A Training Tool for Ultrasound-Guided Central Line Insertion with Webcam-Based Position Tracking

PURPOSE: This paper describes an open-source ultrasound-guided central line insertion training system. Modern clinical guidelines are increasingly recommending ultrasound guidance for this procedure due to the decrease in morbidity it provides. However, there are no adequate low-cost systems for helping new clinicians train their inter-hand coordination for this demanding procedure. METHODS: This paper details a training platform which can be recreated with any standard ultrasound machine using inexpensive components. We describe the hardware, software, and calibration procedures with the intention that a reader can recreate this system themselves. RESULTS: The reproducibility and accuracy of the ultrasound calibration for this system was examined. We found that across the ultrasound image the calibration error was less than 2 mm. In a small feasibility study, two participants performed 5 needle insertions each with an average of slightly above 2 mm error. CONCLUSION: We conclude that the accuracy of the system is sufficient for clinician training.

[1]  Mark Asselin,et al.  Towards webcam-based tracking for interventional navigation , 2018, Medical Imaging.

[2]  M. Phelan,et al.  The oblique view: an alternative approach for ultrasound-guided central line placement. , 2009, The Journal of emergency medicine.

[3]  Raman Uberoi,et al.  CENTRAL VENOUS ACCESS , 1997, Nursing Clinics of North America.

[4]  Gabor Fichtinger,et al.  Computerized training system for ultrasound-guided lumbar puncture on abnormal spine models: a randomized controlled trial , 2015, Canadian Journal of Anesthesia/Journal canadien d'anesthésie.

[5]  Gabor Fichtinger,et al.  Real-time workflow detection using webcam video for providing real-time feedback in central venous catheterization training , 2018, Medical Imaging.

[6]  Eric De Groot,et al.  Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients , 2006, Critical care.

[7]  Andras Lasso,et al.  PLUS: Open-Source Toolkit for Ultrasound-Guided Intervention Systems , 2014, IEEE Transactions on Biomedical Engineering.

[8]  R. Lindwall,et al.  Clinical guidelines on central venous catheterisation , 2014, Acta anaesthesiologica Scandinavica.

[9]  Andras Lasso,et al.  Open-source platforms for navigated image-guided interventions , 2016, Medical Image Anal..

[10]  Gabor Fichtinger,et al.  The development and validation of hand motion analysis to evaluate competency in central line catheterization. , 2015, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[11]  Andrew W Kirkpatrick,et al.  Ultrasound confirmation of guidewire position may eliminate accidental arterial dilatation during central venous cannulation , 2010, Scandinavian journal of trauma, resuscitation and emergency medicine.

[12]  Francisco José Madrid-Cuevas,et al.  Automatic generation and detection of highly reliable fiducial markers under occlusion , 2014, Pattern Recognit..