Published online Jul 20, 2022. doi: 10.5662/wjm.v12.i4.274
Peer-review started: January 23, 2022
First decision: March 25, 2022
Revised: April 8, 2022
Accepted: June 3, 2022
Article in press: June 3, 2022
Published online: July 20, 2022
Processing time: 177 Days and 16.6 Hours
Special circumstances like the current pandemic have led to the need to exploit the utility of robotics and telecommunication systems to perform remote diagnostic ultrasound. It requires robust engineering effort to achieve high precision, flexibility, and repeatability, which can replace the conventional handheld ultrasound examination. A robotic ultrasound system was developed in this study so that ultrasound examination can be performed without having patient contact with the radiologist.
In the coronavirus 2019 (COVID-19) pandemic, the chances of cross-infection significantly increase among health care workers while performing ultrasound examination. There is a need to negate the need for a PPE kit each time when ultrasound examination is done, especially in COVID wards. This has motivated us to develop the robotic ultrasound system and conduct a study to validate it.
To perform ultrasound remotely using a mobile robotic arm on healthy volunteers to assess the feasibility and effectiveness of the system; validate the system by comparing the accuracy of the images generated through remote manipulations of probe attached to robotic arm by the radiologist; and to assess the comfort of the patient and radiologist with the robotic technology.
This prospective study was conducted in the Department of Radio-diagnosis, All India Institute of Medical Sciences, New Delhi, India. Ethical approval was obtained from the institute ethics committee. Informed consent was taken from all the volunteers. A total of 21 healthy volunteers were recruited. On each volunteer, ultrasound was performed in two settings, using the mobile robotic arm and the conventional hand-held ultrasound by the same sonologist. The ultrasound images acquired using the mobile robotic arm and the conventional hand-held ultrasound were analyzed separately by another blinded radiologist.
Our study showed that the robotic arm model was safe and feasible, and the results varied based on the imaged abdominal organs. The liver images showed no significant difference. For other abdominal organs (such as the pancreas, spleen, kidneys, and urinary bladder), the need for repeat imaging was higher in case of robotic arm, which could be attributed to the learning curve and ability to control the haptic device. The doctor and volunteer surveys demonstrated significant comfort with acceptance of the technology and desire to use it in the future.
This study shows that robotic ultrasound is safe and feasible and has potential to perform ultrasound with reliability.
The scope of the developed tele-robotic ultrasound system can be expanded to perform ultrasound examinations remotely in distant rural places, emergency, trauma, and isolation wards.