Objective Evaluation of Sonographic Skill in Focussed Assessment with Sonography for Trauma (FAST) Examinations Matthew S. Holden 1, Tamas Ungi 1, Conor.

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Presentation transcript:

Objective Evaluation of Sonographic Skill in Focussed Assessment with Sonography for Trauma (FAST) Examinations Matthew S. Holden 1, Tamas Ungi 1, Conor McKaigney 2, Colin Bell 2, Louise Rang 2, Gabor Fichtinger 1 1 Laboratory for Percutaneous Surgery, Queen’s University, Kingston, Canada 2 Department of Emergency Medicine, Queen’s University, Kingston, Canada We acknowledge the funding support from the ISCAS student travel scholarship.

FAST Examination Diagnostic examination for internal bleeding Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University, Spleen (perisplenic) Heart (pericardial) Liver/Kidney (perihepatic) Bladder (pelvic)

FAST Examination Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University, Negative FAST ExaminationPositive FAST Examination

Objective Devise a method for objectively evaluating sonographic skill in FAST examinations. Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University,

Interventional Skill Evaluation Needle-Based Intervention Skill Evaluation Laparoscopic Skill Evaluation AnatomyPlastic phantom Box trainer or Virtual reality Skill Evaluation Motion economy metrics Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University, (Keri et al. 2015, CJA)(Stylopoulos et al. 2004, Surg Endosc)

Sonographic Skill Evaluation Sonographic Skill Evaluation AnatomyHuman Volunteer Skill Evaluation Motion economy metrics + Scan completeness metric Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University,

Scan Completeness Metric Anatomical points of interest (POIs) Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University,

Expert Scan: Defining POIs Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University,

Trainee Scan: Checking if POIs Scanned Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University,

Experimental Setup Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University, Probe Image Reference Tracker Volunteer Ultrasound machine Recording computer

Experimental Setup Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University,

Perk Tutor Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University, (Ungi et al. 2012, IEEE TBME) Open-source surgical training platform Data visualization Automatic feedback & skill evaluation Ultrasound-guided facet joint injection Ultrasound-guided nephrostomy

Objective Skill Metrics Motion economy metrics: – Time – Probe path length Scan completeness metrics: – Percentage of POIs scanned Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University,

Expert Determine POIs from expert scan Novice Group (N=14) Intermediate Group (N=15) Experimental Design Liver/KidneySpleenHeartBladder Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University, Liver/KidneySpleenHeartBladderLiver/KidneySpleenHeartBladder

Results: Overall Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University, Time (s) (p < 0.001) Path Length (mm) (p < 0.001) POIs Scanned (%) (p < 0.001)

Results: POIs Scanned (%) Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University, Liver/Kidney (p < 0.001) Heart (p = 0.27) Spleen (p < 0.001) Bladder (p = 0.008)

Conclusion Proposed scan completeness metric correlates with skill (validation) Sonographic skill evaluation with open-source components Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University,

Thank You! Laboratory for Percutaneous Surgery (The Perk Lab) – Copyright © Queen’s University, Matthew S. Holden is funded by the ISCAS student scholarship for travel and the NSERC Canada Graduate Scholarship. Gabor Fichtinger is funded as a Cancer Care Ontario Research Chair in Cancer Imaging. Contact: Matthew Holden PerkTutor: