Keiichiro Ito

Portable and attachable tele-echography robot system: FASTele

The purpose of this report is to propose portable and attachable tele-echography robot system: FASTele. Focused assessment with sonography for trauma (FAST) is important for patients who have shock by internal bleeding. However, the patient has little time, and transportation to a hospital may take too long. A system which enables FAST more quickly is required. Therefore, we aim to develop a tele-echography (FAST) robot system that can be used by a paramedic easily for shock patient in ambulance or at injury scene. To develop the system, portability and usability (for paramedic) are significant issues. We developed a tele-echography robot system which has 4-DOF. The robot is attached to each roughly FAST areas of patient body (body-based set up) and remotely fine-tuned position by a specialist in a hospital. The robot can control the posture of probe by curvature rails. The mechanism that maintains passively the contact force between the probe and patients body surface by using springs enables the robot small and lightweight. Feasibility experiments of FAST are reported.

Usability and performance of a wearable tele-echography robot for focused assessment of trauma using sonography.

Focused Assessment with Sonography for Trauma (FAST) is widely used as a first lifesaving step for patients suffering from internal bleeding. Because it may take a long time to transport such patients to a hospital, a wearable and portable tele-echography robot that a paramedic can attach to the patient has been developed. In the current study, experiments were conducted to evaluate the usability and performance of attached FAST. The proposed robot must be attached to 4 areas to perform FAST. The time required for attachment and the positions of attachment completed by 9 non-medical staff members, as well as the time it took for the FAST to reach a medical doctor, were measured. The echo images obtained when the patients body was in motion were evaluated by a medical doctor. The robot could be attached to all 4 areas within approximately 5min, and the maximum gap was 4.8cm. This indicates that a paramedic who has received training in emergency medical care should be able to attach the robot to a patient quickly and accurately. Additionally, it was confirmed that the robot could be used to complete FAST under a doctors control within 9min and that the extracted echo images were suitable for FAST. A comparison of the results with current ambulance transportation time confirmed that FAST could be completed approximately 14min before the patient reached the hospital. The results of the current study indicate that the robot is worth using, is suitable for FAST, and will be effective in emergency medical care.

Evaluation of a wearable tele-echography robot system: FASTele in a vehicle using a mobile network

This paper shows the focused assessment with sonography for trauma (FAST) performance of a wearable tele-echography robot system we have developed that we call “FASTele”. FAST is a first-step way of assessing the injury severity of patients suffering from internal bleeding who may be some time away from hospital treatment. So far, we have only verified our systems effectiveness under constantly wired network conditions. To determine its FAST performance within an emergency vehicle, we extended it to a WiMAX mobile network and performed experiments on it. Experiment results showed that paramedics could attach the system to FAST areas on a patients body on the basis of the attaching position and procedure. We also assessed echo images to confirm that the system is able to extract the echo images required for FAST under maximum vehicle acceleration.

Wearable echography robot for trauma patient

The purpose of this report is to propose a diagnosis and treatment scenario by assistance of bystander and echography robot for trauma patient. Quick treatment is important for patients who have shock by internal bleeding. Therefore, focused assessment with sonography for trauma (FAST), which is a simple and quick diagnostic method, was developed as a first lifesaving step in a hospital. However, a shock patient has little time, and transportation to a hospital may take too long. Therefore, we aim at development of a system which enables FAST at injury scene by assistance of bystander. To develop the system, life-saving flow and a FAST device are significant issues. First, we constructed a diagnosis and treatment scenario. Then, we developed a tele-echography robot system which has 4-DOF that a bystander could attach. This robot is attached to each roughly FAST areas of patient body by a bystander and remotely fine-tuned position by a doctor in a hospital. In this way, a bystander may not do an exact positioning. In addition, the robot has a mechanism to generate contact force between echo probe and patient body surface by two springs. This mechanism not only fit in patient body motion but also reducing the number of controlled axis. To confirm the medical applications of the scenario and the robot, we performed experiments with some examinees and doctors. We confirmed effectiveness of the mechanism and that a bystander could attach the robot to each roughly FAST areas of patient body. We also confirmed that a doctor could do FAST with the robot by remote-controlled on the roughly FAST areas in approximately three minutes. These results show that the robot would enable FAST by assistance of bystander, and the scenario would make FAST faster than the time required transporting the patient to the hospital.

Internal bleeding detection algorithm based on determination of organ boundary by low-brightness set analysis

This paper proposes an organ boundary determination method for detecting internal bleeding. Focused assessment with sonography for trauma (FAST) is important for patients who are sent into shock by internal bleeding. However, the FAST has a low sensitivity, approximately 42.7%, and delays of lifesaving treatment due to internal bleeding being missed have become a serious problem in emergency medical care. This study aims, therefore, to construct an automatic internal bleeding detection robotic system on the basis of ultrasound (US) image processing to improve the sensitivity. Internal bleeding has two key features: it is extracted from low-brightness areas in US images and accumulates between organs. We developed method for extracting low-brightness areas and determining algorithms of organ boundaries by low-brightness set analysis, and we detect internal bleeding by combining these two methods. Experimental results based on clinical US images of internal bleeding between Liver and Kidney showed that proposed algorithms had a sensitivity of 77.8% and specificity of 95.7%.

