Tele-operated robotic ultrasound system for medical diagnosis

https://doi.org/10.1016/j.bspc.2021.102900Get rights and content

Highlights

  • The operation method of our robot control console is in line with doctor’s habits.

  • The robot control strategy meets the requirements of clinical use.

  • The system could be used with different network conditions.

  • The system verified the clinical effectiveness of the remote ultrasound system.

Abstract

Ultrasound scanning is a commonly used diagnostic method because of its high efficiency and limited side effects. However, unlike computed tomography (CT) and magnetic resonance imaging (MRI), ultrasound scanning requires professional doctors. In China, experienced ultrasound doctors are concentrated in big hospitals. Ultrasound treatment cannot be performed effectively in most rural areas. To provide equal ultrasound treatments to those areas, a novel remote robotic ultrasound scanning system is introduced in this work. The system can be divided into two parts: doctor-side and patient-side. Using our system, doctors could control the robotic arm and ultrasound machine remotely. Integrated position and force control are applied in our system to recur the hand movements of the doctor as well as maintaining flexible contact with the patient body. Real-time audio and video transmission is also realized in our system. The system can be used with the wired network, 4G, and 5G wireless network. The system was tested on 95 subjects in clinical trials. The results show that the remote ultrasound scanning task can be accomplished using our system. The ultrasound images obtained by our system have a high medical diagnostic value.

Introduction

Ultrasound scanning, also known as ultrasound imaging or sonography, uses sound waves to produce pictures inside the body. The ultrasound machine transmits high-frequency (1 to 5 megahertz) sound waves into the body using a probe. Sound waves that bounce back can be collected by the probe and relayed to the ultrasound machine. Those sound waves could then be used to create an image in the ultrasound machine. Compared to other diagnostic techniques such as X-rays and CT scans, ultrasound scanning is widely used because of its real-time performance, low price, and low radiation. However, one limitation of ultrasound scanning is that it depends on trained doctors. This makes it difficult for patients in remote areas to receive ultrasound treatment in time. In China, for example, experienced ultrasound doctors are concentrated in big hospitals and rarely occur in most rural areas.

The combination of ultrasound and robotics provides a solution to this problem. Many researchers have used robots to control the ultrasound probe. Gourdon et al. designed a master/slave system used for ultrasound scanning[1]. Vieyres et al. used tele-operated robotic ultrasound system in space research[2]. Courreges et al. presented a robotic teleoperated system for ultrasound scanning [3]. Similar systems can be found in [4], [5], [6], [7], [8]. Qinghua Huang et al. described a remote ultrasound system for three dimensional imaging[9]. The system uses a joystick to control the robot. Volume reconstruction and visualization are realized based on the acquired B-scans and their positional data.

Most of the previous research in this field focused only on robot design and control, the operating efficiency, ultrasound system control, and audio–video transmission were often ignored. In addition to the above research projects, there is also a commercial tele-robotic ultrasound system(MELODY system) [10]. The system consists of a robot system, an ultrasound system, and a video conference system. The ultrasound probe is attached to a robotic arm and can be controlled by a mock probe remotely. In contrast with systems in previous studies, this system allows ultrasound settings to be adjusted by the remote ultrasound doctor. The doctor can communicate with the patient and assistant at the patient site during the examination through the video conference system. However, the MELODY system can only achieve three degrees of freedom(DOFs) robot control, the doctor needs to cooperate with the remote assistant to complete the examination, which greatly reduces the operation efficiency.

In this study, we describe a novel tele-operated robotic ultrasound system. In addition to tele-operation of the ultrasound probe, our system provides ultrasound system control and audio–video transmission as well. Although the concept of tele-operated robotic ultrasound scanning is not new, we have greatly improved the ease of use of tele-operated robotic ultrasound systems. Our system has obtained Communauté européenne (CE) certificate in March 2020 and obtained China National Medical Products Administration (NMPA) certificates in May 2020. Through the combination of sensors, we created a novel console that allows the doctor to operate as a real ultrasound scan. In order to allow the robot to accurately reproduce the doctor’s movement while maintaining flexible contact with the patient, a novel robot control strategy was applied in our application.

Section snippets

System overview

Our tele-operated robotic ultrasound system consists of two parts: the doctor-side subsystem and the patient-side subsystem. The system can realize remote robot control, remote ultrasound control, and remote audio–video transmission (See Fig. 1).

In general usage scenarios, the doctor-side subsystem is placed in the central hospital, and the patient-side subsystem is placed in the social health center or rural area hospital. Professional doctors can perform remote examinations on patients in

Ultrasound image similarity test

Structural similarity index measure (SSIM) is an index used to measure the similarity of two digital images [15]. The structural similarity is in line with the judgment of the human eye on the image quality in the measurement of image quality. The structural similarity index defines structural information from the perspective of image composition as being independent of brightness and contrast, reflecting the properties of the object structure in the scene, and modeling distortion as a

Conclusion

A novel remote robotic ultrasound scanning system is introduced in this work. As far as we know, the system is the first tele-operated robotic ultrasound system that can be completely controlled by doctors to obtain CE and NMPA certification. Through the clinical trial, it can be proved that the tele-operated robotic ultrasound system is safe and effective for doctors to perform a remote ultrasound examination. Further research will use the tele-operated robotic ultrasound system as a platform

CRediT authorship contribution statement

Bin Duan: Conceptualization, Methodology, Software. Linfei Xiong: Project administration. Xiaolong Guan: Validation. Yongqing Fu: Writing – review & editing. Yongwei Zhang: Supervision.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgments

This work was supported in part by National Key R&D Program of China (2018YFC1002300).

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