Skip to main content
Log in

Open-source surface mesh-based ultrasound-guided spinal intervention simulator

  • Original Article
  • Published:
International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

   Ultrasound is prevalent in image-guided therapy as a safe, inexpensive, and widely available imaging modality. However, extensive training in interpreting ultrasound images is essential for successful procedures. An open-source ultrasound image simulator was developed to facilitate the training of ultrasound-guided spinal intervention procedures, thereby eliminating the need for an ultrasound machine from the phantom-based training environment.

Methods

   Anatomical structures and surgical tools are converted to surface meshes for data compression. Anatomical data are converted from segmented volumetric images, while the geometry of surgical tools is available as a surface mesh. The pose of the objects are either constants or coming from a pose-tracking device. Intersection points between the surface models and the ultrasound scan lines are determined with a binary space partitioning tree. The scan lines are divided into segments and filled with gray values determined by an intensity calculation accounting for material properties, reflection, and attenuation parameters defined in a configuration file. The scan lines are finally converted to a regular brightness-mode ultrasound image.

Results

   The simulator was tested in a tracked ultrasound imaging system, with a mock transducer tracked with an Ascension trakSTAR electromagnetic tracker, on a spine phantom. A mesh model of the spine was created from CT data. The simulated ultrasound images were generated at a speed of 50 frames per second, and a resolution of \(564 \times 597\) pixels, with 256 scan lines per frame, on a PC with a 3.4 GHz processor. A human subject trial was conducted to compare the learning performance of novice trainees, with real and simulated ultrasound, in the localization of facet joints of a spine phantom. With 22 participants split into two equal groups, and each participant localizing 6 facet joints, there was no statistical difference in the performance of the two groups, indicating that simulated ultrasound could indeed replace the real ultrasound in phantom-based ultrasonography training for spinal interventions.

Conclusions

   The ultrasound simulator was implemented and integrated into the open-source Public Library for Ultrasound (PLUS) toolkit.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Gill S, Abolmaesumi P, Fichtinger G, Boisvert J, Pichora D, Borshneck D et al (2010) Biomechanically constrained groupwise ultrasound to CT registration of the lumbar spine. Med Image Anal 16(3):662–674

    Article  PubMed  Google Scholar 

  2. Gjerald SU, Brekken R, Hergum T, D’hooge J (2012) Real-time ultrasound simulation using the GPU. IEEE Trans Ultrason Ferroelectr Freq Control 59(5):885–892

    Article  PubMed  Google Scholar 

  3. Goksel O, Salcudean SE (2009) B-Mode ultrasound image simulation in deformable 3-D medium. IEEE Trans Med Imaging 28(11):1657–1669

    Article  PubMed  Google Scholar 

  4. Hedrick WR, Hykes DL, Starchman DE (2005) Ultrasound physics and instrumentation. Mosby, St. Louis

    Google Scholar 

  5. Hostettler A, Forest C, Forgione A, Soler L, Marescaux J (2005) Real-time ultrasonography simulator based on 3D CT-scan images. Stud Health Technol Inform 111:191–193

    PubMed  Google Scholar 

  6. Jensen JA (1996) FIELD: a program for simulating ultrasound systems, pp 351–353

  7. Jensen J (2004) Simulation of advanced ultrasound systems using Field II, vol 1. pp 636–639

  8. Karamalis A (2009) GPU ultrasound simulation and volume reconstruction. Master’s thesis, Technischen Universität München

  9. Karamalis A, Wein W, Navab N (2010) Fast ultrasound image simulation using the Westervelt equation. In: Medical image computing and computer-assisted intervention-MICCAI 2010. Springer, Berlin, pp 243–250

  10. Kutter O, Shams R, Navab N (2009) Visualization and GPU-accelerated simulation of medical ultrasound from CT images. Comput Methods Programs Biomed 94(3):250–266

    Article  PubMed  Google Scholar 

  11. Lasso A, Heffter T, Pinter C, Ungi T, Fichtinger G (2012) Implementation of the PLUS open-source toolkit for translational research of ultrasound-guided intervention systems. In: Medical image computing and computer-assisted intervention (MICCAI) workshop—Systems and architectures for computer assisted interventions, Nice, France, The MIDAS Journal, pp 1–12, 10/2012

  12. Lasso A, Heffter T, Pinter C, Rankin A, Ungi T, Fichtinger G (in review) PLUS: open-source toolkit for ultrasound-guided intervention systems. IEEE Trans Med Imaging

  13. Magee D, Zhu Y, Ratnalingam R, Gardner P, Kessel D (2007) An augmented reality simulator for ultrasound guided needle placement training. Med Biol Eng Comput 45(10):957–967

    Article  PubMed  CAS  Google Scholar 

  14. Moult E, Ungi T, Welch M, Lu J, McGraw RC, Fichtinger G (2013) Ultrasound-guided facet joint injection training using Perk Tutor. Int J Comput Assist Radiol Surg. doi:10.1007/s11548-012-0811-5

  15. Pieper S, Lorensen W, Schroeder W, Kikinis R (2006, 04) The NA-MIC Kit: ITK, VTK, pipelines, grids and 3D Slicer as an open platform for the medical image computing community, pp 698–701

  16. Schroeder W, Martin K (2004, 01) The visualization Toolkit

  17. Skehan D (2011) Virtual training system for diagnostic ultrasound. Master’s thesis, Worcester Polytechnic Institute, The United States of America

  18. Tokuda J, Fischer G, Papademetris X, Yaniv Z, Ibanez L, Cheng P et al (2009) OpenIGTLink: an open network protocol for image-guided therapy environment. Int J Med Robotics Comput Assist Surg 5(4):423–434

    Article  Google Scholar 

  19. Ungi T, Sargent D, Moult E, Lasso A, Pinter C, McGraw R et al (2012) Perk Tutor: an open-source training platform for ultrasound-guided needle insertions. IEEE Trans Biomed Eng 59(12):3475–3481

    Article  PubMed  Google Scholar 

  20. Vidal FP, John NW, Healey AE, Gould DA (2008) Simulation of ultrasound guided needle puncture using patient specific data with 3D textures and volume haptics. Comput Animat Virtual Worlds 19(2):111–127

    Article  Google Scholar 

  21. Wein W, Khamene A, Clevert D-A, Kutter O, Navab N (2007) Simulation and fully automatic multimodal registration of medical ultrasound. In: Medical image computing and computer-assisted intervention—MICCAI 2007. Springer, Berlin, pp 136–143

  22. Zhu M, Salcudean S (2010) Real time ultrasound needle image simulation using multi-dimensional interpolation. In: Jiang, T, Navab, N, Pluim J, Viergever, M (eds) Medical image computing and computer-assisted intervention “ MICCAI 2010”, vol 6362. Springer, Berlin, pp 429–436

Download references

Acknowledgments

This work was supported through the Applied Cancer Research Unit program of Cancer Care Ontario with funds provided by the Ontario Ministry of Health and Long-Term Care. Gabor Fichtinger was funded as a Cancer Ontario Research Chair. Tamas Ungi was supported as a Queen’s University—Ontario Ministry of Research and Innovation Postdoctoral Fellow. Laura Bartha was supported by the Human Mobility CREATE program of The Natural Sciences and Engineering Research Council of Canada. Conflict of interest   None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Laura Bartha.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bartha, L., Lasso, A., Pinter, C. et al. Open-source surface mesh-based ultrasound-guided spinal intervention simulator. Int J CARS 8, 1043–1051 (2013). https://doi.org/10.1007/s11548-013-0901-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11548-013-0901-z

Keywords

Navigation