Abstract
The overall prevalence of chronic kidney disease in the general population is ∼14% with more than 661,000 Americans having a kidney failure. Ultrasound (US)-guided renal biopsy is a critically important tool in the evaluation and management of renal pathologies. This Letter presents KBVTrainer, a virtual simulator that the authors developed to train clinicians to improve procedural skill competence in US-guided renal biopsy. The simulator was built using low-cost hardware components and open source software libraries. They conducted a face validation study with five experts who were either adult/pediatric nephrologists or interventional/diagnostic radiologists. The trainer was rated very highly (>4.4) for the usefulness of the real US images (highest at 4.8), potential usefulness of the trainer in training for needle visualization, tracking, steadiness and hand-eye coordination, and overall promise of the trainer to be useful for training US-guided needle biopsies. The lowest score of 2.4 was received for the look and feel of the US probe and needle compared to clinical practice. The force feedback received a moderate score of 3.0. The clinical experts provided abundant verbal and written subjective feedback and were highly enthusiastic about using the trainer as a valuable tool for future trainees.
Highlights
The overall prevalence of chronic kidney disease in the general population is ∼14% with more than 661,000 Americans having a kidney failure [1]
We developed a low-cost, virtual simulator called KBVTrainer (Kidney Biopsy Virtual Trainer), for US-guided kidney biopsy training
The Volume Reslice Driver module allows for programmatically setting the orientation and location of a slice to advanced virtual simulator for real-time US-guided renal biopsy training provides several advantages including acceleration of the training of US-guided renal biopsy in a risk-free environment to improve the safety of kidney biopsy and ensuring that the biopsy procedure yields high-quality specimen
Summary
The overall prevalence of chronic kidney disease in the general population is ∼14% with more than 661,000 Americans having a kidney failure [1]. Ultrasound (US)-guided kidney biopsy is a critically important tool in the evaluation and management of renal pathologies. Poor renal biopsy technique can potentially lead to significant complications and adverse lethal outcomes including severe bleeding, arteriovenous fistula and infection [2, 3]. Technologies that improve the safety profile and accuracy of kidney biopsy are needed (Fig. 1). Training in US-guided kidney biopsy procedures includes anatomical understanding, US image interpretation and eye-hand coordination required to successfully complete the procedure. Apprenticeship learning requires the radiologist to show the technique to the trainee and guide him or her through the procedure. This can be a very time consuming and tedious process
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