Silicon Phantom Research Articles

Assessing Near-Infrared Optical Tomography's Depth Capability in Imaging Brain Vessels: An Experimental Study.

Advanced brain vessel imaging is crucial for diagnosing and treating brain-related conditions such as lesions and strokes, ultimately enhancing brain health. Among the range of cerebrovascular imaging modalities, near-infrared optical tomography (NIROT) stands out for its cost-effectiveness and brain oxygenation quantification. The objective of this project, as a continuation of our prior simulation study, is to evaluate in vitro the Pioneer system for imaging blood vessels. An experimental study was performed on a silicon phantom with a tube inclusion mimicking the superficial blood vessels at a depth of 5 mm. The experiment employed a time domain (TD) NIROT called Pioneer system. Image reconstruction was performed using the obtained TD data. We used root mean square error (RMSE) to evaluate the accuracy of the reconstructed images. We were able to detect the location and structure of the tube with a RMSE of 0.0285. This experimental study showed that the TD NIROT Pioneer system can detect vessel-like inclusion at the depth of 5 mm.

Validating Homogeneity for a Novel 3-Dimensional Tissue Phantom Modeling System of the Human Maxilla.

Silicon phantom models have been utilized to calculate light fluence in patients being treated with Photodynamic Therapy (PDT). This application can be utilized for other non-ionizing wavelength therapies such as Photobiomodulation (PBM). We have developed a novel protocol to validate homogeneity for 3-dimensional silicon phantom models of the human maxilla. Accurately quantifying the light profiles of human tissue can accommodate for varying optical properties that occur between subjects. More importantly, this can help optimize light fluence dosimetry calculations to achieve intended results. Silicon models of identical composition were fabricated into two different shapes: 1 flat-planar cylindrical shaped model, 2) non-flat planar (3-dimensional) mold of the human maxilla. Fabricating homogenous silicon phantom models continues to be a challenge as micro-bubbles can contaminate the compound during the curing process. Integrating both proprietary CBCT and handheld surface acquisition imaging devices confirmed our results to be within 0.5mm of accuracy. This protocol was specifically used to cross-reference and validate homogeneity at various depths of penetration. These results present the first known successful validation of identical silicon tissue phantoms with a flat-planar surface vs. a non-flat 3D planar surface. This proof-of-concept phantom validation protocol is sensitive to the specific variations of 3-dimensional surfaces and can be applied to a workflow used to capture accurate light fluence calculations in the clinical setting.

A CMOS Lock-In Pixel Image Sensor With Multisimultaneous Gate for Time-Resolved Near-Infrared Spectroscopy

This article proposes a CMOS lock-in pixel image sensor aiming for time-resolved near-infrared spectroscopy (TR-NIRS). The pixel employs lateral electric field charge modulation (LEFM) with an eight-tap multisimultaneous gate structure and negative substrate bias. The optimization of pixel structure creates a high potential slope with no barrier to facilitate the high-speed photo-generated charge transfer required in the time-resolved application. The sensor employs a two-stage charge transfer architecture with pinned storage diodes (SDs). The effectiveness of the sensor is demonstrated through simulations and experimental measurements. A prototype sensor with 70 (V) <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\times110$ </tex-math></inline-formula> (H) effective pixels to characterize the multisimultaneous gate lock-in pixel is implemented in a 0.11- <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\mu \text{m}$ </tex-math></inline-formula> 1-poly-4-metal CMOS image sensor (CIS) technology. A fast intrinsic response of 240 ps is achieved using an 80-ps pulsewidth 780-nm laser diode by the characterization using two simultaneous gates and a single time window of the lock-in pixel. Performance evaluation using silicon phantoms and further measurement with a rat demonstrates the feasibility of the proposed sensor and setup for TR-NIRS applications.

Design of a Patient-Specific Respiratory-Motion-Simulating Platform for In Vitro 4D Flow MRI.

