AutoInFocus, a new paradigm for ultrasound-guided spine intervention: a multi-platform validation study

Int J Comput Assist Radiol Surg. 2022 May;17(5):911-920. doi: 10.1007/s11548-022-02583-6. Epub 2022 Mar 25.

Abstract

Purpose: Ultrasound-guided spine interventions often suffer from the insufficient visualization of key anatomical structures due to the complex shapes of the self-shadowing vertebrae. Therefore, we propose an ultrasound imaging paradigm, AutoInFocus (automatic insonification optimization with controlled ultrasound), to improve the key structure visibility.

Methods: A phased-array probe is used in conjunction with a motion platform to image a controlled workspace, and the resulting images from multiple insonification angles are combined to reveal the target anatomy. This idea is first evaluated in simulation and then realized as a robotic platform and a miniaturized patch device. A spine phantom (CIRS) and its CT scan were used in the evaluation experiments to quantitatively and qualitatively analyze the advantages of the proposed method over the traditional approach.

Results: We showed in simulation that the proposed system setup increased the visibility of interspinous space boundary, a key feature for lumbar puncture guidance, from 44.13 to 67.73% on average, and the 3D spine surface coverage from 14.31 to 35.87%, compared to traditional imaging setup. We also demonstrated the feasibility of both robotic and patch-based realizations in a spine phantom study.

Conclusion: This work lays the foundation for a new imaging paradigm that leverages redundant and controlled insonification to allow for imaging optimization of the complex vertebrae anatomy, making it possible for high-quality visualization of key anatomies during ultrasound-guided spine interventions.

Keywords: Image-guided procedure; Medical robotics; Spine intervention; Ultrasound imaging.

MeSH terms

  • Humans
  • Phantoms, Imaging
  • Spine* / diagnostic imaging
  • Tomography, X-Ray Computed*
  • Ultrasonography / methods
  • Ultrasonography, Interventional / methods