Development of attachable tele-echography robot by a bystander at injury scene

This paper reports a wearable tele-echography robot that a bystander could attach to a patient at injury scene. Quick diagnosis and treatment are important for patients who have shock by internal bleeding. Therefore, focused assessment with sonography for trauma (FAST), which is a simple and quick diagnostic method, was developed as a first lifesaving step in a hospital. However, a shock patient has little time, and transportation to a hospital may take too long. Therefore, a system which enables FAST at injury scene by assistance of bystander is important. First, we constructed a medical treatment scenario from the victims discovery to FAST and treatment at the injury scene. Then, we developed a remote-controlled FAST robot that a bystander could attach to a patient. This robot is attached to each roughly FAST areas of patient body by a bystander and remotely fine-tuned position by a doctor in a hospital. In this way, a bystander may not do an exact positioning. In addition, the robot has two springs to generate contact force between echo probe and patient body surface. This mechanism not only fit in patient body motion but also downsizing based on reducing the number of controlled axis. To confirm the effectiveness of the robot, we performed experiments with some examinees and doctors. We confirmed effectiveness of the mechanism and that a bystander could attach the robot to each roughly FAST areas of patient body. We also confirmed that a doctor could do FAST with the robot by remote-controlled on the roughly FAST areas in approximately three minutes. These results show that the robot would enable FAST at injury scene by assistance of bystander, and FAST would be faster than the time required transporting the patient to the hospital with the robot. This is effective in improving the survival rate for traumatic shock patients.

Measurement algorithms of cross-section area and blood speed for noninvasive blood flow measurement system

The purpose of this paper is to propose measurement algorithms of cross-section area and blood speed of an artery by controlling a robotic system equipped with an ultrasound probe for large pulsation and a displacement towards the out-of-plane of a US image. Detecting the position and speed of a bleeding source is required as the first step in treating internal bleeding in emergency medical medicine. However, the current methods for detecting a bleeding source involve an invasive approach and cannot quantitatively estimate the speed of bleeding. Therefore, current emergency medical care requires an alternative system to address these problems. In this study, we aim to develop a robotic system for detecting bleeding source based on the blood flow measured by using a noninvasive modality like an ultrasound (US) imaging device. Some problems related to the measurement error still need to be addressed before we can create this system. In particular, the blood flow measurement error in the abdominal area is typically large, because the pulse amplitude and displacement of the artery is too large even to adequately control the probe. As the first step in solving these problems, we focused on the large pulse amplitude and displacement of the artery towards the out-of-plane of a US image, and developed measurement algorithms to control the probe. We conducted flow volume measurement experiments using an ultrasound phantom containing artery model and a manipulator equipped with a US probe (BASIS-1). The results present the first experimental validation of the proposed algorithms.

Blood flow measurement algorithms to detect bleeding source noninvasively

The purpose of this paper is to propose ultrasound visual servoing algorithms for controlling a robotic system equipped with an ultrasound probe for large pulsation and a displacement towards the out-of-plane of a US image. In this study, we aim to develop a robotic system for detecting bleeding source based on the blood flow measured by using a non-invasive modality like an ultrasound (US) imaging device. Some problems related to the measurement error still need to be addressed. As the first step in solving these problems, we focused on the large pulse amplitude and displacement of the artery towards the out-of-plane of a US image, and developed US visual servoing algorithms to control the probe. We conducted preliminary blood flow measurement experiments using an phantom containing artery model and a manipulator equipped with a US probe (BASIS-1). The results present the first experimental validation of the proposed algorithms.

Noninvasive internal bleeding detection method by measuring blood flow under ultrasound cross-section image

The purpose of this paper is to propose noninvasive internal bleeding detection method by using ultrasound (US) image processing under US cross-section image. In this study, we have developed a robotic system for detecting internal bleeding based on the blood flow measured by using a noninvasive modality like an US imaging device. Some problems related to the measurement error, however, still need to be addressed. In this paper, we focused on US image processing under US cross-section image, and constructed blood flow measurement algorithm under US cross-section image for internal bleeding detection. We conducted preliminary blood flow measurement experiments using a phantom containing artery model and a manipulator equipped with a US probe (BASIS-1). The results present the experimental validation of the proposed method.

Organ boundary determination algorithm for detecting internal bleeding

The purpose of this paper is to propose an organ boundary determination method for detecting internal bleeding. Focused assessment with sonography for trauma (FAST) is important for patients who are sent into shock by internal bleeding. However, the FAST has a low sensitivity, approximately 42.7 %. This study aims, therefore, to construct an automatic internal bleeding detection robotic system on the basis of ultrasound (US) image processing to improve the sensitivity. We developed method for determining algorithms of organ boundaries by low-brightness set analysis, and we detected internal bleeding by the proposed method. Experimental results based on clinical US images of internal bleeding between Liver and Kidney showed that proposed algorithms had a sensitivity of 77.8% and specificity of 95.7%.