Development, evaluation, and overview of standardized training phantoms for abdominal ultrasound-guided interventions

Max Seitzinger; Franziska Gnatzy; Sabine Kern; Ralf Steinhausen; Jana Klammer; Tobias Schlosser; Valentin Blank; Thomas Karlas

doi:10.1055/a-2242-7074

Ultraschall in der Medizin - European Journal of Ultrasound, Table of Contents

Ultraschall Med 2024; 45(02): 176-183
DOI: 10.1055/a-2242-7074

Original Article

Development, evaluation, and overview of standardized training phantoms for abdominal ultrasound-guided interventions

Entwicklung und Evaluation von Trainingsphantomen für ultraschallgeführte Interventionen im Abdomen

Max Seitzinger

¹Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Centre, Leipzig, Germany

,

Franziska Gnatzy

²Department of Medicine II, St. Elisabeth Hospital, Leipzig, Germany

,

Sabine Kern

³Forschungszentrum Ultraschall gGmbH, Research Center Ultrasound, Halle (Saale), Germany

,

Ralf Steinhausen

³Forschungszentrum Ultraschall gGmbH, Research Center Ultrasound, Halle (Saale), Germany

,

Jana Klammer

³Forschungszentrum Ultraschall gGmbH, Research Center Ultrasound, Halle (Saale), Germany

,

Tobias Schlosser

¹Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Centre, Leipzig, Germany

,

Valentin Blank‡

⁴Division of Interdisciplinary Ultrasound; Department of Internal Medicine I (Gastroenterology, Pneumology), University Hospital Halle, Halle, Germany (Ringgold ID: RIN14942)

¹Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Centre, Leipzig, Germany

,

Thomas Karlas ‡

¹Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Centre, Leipzig, Germany

› Author Affiliations

Abstract

Purpose Ultrasound (US) represents the primary approach for abdominal diagnosis and is regularly used to guide diagnostic and therapeutic interventions (INVUS). Due to possible serious INVUS complications, structured training concepts are required. Phantoms can facilitate teaching, but their use is currently restricted by complex manufacturing and short durability of the materials. Hence, the aim of this study was the development and evaluation of an optimized abdominal INVUS phantom.

Materials and Methods Phantom requirements were defined in a structured research process: Skin-like surface texture, homogeneous matrix with realistic tissue properties, implementation of lesions and abscess cavities in different sizes and depths as well as a modular production process allowing for customized layouts. The phantom prototypes were evaluated in certified ultrasound courses.

Results In accordance with the defined specifications, a new type of matrix was developed and cast in multiple layers including different target materials. The phantom structure is based on features of liver anatomy and includes solid focal lesions, vessels, and abscess formations. For a realistic biopsy procedure, ultrasound-proof material was additionally included to imitate bone. The evaluation was performed by US novices (n=40) and experienced participants (n=41). The majority (73/81) confirmed realistic visualization of the lesions. The 3D impression was rated as “very good” in 64% of cases (52/81) and good in 31% (25/81). Overall, 86% (70/81) of the participants certified high clinical relevance of the phantom.

Conclusion The presented INVUS phantom concept allows standardized and realistic training for interventions.

Zusammenfassung

Ziel Der Ultraschall (US) hat einen hohen Stellenwert in der Viszeralmedizin und wird häufig als primäre Bildgebung und zur Steuerung interventioneller Eingriffe (INVUS) eingesetzt. Aufgrund potenziell schwerwiegender Komplikationen ist ein strukturiertes INVUS-Training mit möglichst realitätsnahen Interventionsphantomen sinnvoll. Bisher ist deren Einsatz durch eine komplexe Herstellung und begrenzte Haltbarkeit limitiert. Ziel war daher die Entwicklung und Evaluation eines neuartigen abdominalen INVUS-Phantoms.

Material und Methodik Die folgenden Anforderungen an das Phantom wurden im Vorfeld definiert: Hautähnliche Oberflächentextur, homogene Matrix mit realistischen Gewebeeigenschaften, Implementierung von Läsionen und Abszesshöhlen sowie ein modularer Herstellungsprozess. Die Phantome wurden in verschiedenen Ultraschallkursen evaluiert.

Ergebnis Gemäß den Anforderungen wurde eine neuartige Matrix entwickelt und in mehreren Lagen gegossen. Die Phantomstruktur umfasst fokale Läsionen, Gefäße und Abszessformationen. Für einen möglichst realistischen Interventionsablauf wurde zusätzlich ultraschalldichtes Material als Imitierung von Rippen eingegossen. Die Bewertung wurde von im INVUS ungeübten (n=40) und erfahrenen Ultraschallern (n=41) durchgeführt. Die Mehrheit der Teilnehmer (73/81) bestätigte eine realistische Visualisierung der Läsionen. Der 3D-Eindruck wurde von 64% (52/81) der Teilnehmer als „sehr gut“ und von 31% (25/81) als „gut“ bewertet. Insgesamt bescheinigten 86% (70/81) der Teilnehmer dem Phantom eine hohe klinische Relevanz.

Schlussfolgerung Das vorgestellte INVUS-Phantom ermöglicht ein standardisiertes und realistisches Training von ultraschallgestützten Eingriffen.

Keywords

ultrasound training - free hand puncture - ultrasound-guided interventions - ultrasound-guided biopsy - ultrasound phantom

Full Text

References

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Supplementary Material

Supplementary material