Zhang Gesiren, Nguyen Trong N, Fooladi-Talari Hadi, Salvador Tyler, Thomas Kia, Crowley Daragh, Dingeman R Scott, Shekhar Raj
Children's National Hospital, Washington, DC, United States.
AusculTech Dx, Silver Spring, Maryland, United States.
J Med Imaging (Bellingham). 2024 Nov;11(6):062604. doi: 10.1117/1.JMI.11.6.062604. Epub 2024 Sep 13.
Conventional ultrasound-guided vascular access procedures are challenging due to the need for anatomical understanding, precise needle manipulation, and hand-eye coordination. Recently, augmented reality (AR)-based guidance has emerged as an aid to improve procedural efficiency and potential outcomes. However, its application in pediatric vascular access has not been comprehensively evaluated.
We developed an AR ultrasound application, HoloUS, using the Microsoft HoloLens 2 to display live ultrasound images directly in the proceduralist's field of view. We presented our evaluation of the effect of using the Microsoft HoloLens 2 for point-of-care ultrasound (POCUS)-guided vascular access in 30 pediatric patients.
A custom software module was developed on a tablet capable of capturing the moving ultrasound image from any ultrasound machine's screen. The captured image was compressed and sent to the HoloLens 2 via a hotspot without needing Internet access. On the HoloLens 2, we developed a custom software module to receive, decompress, and display the live ultrasound image. Hand gesture and voice command features were implemented for the user to reposition, resize, and change the gain and the contrast of the image. We evaluated 30 (15 successful control and 12 successful interventional) cases completed in a single-center, prospective, randomized study.
The mean overall rendering latency and the rendering frame rate of the HoloUS application were 139.30 ms and 30 frames per second, respectively. The average procedure completion time was 17.3% shorter using AR guidance. The numbers of puncture attempts and needle redirections were similar between the two groups, and the number of head adjustments was minimal in the interventional group.
We presented our evaluation of the results from the first study using the Microsoft HoloLens 2 that investigates AR-based POCUS-guided vascular access in pediatric patients. Our evaluation confirmed clinical feasibility and potential improvement in procedural efficiency.
传统超声引导下的血管穿刺操作具有挑战性，因为需要了解解剖结构、精确操作针头以及手眼协调。最近，基于增强现实（AR）的引导技术应运而生，有助于提高操作效率和潜在效果。然而，其在儿科血管穿刺中的应用尚未得到全面评估。
我们使用微软HoloLens 2开发了一款AR超声应用程序HoloUS，可将实时超声图像直接显示在操作人员的视野中。我们展示了对30例儿科患者使用微软HoloLens 2进行床旁超声（POCUS）引导下血管穿刺效果的评估。
在平板电脑上开发了一个定制软件模块，能够从任何超声设备的屏幕上捕捉动态超声图像。捕捉到的图像经过压缩后通过热点发送到HoloLens 2，无需互联网接入。在HoloLens 2上，我们开发了一个定制软件模块来接收、解压并显示实时超声图像。还实现了手势和语音命令功能，以便用户重新定位、调整图像大小以及更改图像的增益和对比度。我们在一项单中心、前瞻性、随机研究中评估了30例（15例成功对照和12例成功干预）病例。
HoloUS应用程序的平均总渲染延迟和渲染帧率分别为139.30毫秒和每秒30帧。使用AR引导时，平均操作完成时间缩短了17.3%。两组之间的穿刺尝试次数和针头重新定位次数相似，干预组的头部调整次数最少。
我们展示了对第一项使用微软HoloLens 2研究儿科患者基于AR的POCUS引导血管穿刺结果的评估。我们的评估证实了其临床可行性以及操作效率的潜在提高。
