Evaluation of Deep Learning Model Architectures for Point-of-Care Ultrasound Diagnostics.

Point-of-care ultrasound imaging is a critical tool for patient triage during trauma for diagnosing injuries and prioritizing limited medical evacuation resources. Specifically, an eFAST exam evaluates if there are free fluids in the chest or abdomen but this is only possible if ultrasound scans can be accurately interpreted, a challenge in the pre-hospital setting. In this effort, we evaluated the use of artificial intelligent eFAST image interpretation models. Widely used deep learning model architectures were evaluated as well as Bayesian models optimized for six different diagnostic models: pneumothorax (i) B- or (ii) M-mode, hemothorax (iii) B- or (iv) M-mode, (v) pelvic or bladder abdominal hemorrhage and (vi) right upper quadrant abdominal hemorrhage. Models were trained using images captured in 27 swine. Using a leave-one-subject-out training approach, the MobileNetV2 and DarkNet53 models surpassed 85% accuracy for each M-mode scan site. The different B-mode models performed worse with accuracies between 68% and 74% except for the pelvic hemorrhage model, which only reached 62% accuracy for all model architectures. These results highlight which eFAST scan sites can be easily automated with image interpretation models, while other scan sites, such as the bladder hemorrhage model, will require more robust model development or data augmentation to improve performance. With these additional improvements, the skill threshold for ultrasound-based triage can be reduced, thus expanding its utility in the pre-hospital setting.

Design and testing of ultrasound probe adapters for a robotic imaging platform.

Medical imaging-based triage is a critical tool for emergency medicine in both civilian and military settings. Ultrasound imaging can be used to rapidly identify free fluid in abdominal and thoracic cavities which could necessitate immediate surgical intervention. However, proper ultrasound image capture requires a skilled ultrasonography technician who is likely unavailable at the point of injury where resources are limited. Instead, robotics and computer vision technology can simplify image acquisition. As a first step towards this larger goal, here, we focus on the development of prototypes for ultrasound probe securement using a robotics platform. The ability of four probe adapter technologies to precisely capture images at anatomical locations, repeatedly, and with different ultrasound transducer types were evaluated across more than five scoring criteria. Testing demonstrated two of the adapters outperformed the traditional robot gripper and manual image capture, with a compact, rotating design compatible with wireless imaging technology being most suitable for use at the point of injury. Next steps will integrate the robotic platform with computer vision and deep learning image interpretation models to automate image capture and diagnosis. This will lower the skill threshold needed for medical imaging-based triage, enabling this procedure to be available at or near the point of injury.