Four-dimensional (4D) flow magnetic resonance imaging (MRI) is a leading-edge imaging technique and has numerous medicinal applications. In vitro 4D flow MRI can offer some advantages over in vivo ones, especially in accurately controlling flow rate (gold standard), removing patient and user-specific variations, and minimizing animal testing. Here, a complete testing method and a respiratory-motion-simulating platform are proposed for in vitro validation of 4D flow MRI. A silicon phantom based on the hepatic arteries of a living pig is made. Under the free-breathing, a human volunteer's liver motion (inferior-superior direction) is tracked using a pencil-beam MRI navigator and is extracted and converted into velocity-distance pairs to program the respiratory-motion-simulating platform. With the magnitude displacement of about 1.3cm, the difference between the motions obtained from the volunteer and our platform is ≤ 1mm which is within the positioning error of the MRI navigator. The influence of the platform on the MRI signal-to-noise ratio can be eliminated even if the actuator is placed in the MRI room. The 4D flow measurement errors are respectively 0.4% (stationary phantom), 9.4% (gating window = 3mm), 27.3% (gating window = 4mm) and 33.1% (gating window = 7mm). The vessel resolutions decreased with the increase of the gating window. The low-cost simulation system, assembled from commercially available components, is easy to be duplicated.

Toward Robust Partial-Image Based Template Matching Techniques for MRI-Guided Interventions.

We have developed an MRI-safe needle guidance toolkit for MRI-guided interventions intended to enable accurate positioning for needle-based procedures. The toolkit allows intuitive and accurate needle angulation and entry point positioning according to an MRI-based plan, using a flexible, patterned silicone 2D grid. The toolkit automatically matches the grid on MRI planning images with a physical silicon grid placed conformally on the patient's skin and provides the Interventional Radiologist an easy-to-use guide showing the needle entry point on the silicon grid as well as needle angle information. The radiologist can use this guide along with a 2-degree-of-freedom (rotation and angulation relative to the entry point) hand-held needle guide to place the needle into the anatomy of interest. The initial application that we are considering for this toolkit is arthrography, a diagnostic procedure to evaluate the joint space condition. However, this toolkit could be used for any needle-based and percutaneous procedures such as MRI-guided biopsy and facet joint injection. For matching the images, we adopt a transformation parameter estimation technique using the phase-only correlation method in the frequency domain. We investigated the robustness of this method against rotation, displacement, and Rician noise. The algorithm was able to successfully match all the dataset images. We also investigated the accuracy of identifying the entry point from registered template images as a prerequisite for a future targeting study. Application of the template matching algorithm to locate the needle entry points within the MRI dataset resulted in an average entry point location estimation accuracy of 0.12 ±0.2 mm. This promising result motivates a more detailed assessment of this algorithm in the future including a targeting study on a silicon phantom with embedded plastic targets to investigate the end-to-end accuracy of this automatic template matching algorithm in the interventional MRI room.

Real-time stereo reconstruction of intraoperative scene and registration to preoperative 3D models for augmenting surgeons' view during RAMIS.

During minimally invansive surgery (MIS) procedures, there exists an ever-growing/apparent need for providing computer generated visual feedback to the surgeon(s), through a visualization device. While multiple solutions have been proposed in the literature, there is limited evidence of such a system performing reliably in practice, and when it does, it is often tailored to a specific operation type. Another important aspect is regarding the usability of such systems, which typically include complicated and time-consuming steps, and often require the assistance of specialized personnel. In this study, we propose an auxiliary visualization system for surgeons, which includes streamlined process to use preoperative data of the patient, and apply it to two different MIS cases, namely, robot-assisted partial nephrectomy and robot-assisted partial lateral meniscectomy. The visualization and processing pipeline consists of an intraoperative 3D reconstruction of the surgical area, using an optimized version of the quasi-dense method, aimed to perform with good accuracy while maintaining real-time speed. A set of preprocessing and postprocessing techniques further contribute to the result by providing a smoother and more dense point cloud. DynamicFusion is used for the registration of the preoperative model to the intraoperative scene. Two silicon kidney phantoms and an ex-vivo porcine meniscus are used for evaluation, representing subjects for the examined surgicalcases. Performance is evaluated qualitatively using the two datasets. The preoperative model of the subject is projected on top of the actual 2D image and also in 3D space. The model is superimposed on top of the actual physical structure it represents, and remains in the correct position throughout the experiments, even when abrupt camera movements are taking place. Finally, when deformation is introduced, the model is deformed as well, resembling the real subject's structure. Results demonstrate and validate the use of the presented algorithms for each separate task of the pipeline. A complete methodology to provide surgeon(s) with visual information during surgery is presented. Its operation is evaluated over two different surgical scenarios, paving the way for a single visualization methodology that can adapt and perform robustly for multiple cases, with minimaleffort.

Temperature Characteristics of Traditional Indirect Moxibustion and Electronic Moxibustion.

