Towards the development of safe, collaborative robotic freehand ultrasound

The use of robotics in medicine is of growing importance for modern health services, as robotic systems have the capacity to improve upon human tasks, thereby enhancing the treatment ability of a healthcare provider. In the medical sector, ultrasound imaging is an inexpensive approach without the high radiation emissions often associated with other modalities, especially when compared to MRI and CT imaging respectively. Over the past two decades, considerable effort has been invested into freehand ultrasound robotics research and development. However, this research has focused on the feasibility of the application, not the robotic fundamentals, such as motion control, calibration, and contextual awareness. Instead, much of the work is concentrated on custom designed robots, ultrasound image generation and visual servoing, or teleoperation. Research based on these topics often suffer from important limitations that impede their use in an adaptable, scalable, and real-world manner. Particularly, while custom robots may be designed for a specific application, commercial collaborative robots are a more robust and economical solution. Otherwise, various robotic ultrasound studies have shown the feasibility of using basic force control, but rarely explore controller tuning in the context of patient safety and deformable skin in an unstructured environment. Moreover, many studies evaluate novel visual servoing approaches, but do not consider the practicality of relying on external measurement devices for motion control. These studies neglect the importance of robot accuracy and calibration, which allow a system to safely navigate its environment while reducing the imaging errors associated with positioning. Hence, while the feasibility of robotic ultrasound has been the focal point in previous studies, there is a lack of attention to what occurs between system design and image output. This thesis addresses limitations of the current literature through three distinct contributions. Given the force-controlled nature of an ultrasound robot, the first contribution presents a closed-loop calibration approach using impedance control and low-cost equipment. Accuracy is a fundamental requirement for high-quality ultrasound image generation and targeting. This is especially true when following a specified path along a patient or synthesizing 2D slices into a 3D ultrasound image. However, even though most industrial robots are inherently precise, they are not necessarily accurate. While robot calibration itself has been extensively studied, many of the approaches rely on expensive and highly delicate equipment. Experimental testing showed that this method is comparable in quality to traditional calibration using a laser tracker. As demonstrated through an experimental study and validated with a laser tracker, the absolute accuracy of a collaborative robot was improved to a maximum error of 0.990mm, representing a 58.4% improvement when compared to the nominal model. The second contribution explores collisions and contact events, as they are a natural by-product of applications involving physical human-robot interaction (pHRI) in unstructured environments. Robot-assisted medical ultrasound is an example of a task where simply stopping the robot upon contact detection may not be an appropriate reaction strategy. Thus, the robot should have an awareness of body contact location to properly plan force-controlled trajectories along the human body using the imaging probe. This is especially true for remote ultrasound systems where safety and manipulability are important elements to consider when operating a remote medical system through a communication network. A framework is proposed for robot contact classification using the built-in sensor data of a collaborative robot. Unlike previous studies, this classification does not discern between intended vs. unintended contact scenarios, but rather classifies what was involved in the contact event. The classifier can discern different ISO/TS 15066:2016 specific body areas along a human-model leg with 89.37% accuracy. Altogether, this contact distinction framework allows for more complex reaction strategies and tailored robot behaviour during pHRI. Lastly, given that the success of an ultrasound task depends on the capability of the robot system to handle pHRI, pure motion control is insufficient. Force control techniques are necessary to achieve effective and adaptable behaviour of a robotic system in the unstructured ultrasound environment while also ensuring safe pHRI. While force control does not require explicit knowledge of the environment, to achieve an acceptable dynamic behaviour, the control parameters must be tuned. The third contribution proposes a simple and effective online tuning framework for force-based robotic freehand ultrasound motion control. Within the context of medical ultrasound, different human body locations have a different stiffness and will require unique tunings. Through real-world experiments with a collaborative robot, the framework tuned motion control for optimal and safe trajectories along a human leg phantom. The optimization process was able to successfully reduce the mean absolute error (MAE) of the motion contact force to 0.537N through the evolution of eight motion control parameters. Furthermore, contextual awareness through motion classification can offer a framework for pHRI optimization and safety through predictive motion behaviour with a future goal of autonomous pHRI. As such, a classification pipeline, trained using the tuning process motion data, was able to reliably classify the future force tracking quality of a motion session with an accuracy of 91.82 %

