器所提供的触觉信息。我们聚焦于常见的超声弹性成像模式，评估用于测量触觉信息的各种传感机制，并描述它们在触诊不足或受限的临床环境中的新应用。随着超声技术的不断进步，尤其是微机电超声换能器的出现，这些设备在促进组织异常的早期检测以及提供患者健康的客观指标方面具有巨大潜力。
