Publications
Optimizing MobileNet algorithms for real-time vessel detection on smartphones
October 9, 2023
Conference Paper
Published in:
Proc. 2023 IEEE 19th Intl. Conf. on Body Sensor Networks, BSN, 9-11 October 2023.
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Summary
Internal bleeding due to non-compressible torso hemorrhage is the leading cause of prehospital fatalities in civilian and military trauma. A limited number of trauma surgeons are expected to be available in disaster scenarios and future large-scale combat operations. As a result, non-specialists will need to perform life-saving interventions to address internal bleeding. A first step in mitigation is ultrasound-guided central vascular access, which involves identifying a deep blood vessel in the imagery, such as the femoral vein, femoral artery, or internal jugular vein, and then placing a needle and catheter into the vessel for follow-on resuscitation. In this paper, we demonstrate machine learning algorithms for both femoral and neck vessel detection with high accuracy and real-time speed on smartphones. The algorithms are integrated with commercial ultrasound and optimized for use on low size, weight, and power devices. Coupled with custom robotics, this technology can enable rapid vascular access by non-specialist operators using a handheld platform.
Summary
Internal bleeding due to non-compressible torso hemorrhage is the leading cause of prehospital fatalities in civilian and military trauma. A limited number of trauma surgeons are expected to be available in disaster scenarios and future large-scale combat operations. As a result, non-specialists will need to perform life-saving interventions to address...
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Individualized ultrasound-guided intervention phantom development, fabrication, and proof of concept
July 24, 2023
Conference Paper
Published in:
45th Annual Intl. Conf. of the IEEE Engineering in Medicine and Biology Society, EMBC, 24-27 July 2023.
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Commercial ultrasound vascular phantoms lack the anatomic diversity required for robust pre-clinical interventional device testing. We fabricated individualized phantoms to test an artificial intelligence enabled ultrasound-guided surgical robotic system (AI-GUIDE) which allows novices to cannulate deep vessels. After segmenting vessels on computed tomography scans, vessel cores, bony anatomy, and a mold tailored to the skin contour were 3D-printed. Vessel cores were coated in silicone, surrounded in tissue-mimicking gel tailored for ultrasound and needle insertion, and dissolved with water. One upper arm and four inguinal phantoms were constructed. Operators used AI-GUIDE to deploy needles into phantom vessels. Two groin phantoms were tested due to imaging artifacts in the other two phantoms. Six operators (medical experience: none, 3; 1-5 years, 2; 5+ years, 1) inserted 27 inguinal needles with 81% (22/27) success in a median of 48 seconds. Seven operators performed 24 arm injections, without tuning the AI for arm anatomy, with 71% (17/24) success. After excluding failures due to motor malfunction and a defective needle, success rate was 100% (22/22) in the groin and 85% (17/20) in the arm. Individualized 3D-printed phantoms permit testing of surgical robotics across a large number of operators and different anatomic sites. AI-GUIDE operators rapidly and reliably inserted a needle into target vessels in the upper arm and groin, even without prior medical training. Virtual device trials in individualized 3-D printed phantoms may improve rigor of results and expedite translation.
Summary
Commercial ultrasound vascular phantoms lack the anatomic diversity required for robust pre-clinical interventional device testing. We fabricated individualized phantoms to test an artificial intelligence enabled ultrasound-guided surgical robotic system (AI-GUIDE) which allows novices to cannulate deep vessels. After segmenting vessels on computed tomography scans, vessel cores, bony anatomy, and a...
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Development of 3D-Printed Individualized Vascular Phantoms for Artificial Intelligence (AI) Enabled Interventional Device Testing
March 1, 2023
Abstract
Published in:
Journal of Vascular and Interventional Radiology 34 (3), S12.
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We developed vascular phantoms mapped from human subjects to test AI-enabled ultrasound-guided vascular cannulation. Translational device prototyping necessitates anatomically accurate models. Commercial phantoms fail to address anatomic variability. Uniformity leads to optimistic AI model and operator performance. Individualized 3D-printed vascular phantoms yield anatomically correct models optimized for AI-device testing.
Summary
We developed vascular phantoms mapped from human subjects to test AI-enabled ultrasound-guided vascular cannulation. Translational device prototyping necessitates anatomically accurate models. Commercial phantoms fail to address anatomic variability. Uniformity leads to optimistic AI model and operator performance. Individualized 3D-printed vascular phantoms yield anatomically correct models optimized for AI-device testing.
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Transfer learning for automated COVID-19 B-line classification in lung ultrasound
July 15, 2022
Conference Paper
Published in:
44th Annual Int. Conf. of IEEE Engineering in Medicine & Biology Society (EMBC), DOI: 10.1109/EMBC48229.2022.9871894.