Robotic Ultrasound Imaging: State-of-the-Art and Future Perspectives

Ultrasound (US) is one of the most widely used modalities for clinical intervention and diagnosis due to the merits of providing non-invasive, radiation-free, and real-time images. However, free-hand US examinations are highly operator-dependent. Robotic US System (RUSS) aims at overcoming this shortcoming by offering reproducibility, while also aiming at improving dexterity, and intelligent anatomy and disease-aware imaging. In addition to enhancing diagnostic outcomes, RUSS also holds the potential to provide medical interventions for populations suffering from the shortage of experienced sonographers. In this paper, we categorize RUSS as teleoperated or autonomous. Regarding teleoperated RUSS, we summarize their technical developments, and clinical evaluations, respectively. This survey then focuses on the review of recent work on autonomous robotic US imaging. We demonstrate that machine learning and artificial intelligence present the key techniques, which enable intelligent patient and process-specific, motion and deformation-aware robotic image acquisition. We also show that the research on artificial intelligence for autonomous RUSS has directed the research community toward understanding and modeling expert sonographers' semantic reasoning and action. Here, we call this process, the recovery of the "language of sonography". This side result of research on autonomous robotic US acquisitions could be considered as valuable and essential as the progress made in the robotic US examination itself. This article will provide both engineers and clinicians with a comprehensive understanding of RUSS by surveying underlying techniques.Comment: Accepted by Medical Image Analysi

A Review of Pneumatic Actuators Used for the Design of Medical Simulators and Medical Tools

International audienc

Medical microprocessor systems

The practical classes and laboratory work in the discipline "Medical microprocessor systems", performed using software in the programming environment of microprocessors Texas Instruments (Code Composer Studio) and using of digital microprocessors of the Texas Instruments DSK6400 family, and models of electrical equipment in the environment of graphical programming LabVIEW 2010.Лабораторний практикум з програмування та побудови медичних мікропроцесорних систем, який викладено у навчальному посібнику допомагає накопичувати й ефективно використовувати отриману інформацію з теоретичного курсу на всіх стадіях навчального процесу, що є важливим для підготовки магістрів та необхідною ланкою у науковому пізнанні практичних основ біомедичної електроніки.The laboratory workshop on the programming and construction of medical microprocessor systems, which is outlined in the tutorial, helps to accumulate and effectively use the information obtained from a theoretical course at all stages of the educational process, which is important for the preparation of masters and a necessary link in the scientific knowledge of the practical basics of biomedicine.Лабораторный практикум по программированию и построению медицинских микропроцессорных систем, который изложен в учебном пособии помогает накапливать и эффективно использовать полученную информацию из теоретического курса на всех стадиях учебного процесса, что важно для подготовки магистров и является необходимым звеном в научном познании практических основ биомедицинской электроники

A New Concept for Medical Imaging Centered on Cellular Phone Technology

According to World Health Organization reports, some three quarters of the world population does not have access to medical imaging. In addition, in developing countries over 50% of medical equipment that is available is not being used because it is too sophisticated or in disrepair or because the health personnel are not trained to use it. The goal of this study is to introduce and demonstrate the feasibility of a new concept in medical imaging that is centered on cellular phone technology and which may provide a solution to medical imaging in underserved areas. The new system replaces the conventional stand-alone medical imaging device with a new medical imaging system made of two independent components connected through cellular phone technology. The independent units are: a) a data acquisition device (DAD) at a remote patient site that is simple, with limited controls and no image display capability and b) an advanced image reconstruction and hardware control multiserver unit at a central site. The cellular phone technology transmits unprocessed raw data from the patient site DAD and receives and displays the processed image from the central site. (This is different from conventional telemedicine where the image reconstruction and control is at the patient site and telecommunication is used to transmit processed images from the patient site). The primary goal of this study is to demonstrate that the cellular phone technology can function in the proposed mode. The feasibility of the concept is demonstrated using a new frequency division multiplexing electrical impedance tomography system, which we have developed for dynamic medical imaging, as the medical imaging modality. The system is used to image through a cellular phone a simulation of breast cancer tumors in a medical imaging diagnostic mode and to image minimally invasive tissue ablation with irreversible electroporation in a medical imaging interventional mode

