RESUMEN
Percutaneous coronary intervention (PCI) has increasingly become the main treatment for coronary artery disease. The procedure requires high experienced skills and dexterous manipulations. However, there are few techniques to model PCI skill so far. In this study, a learning framework with local and ensemble learning is proposed to learn skill characteristics of different skill-level subjects from their PCI manipulations. Ten interventional cardiologists (four experts and six novices) were recruited to deliver a medical guidewire to two target arteries on a porcine model for in vivo studies. Simultaneously, translation and twist manipulations of thumb, forefinger, and wrist are acquired with electromagnetic (EM) and fiber-optic bend (FOB) sensors, respectively. These behavior data are then processed with wavelet packet decomposition (WPD) under 1-10 levels for feature extraction. The feature vectors are further fed into three candidate individual classifiers in the local learning layer. Furthermore, the local learning results from different manipulation behaviors are fused in the ensemble learning layer with three rule-based ensemble learning algorithms. In subject-dependent skill characteristics learning, the ensemble learning can achieve 100% accuracy, significantly outperforming the best local result (90%). Furthermore, ensemble learning can also maintain 73% accuracy in subject-independent schemes. These promising results demonstrate the great potential of the proposed method to facilitate skill learning in surgical robotics and skill assessment in clinical practice.
Asunto(s)
Intervención Coronaria Percutánea , Robótica , Humanos , Animales , Porcinos , Redes Neurales de la Computación , Algoritmos , AprendizajeRESUMEN
The clinical success of the percutaneous coronary intervention (PCI) is highly dependent on endovascular manipulation skills and dexterous manipulation strategies of interventionalists. However, the analysis of endovascular manipulations and related discussion for technical skill assessment are limited. In this study, a multilayer and multimodal-fusion architecture is proposed to recognize six typical endovascular manipulations. The synchronously acquired multimodal motion signals from ten subjects are used as the inputs of the architecture independently. Six classification-based and two rule-based fusion algorithms are evaluated for performance comparisons. The recognition metrics under the determined architecture are further used to assess technical skills. The experimental results indicate that the proposed architecture can achieve the overall accuracy of 96.41%, much higher than that of a single-layer recognition architecture (92.85%). In addition, the multimodal fusion brings significant performance improvement in comparison with single-modal schemes. Furthermore, the K -means-based skill assessment can obtain an accuracy of 95% to cluster the attempts made by different skill-level groups. These hopeful results indicate the great possibility of the architecture to facilitate clinical skill assessment and skill learning.
Asunto(s)
Intervención Coronaria Percutánea , Algoritmos , Competencia Clínica , Humanos , AprendizajeRESUMEN
Robot-assisted vascular interventions present promising trend for reducing the X-ray radiation to the surgeon during the operation. However, the control methods in the current vascular interventional robots only repeat the manipulation of the surgeon. While under certain circumstances, it is necessary to scale the manipulation of the surgeon to obtain a higher precision or a shorter manipulation time. A novel control method based on motion scaling for vascular interventional robot is proposed in this paper. The main idea of the method is to change the motion speed ratios between the master and the slave side. The motion scaling based control method is implemented in the vascular interventional robot we've developed before, so the operator can deliver the interventional devices under different motion scaling factors. Experiment studies verify the effectiveness of the motion scaling based control.