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Lung ultrasound (LUS) as a diagnostic tool is gaining support for its role in the diagnosis and management of COVID-19 and a number of other lung pathologies. B-lines are a predominant feature in COVID-19, however LUS requires a skilled clinician to interpret findings. To facilitate the interpretation, our main objective was to develop automated methods to classify B-lines as pathologic vs. normal. We developed transfer learning models based on ResNet networks to classify B-lines as pathologic (at least 3 B-lines per lung field) vs. normal using COVID-19 LUS data. Assessment of B-line severity on a 0-4 multi-class scale was also explored. For binary B-line classification, at the frame-level, all ResNet models pretrained with ImageNet yielded higher performance than the baseline nonpretrained ResNet-18. Pretrained ResNet-18 has the best Equal Error Rate (EER) of 9.1% vs the baseline of 11.9%. At the clip-level, all pretrained network models resulted in better Cohen's kappa agreement (linear-weighted) and clip score accuracy, with the pretrained ResNet-18 having the best Cohen's kappa of 0.815 [95% CI: 0.804-0.826], and ResNet-101 the best clip scoring accuracy of 93.6%. Similar results were shown for multi-class scoring, where pretrained network models outperformed the baseline model. A class activation map is also presented to guide clinicians in interpreting LUS findings. Future work aims to further improve the multi-class assessment for severity of B-lines with a more diverse LUS dataset.
Summary
Lung ultrasound (LUS) as a diagnostic tool is gaining support for its role in the diagnosis and management of COVID-19 and a number of other lung pathologies. B-lines are a predominant feature in COVID-19, however LUS requires a skilled clinician to interpret findings. To facilitate the interpretation, our main objective...
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Axon tracing and centerline detection using topologically-aware 3D U-nets
July 11, 2022
Journal Article
Published in:
2022 44th Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC), 2022, pp. 238-242
Summary
As advances in microscopy imaging provide an ever clearer window into the human brain, accurate reconstruction of neural connectivity can yield valuable insight into the relationship between brain structure and function. However, human manual tracing is a slow and laborious task, and requires domain expertise. Automated methods are thus needed to enable rapid and accurate analysis at scale. In this paper, we explored deep neural networks for dense axon tracing and incorporated axon topological information into the loss function with a goal to improve the performance on both voxel-based segmentation and axon centerline detection. We evaluated three approaches using a modified 3D U-Net architecture trained on a mouse brain dataset imaged with light sheet microscopy and achieved a 10% increase in axon tracing accuracy over previous methods. Furthermore, the addition of centerline awareness in the loss function outperformed the baseline approach across all metrics, including a boost in Rand Index by 8%.
Summary
As advances in microscopy imaging provide an ever clearer window into the human brain, accurate reconstruction of neural connectivity can yield valuable insight into the relationship between brain structure and function. However, human manual tracing is a slow and laborious task, and requires domain expertise. Automated methods are thus needed...
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AI-enabled, ultrasound-guided handheld robotic device for femoral vascular access
December 18, 2021
Journal Article
Published in:
Biosensors, Vol. 11, No. 12, 18 December 2021, 522.
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Hemorrhage is a leading cause of trauma death, particularly in prehospital environments when evacuation is delayed. Obtaining central vascular access to a deep artery or vein is important for administration of emergency drugs and analgesics, and rapid replacement of blood volume, as well as invasive sensing and emerging life-saving interventions. However, central access is normally performed by highly experienced critical care physicians in a hospital setting. We developed a handheld AI-enabled interventional device, AI-GUIDE (Artificial Intelligence Guided Ultrasound Interventional Device), capable of directing users with no ultrasound or interventional expertise to catheterize a deep blood vessel, with an initial focus on the femoral vein. AI-GUIDE integrates with widely available commercial portable ultrasound systems and guides a user in ultrasound probe localization, venous puncture-point localization, and needle insertion. The system performs vascular puncture robotically and incorporates a preloaded guidewire to facilitate the Seldinger technique of catheter insertion. Results from tissue-mimicking phantom and porcine studies under normotensive and hypotensive conditions provide evidence of the technique's robustness, with key performance metrics in a live porcine model including: a mean time to acquire femoral vein insertion point of 53 plus or minus 36 s (5 users with varying experience, in 20 trials), a total time to insert catheter of 80 plus or minus 30 s (1 user, in 6 trials), and a mean number of 1.1 (normotensive, 39 trials) and 1.3 (hypotensive, 55 trials) needle insertion attempts (1 user). These performance metrics in a porcine model are consistent with those for experienced medical providers performing central vascular access on humans in a hospital.
Summary
Hemorrhage is a leading cause of trauma death, particularly in prehospital environments when evacuation is delayed. Obtaining central vascular access to a deep artery or vein is important for administration of emergency drugs and analgesics, and rapid replacement of blood volume, as well as invasive sensing and emerging life-saving interventions...
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