A mixed reality telemedicine system for collaborative ultrasound diagnostics and ultrasound-guided interventions

Abstract

In acute care settings (emergency room [ER], intensive care unit [ICU], operating room [OR]), it is common for inexperienced physicians to have problems making an ultrasound (US) diagnosis, so they have to consult an expert. In this article, we would like to present a methodology by which geographically independent expert physicians can engage during an US examination through virtual and augmented reality. The expert can view the set-up and the US images obtained by the examiner and discuss the clinical case over video chat. In turn, s/he can advise on the proper positioning of the US transducer on the patient with the help of a virtual US transducer. This technology can be used to obtain experts’ opinion from a remote location, whether it is inside a hospital or many miles away. Similarly, it can be used for distant training; whatever the indication, it will lead to improved care. We discuss two different use cases inside an ER: US for a Focused Assessment with Sonography in Trauma (FAST) examination and US for the insertion of a central venous catheter (CVC). Currently, we position this technology to Technology Readiness Level 2, as the concept is formulated and the practical application is identified. The basic properties of algorithms are defined and the basic principles are coded. We performed experiments with parts of the technology in an artificial environment. We asked a doctor, Arnaud Bosteels, to review this method and create this article together.