The target users of the proposed Slicer+PLUS framework are researchers and developers who are focusing on low-cost point-of-care ultrasound (POCUS) applications. POCUS applications are characterized by utilizing low-cost, portable U/S systems; in the hands of novice operators; with novel data acquisition, signal processing, and machine learning methods; with imprecise trackers; and in highly unconstrained point-of-care environments, e.g.: at the scene of accidents for patient triage, in the offices of general practitioners for scoliosis detection and monitoring, in patients' homes for an aging population, as well as throughout hospitals. In these contexts, many are considering POCUS devices to be the stethoscopes of the future. The foundation of Slicer+PLUS is the integration and extension of 3D Slicer, PLUS, and MUSiiC. We are the developers of these libraries. We, and the users of our libraries, are proposing Slicer+PLUS so that the Slicer, PLUS, and MUSiiC communities can come together and cohesively address the important challenges and opportunities posed by POCUS applications. Over 30 letters of support are included with this application. 3D Slicer is a world-class, freely available open-source platform for medical image segmentation, registration, and visualization. PLUS is a world-class, open-source library for communicating with ultrasound machines and trackers (for following objects in 3D using magnetic, optical, and other technologies). MUSiiC is a (previously closed source) library that focuses on advanced ultrasound acquisition and analysis methods, such as ultrasound reconstruction pipelines, elastography, and photoacoustic imaging. Together, these toolkits have averaged over 5,100 downloads per month for the past year. A central tenant of our work is that POCUS applications should not be viewed as simply involving the use of inexpensive, portable U/S systems; POCUS must be viewed as a new modality for it to attain its full potential. POCUS must involve innovative, automated data analysis methods and workflows that can guide a user to properly place and manipulate an ultrasound probe and interpret the returned ultrasound data. In particular, the output of those workflows and analyses should be quantitative measures, not b-mode images, since the expertise to interpret such images will not be readily available at points-of-care. To that end, the proposed work goes well beyond simple integration of Slicer, PLUS, and MUSiiC. Multiple innovations are proposed such as Ultrasound Spectroscopy for tissue labeling, Dynamic Textures for anatomic localization of ultrasound probes, and self-tracking ultrasound probes. To assess our progress towards our goals, our team includes our target users: researchers, medical device manufacturers, and clinical innovators dedicated to low-cost POCUS applications. They will be validating our efforts by integrating them into their research and translational POCUS product development projects.

Public Health Relevance

Low-cost ultrasound probes have the potential to become the stethoscopes of the future and revolutionize in-field and in-hospital patient care. Our goal is to integrate, enhance, and disseminate three cutting edge ultrasound acquisition, analysis, and display toolkits to create a new framework called Slicer+PLUS that will serve as a catalyst for research and product development into low-cost point-of-care ultrasound applications. In particular, our framework will include and facilitate innovative methods for guiding a novice user in ultrasound probe placement and for automatically interpreting ultrasound data to provide a diagnosis, without the user having to interpret a traditional B-mode ultrasound image at any point in the process. The Slicer+PLUS framework will be validated using tasks associated with (a) emergency service personnel performing Focused Assessment with Sonography for Trauma (FAST) exams at the scene of an accident to detect or rule-out intra-abdominal bleeding; (b) the clinical monitoring of scoliosis progression in children in general practitioners' offices; and (c) the translation of research into regulatory-approved products based on Slicer+PLUS.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
3R01EB021396-02S1
Application #
9544350
Study Section
Program Officer
Lash, Tiffani Bailey
Project Start
2016-09-21
Project End
2020-07-31
Budget Start
2017-09-21
Budget End
2018-07-31
Support Year
2
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Kitware, Inc.
Department
Type
DUNS #
010926207
City
Clifton Park
State
NY
Country
United States
Zip Code
12065
Cheng, Alexis; Kim, Younsu; Itsarachaiyot, Yuttana et al. (2018) Photoacoustic-based catheter tracking: simulation, phantom, and in vivo studies. J Med Imaging (Bellingham) 5:021223
Zhang, Haichong K; Chen, Ying; Kang, Jeeun et al. (2018) Prostate-specific membrane antigen-targeted photoacoustic imaging of prostate cancer in vivo. J Biophotonics 11:e201800021
Ziegle, Jens; Audigier, ChloƩ; Krug, Johannes et al. (2018) RF-ablation pattern shaping employing switching channels of dual bipolar needle electrodes: ex vivo results. Int J Comput Assist Radiol Surg 13:905-916
Greer, Hastings; Gerber, Sam; Niethammer, Marc et al. (2018) SCOLIOSIS SCREENING AND MONITORING USING SELF CONTAINED ULTRASOUND AND NEURAL NETWORKS. Proc IEEE Int Symp Biomed Imaging 2018:1500-1503
Kim, Younsu; Audigier, ChloƩ; Ziegle, Jens et al. (2018) Ultrasound thermal monitoring with an external ultrasound source for customized bipolar RF ablation shapes. Int J Comput Assist Radiol Surg 13:815-826
Zhang, Haichong K; Kim, Younsu; Lin, Melissa et al. (2018) Toward dynamic lumbar puncture guidance using needle-based single-element ultrasound imaging. J Med Imaging (Bellingham) 5:021224
Han, Xu; Yang, Xiao; Aylward, Stephen et al. (2017) EFFICIENT REGISTRATION OF PATHOLOGICAL IMAGES: A JOINT PCA/IMAGE-RECONSTRUCTION APPROACH. Proc IEEE Int Symp Biomed Imaging 2017:10-14
Cheng, Alexis; Guo, Xiaoyu; Zhang, Haichong K et al. (2017) Active phantoms: a paradigm for ultrasound calibration using phantom feedback. J Med Imaging (Bellingham) 4:035001
Jallais, Maeliss; Greer, Hastings; Gerber, Sam et al. (2017) Ultrasound Augmentation: Rapid 3-D Scanning for Tracking and On-Body Display. Imaging Patient Cust Simul Syst Point Care Ultrasound (2017) 10549:138-145
Gerber, Samuel; Jallais, Maeliss; Greer, Hastings et al. (2017) Automatic Estimation of the Optic Nerve Sheath Diameter from Ultrasound Images. Imaging Patient Cust Simul Syst Point Care Ultrasound (2017) 10549:113-120

Showing the most recent 10 out of 12 publications