A Passive Variable Impedance Control Strategy with Viscoelastic Parameters Estimation of Soft Tissues for Safe Ultrasonography

In the context of telehealth, robotic approaches have proven a valuable solution to in-person visits in remote areas, with decreased costs for patients and infection risks. In particular, in ultrasonography, robots have the potential to reproduce the skills required to acquire high-quality images while reducing the sonographer's physical efforts. In this paper, we address the control of the interaction of the probe with the patient's body, a critical aspect of ensuring safe and effective ultrasonography. We introduce a novel approach based on variable impedance control, allowing real-time optimisation of a compliant controller parameters during ultrasound procedures. This optimisation is formulated as a quadratic programming problem and incorporates physical constraints derived from viscoelastic parameter estimations. Safety and passivity constraints, including an energy tank, are also integrated to minimise potential risks during human-robot interaction. The proposed method's efficacy is demonstrated through experiments on a patient dummy torso, highlighting its potential for achieving safe behaviour and accurate force control during ultrasound procedures, even in cases of contact loss.Comment: 7 pages, 7 figures, submitted to ICRA 202

Recent advances in robot-assisted echography: Combining perception, control and cognition

Echography imaging is an important technique frequently used in medical diagnostics due to low-cost, non-ionising characteristics, and pragmatic convenience. Due to the shortage of skilful technicians and injuries of physicians sustained from diagnosing several patients, robot-assisted echography (RAE) system is gaining great attention in recent decades. A thorough study of the recent research advances in the field of perception, control and cognition techniques used in RAE systems is presented in this study. This survey introduces the representative system structure, applications and projects, and products. Challenges and key technological issues faced by the traditional RAE system and how the current artificial intelligence and cobots attempt to overcome these issues are summarised. Furthermore, significant future research directions in this field have been identified by this study as cognitive computing, operational skills transfer, and commercially feasible system design

Open electronics for medical devices: State-of-art and unique advantages

A wide range of medical devices have significant electronic components. Compared to open-source medical software, open (and open-source) electronic hardware has been less published in peer-reviewed literature. In this review, we explore the developments, significance, and advantages of using open platform electronic hardware for medical devices. Open hardware electronics platforms offer not just shorter development times, reduced costs, and customization; they also offer a key potential advantage which current commercial medical devices lack—seamless data sharing for machine learning and artificial intelligence. We explore how various electronic platforms such as microcontrollers, single board computers, field programmable gate arrays, development boards, and integrated circuits have been used by researchers to design medical devices. Researchers interested in designing low cost, customizable, and innovative medical devices can find references to various easily available electronic components as well as design methodologies to integrate those components for a successful design

Hand held force-controlled ultrasound probe

Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2010.Cataloged from PDF version of thesis.Includes bibliographical references (p. 129-131).An hand-held force controlled ultrasound probe has been developed. The controller maintains a prescribed contact force between the probe and a patient's body. The device will enhance the diagnostic capability of free-hand elastography, swept-force compound imaging, and make it easier for a technician to acquire repeatable (i.e. directly comparable) images over time. The mechanical system consists of an ultrasound probe, ballscrew-driven linear actuator, and a force/torque sensor. The feedback controller commands the motor to rotate the ballscrew to translate the ultrasound probe in order to maintain a desired contact force. In preliminary user studies it was found that the control system maintained a constant contact force with 1.7 times less variation than human subjects who watched a force gauge. Users without a visual force display maintained a constant force with 20 times worse variation. The system was also used to determine the viscoelastic properties of soft tissue. In three mock ultrasound examinations one hour apart in which the goal was two obtain two consistent images at the same force, an unassisted operator obtained the second image at a 20% lower force, while the operator assisted by the controller obtained the same force to within <2%. The device enables users to gather more force-consistent images over time.by Matthew Wright Gilbertson.S.M