Physics-based virtual environment for training in vascular interventional radiological procedures
Lead Research Organisation:
Imperial College London
Department Name: Surgery and Cancer
Abstract
The aim of this project is to develop a computer generated virtual environment (VE) with variable virtual anatomy, in which the appearance, 'feel' and human factors of invasive radiological procedures (interventional radiology, IR) in patients can be reproduced and assessed.IR is keyhole surgery using needles, specialised wires and tubes (catheters), guided by touch and imaging (x-ray, 'Cat Scan'--CT, ultrasound). IR benefits from local anaesthesia, a tiny incision, few complications, reduced postoperative pain, short hospital stay and low cost. Most IR procedures commence with needle puncture of a blood vessel to insert guide wires and catheters: these clinical skills are acquired by all radiologists during training, as an apprenticeship in patients, inevitably associated with some discomfort and occasionally, complications. 'Straightforward' cases for diagnosis are ideal for training but are being replaced by state-of-the-art, non-invasive imaging methods. While some skills (mainly visual skills, relating to orientation and spatial negotiation) can be acquired using models (as in surgery), these have limitations for IR which relies heavily on a sense of touch. Both patients and trainees would benefit from the use of computers to create a VE with devices conveying touch sensation (haptics) to realistically mimic procedures on patients. Removal of this initial experience from the clinical environment would be time efficient while improving patient safety and reducing the time taken for medical trainees to attain and maintain higher levels of competence.The key aims of this project are to:1. develop and validate a complete VE for training in vascular interventional radiology, encompassing needle puncture as well as guidewire and catheter insertion and manipulation. This is the overarching objective of this project and will be based on a task analysis of interventional procedures.2. develop methods of semi-automatically processing medical imaging data to create a variable range of 3D geometry of anatomy.3. determine and localise the forces experienced by an operator during IR procedures in patients using miniature sensors, enabling the 'feel' of a real procedure to be accurately reproduced.4. simulate needle puncture, and introduction of a guidewire and catheter into a blood vessel, with realistic behaviour of tissue and vessels.5. reproduce the feel of a pulse to guide instrumentation of an artery using a novel device which mimics a patient's physiological pulse.6. simulate ultrasound to guide needle puncture of an artery, and fluoroscopy to guide guidewire and catheter manipulation within an artery.7. validate the VE and assess its potential for training and certification. We will also make suggestions for inclusion in curricula and criteria for certification.The VE developed in this project will be generic, capable of incorporation into an existing system, or of forming the basis of a new generation of systems applicable to training. The work will be undertaken by researchers at the Universities ofLiverpool, Bangor, Hull, Leeds and Imperial; the PI (Gould) is an interventional radiologist with extensive clinical research experience and who will be the overall project co-ordinator. The technical project manager is a Computer Science professor (John) whose Research Assistant will also assist in project management. This proposal accords with the aims of EPSRC in introducing improvements in health and will also enhance economic development and stimulate interest in the sciences.
Publications
Fernando Bello (Co-Author)
(2008)
Physics-based virtual environment for training core skills in vascular interventional radiological procedures
Gould DA
(2012)
Simulation: moving from technology challenge to human factors success.
in Cardiovascular and interventional radiology
John NW
(2008)
Physics-based virtual environment for training core skills in vascular interventional radiological procedures.
in Studies in health technology and informatics
Korzeniowski P
(2016)
NOViSE: a virtual natural orifice transluminal endoscopic surgery simulator.
in International journal of computer assisted radiology and surgery
Korzeniowski P
(2018)
VCSim3: a VR simulator for cardiovascular interventions.
in International journal of computer assisted radiology and surgery
Luboz V
(2011)
Guidewire and catheter behavioural simulation.
in Studies in health technology and informatics
Luboz V
(2011)
Simulation of endovascular guidewire behaviour and experimental validation.
in Computer methods in biomechanics and biomedical engineering
Luboz V
(2009)
Real-time Seldinger technique simulation in complex vascular models.
in International journal of computer assisted radiology and surgery
Luboz V
(2013)
Real-time stent and balloon simulation for stenosis treatment
in The Visual Computer
Luboz V
(2009)
Real-time guidewire simulation in complex vascular models
in The Visual Computer
Description | The project findings can be summarised as follows: Cognitive task analysis of vascular interventional radiology procedures Software algorithms for tissue modelling, endovascular tools, collision detection, etc Customised haptic hardware interfaces Working prototype for simulating the Seldinger technique |
Exploitation Route | The prototype developed is targeted at practicing interventional radiologists. In addition, the software algorithms and interfaces developed are suitable for adaptation and use in other domains. Various possible exploitation routes have been explored, including further funding to refine the existing prototype and discussions with venture capitalist firms. The resulting prototype is part of the portfolio of simulation-based training environments offered by Convincis Ltd, a new Imperial College spin-out company. |
Sectors | Digital/Communication/Information Technologies (including Software),Education,Healthcare |
URL | http://www.craive.org.uk |
Description | The findings of the project have been used in the further development of our endovascular simulator to include interventional cardiology, as well as to instigate other applications of our modelling and simulation techniques. A simulation-based training programme has emerged as a result of work undertaken in the original project and is now well established with over 60 trainees taking part. In addition, the modelling techniques developed during the project have been expanded and applied to the area of advanced endoscopy and NOTES (Natural Orifice Transluminal Endoscopic Surgery). |
First Year Of Impact | 2011 |
Sector | Digital/Communication/Information Technologies (including Software),Education,Healthcare |
Impact Types | Societal,Economic |
Description | iCAST - Imperial College Cardiovascular Simulation-based Training Programme |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | iCAST has successfully trained over 60 Interventional Cardiology trainees in dealing with emergency situations in the cath lab. |
Description | EPSRC Impact Acceleration Account |
Amount | £79,686 (GBP) |
Funding ID | EP/J018201/1 |
Organisation | Engineering and Physical Sciences Research Council (EPSRC) |
Sector | Public |
Country | United Kingdom |
Start | 07/2014 |
End | 12/2015 |
Description | Haptic Interface for Simulation of Endovascular Procedures |
Amount | £60,000 (GBP) |
Organisation | Government of Malaysia |
Sector | Public |
Country | Malaysia |
Start | 12/2010 |
End | 11/2014 |
Description | Information Driven Optimisation of Care Pathways and Procedure |
Amount | £2,049,353 (GBP) |
Funding ID | EP/H019804/1 |
Organisation | Engineering and Physical Sciences Research Council (EPSRC) |
Sector | Public |
Country | United Kingdom |
Start | 10/2009 |
End | 03/2013 |
Description | Simulation -based Training for Interventional Cardiology |
Organisation | Imperial College Healthcare NHS Trust |
Country | United Kingdom |
Sector | Hospitals |
PI Contribution | A partnership has been established with leading interventional cardiologists at Imperial College NHS Trust |
Collaborator Contribution | We have contributed to the design and implementation of the training programme, as well as its research component (validation, assessment, etc) |
Impact | Multi-disciplinary collaboration with Interventional Cardiologists, Anaesthetists, Endovascular Surgeons, Educationalists |
Start Year | 2010 |