Prospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Jul 20, 2022; 12(4): 274-284
Published online Jul 20, 2022. doi: 10.5662/wjm.v12.i4.274
Robotic ultrasound: An initial feasibility study
Sheragaru Hanumanthappa Chandrashekhara, Krithika Rangarajan, Ayushi Agrawal, Sanjay Thulkar, Shivanand Gamanagatti, Deepak Raina, Subir Kumar Saha, Chetan Arora
Sheragaru Hanumanthappa Chandrashekhara, Krithika Rangarajan, Ayushi Agrawal, Sanjay Thulkar, Shivanand Gamanagatti, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India
Deepak Raina, Subir Kumar Saha, Department of Mechanical Engineering, Indian Institute of Technology, Delhi 110016, India
Chetan Arora, Department of Computer Science, Indian Institute of Technology, Delhi 110016, India
Author contributions: Chandrashekhara SH led the study in its conception, study design, statistical design, and manuscript writing and editing; all the authors have contributed in manuscript writing, study design and conduct, and statistical analysis.
Institutional review board statement: The study was reviewed and approved by the All India Institute of Medical Sciences, Delhi Institutional Review Board [Approval No. IEC-855/04.09.2020, RP-16/2020)].
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: There is no conflict of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at drchandruradioaiims@gmail.com.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement—checklist of items, and the manuscript was prepared and revised according to the CONSORT 2010 statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sheragaru Hanumanthappa Chandrashekhara, MD, Additional Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Delhi, India. drchandruradioaiims@gmail.com
Received: January 23, 2022
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

This study shows that robotic ultrasound is safe and feasible and has potential to perform ultrasound with reliability.

Research perspectives

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.