Electronic moxibustion (EM) was developed to minimize the side effects of traditional moxibustion, such as burns, and to overcome therapeutic compliances such as smoke or smell. To investigate distributions and thermal stimulation of EM at various depths using silicon phantom and to compare this methodology to traditional indirect moxibustion (TIM). A silicon phantom composed of polydimethylsiloxane was heated and immersed in a hot plate containing warm water to set the phantom's temperature to that of biological tissue. K-type thermocouples were inserted into the phantom at depths of 0, 2, 5, 7, and 10 mm to measure temperature changes with thermal stimulation of EM or TIM placed on top of the phantom. At the surface of the phantom, the peak temperature after applying TIM (55.04 ± 0.92℃ [Δ23.79 ± 0.96℃]) was significantly higher than after EM (43.25 ± 1.95℃ [Δ13.00 ± 2.23℃]), with both interventions reaching the highest temperature after 2 minutes. The temperature increase for TIM was also statistically significant compared to EM when measured at a depth of 2 mm. For the experimental setting with TIM, after reaching peak surface temperature, a rapid decrease was observed at the surface and 2 mm while EM showed a much more gradual decline. There was no significant difference in temperature change between the groups at depths of 5, 7, and 10 mm. TIM resulted in a higher temperature rise compared to EM at the surface and at a 2 mm depth reaching over 50℃, which creates risk of burns. Thermal stimulation with EM had a lower risk of burns with temperature increment not being statistically different from TIM below the depth of 5 mm.

Thermal Properties of Warm- versus Heated-Needle Acupuncture.

Background Warm-needle acupuncture (WA) and fire-needle acupuncture are treatment techniques that use the combination of acupuncture and thermal stimulation. In clinical practice, a new method of fire-needle acupuncture called “heated-needle acupuncture (HA)” has been proposed, wherein the needle is directly heated after insertion. WA and HA share similarities in their methods, and no previous study has sought to assess whether their thermal outcomes are also similar. Methods We controlled environmental variables and measured the maximum temperatures and temperature changes of a silicon phantom in which K-type thermocouples were embedded at depths of 0, 2, 5, 7, and 10 mm. WA and HA were also performed with acupuncture needles of various thicknesses (0.30 × 40 mm, 0.40 × 40 mm, and 0.50 × 40 mm). Results Different time-dependent temperature distributions were observed between the two acupuncture methods: HA yielded a higher maximum temperature and temperature change on the surface, whereas WA yielded higher temperatures at the other tested depths. The thermal patterns were similar among the needles of different thicknesses for each method, with the following exception: while the temperature change and maximum temperature did not differ significantly by needle thickness for WA, these parameters increased significantly with needle thickness for HA. Conclusion The two acupuncture procedures yielded different thermal patterns in a controlled environment. Further studies are necessary to reflect the effect of external environment variables occurring in reality.

Enhanced diffuse optical tomographic reconstruction using concurrent ultrasound information.

Multimodal imaging is an active branch of research as it has the potential to improve common medical imaging techniques. Diffuse optical tomography (DOT) is an example of a low resolution, functional imaging modality that typically has very low resolution due to the ill-posedness of its underlying inverse problem. Combining the functional information of DOT with a high resolution structural imaging modality has been studied widely. In particular, the combination of DOT with ultrasound (US) could serve as a useful tool for clinicians for the formulation of accurate diagnosis of breast lesions. In this paper, we propose a novel method for US-guided DOT reconstruction using a portable time-domain measurement system. B-mode US imaging is used to retrieve morphological information on the probed tissues by means of a semi-automatical segmentation procedure based on active contour fitting. A two-dimensional to three-dimensional extrapolation procedure, based on the concept of distance transform, is then applied to generate a three-dimensional edge-weighting prior for the regularization of DOT. The reconstruction procedure has been tested on experimental data obtained on specifically designed dual-modality silicon phantoms. Results show a substantial quantification improvement upon the application of the implemented technique.This article is part of the theme issue ‘Synergistic tomographic image reconstruction: part 2’.

Choosing an Effective and Safe Direct Aspiration Setup for Tortuous Anatomy in Acute Ischemic Stroke: In vitro Study in a Physiological Flow Model.

A direct aspiration first pass technique (ADAPT) is an effective thrombectomy option in patients with acute ischemic stroke. Balloon guide catheters (BGC) seem to improve the efficacy of stent retrievers and ADAPT. The last generation 6F aspiration catheters require 9F BGCs, which are rigid devices that are challenging to position in a tortuous anatomy. In this experimental study the efficacy of 6F ADAPT alone and 5F ADAPT combined with 8F BGC was evaluated. Either a fibrin rich (white) clot or an RBC rich (red) clot was placed in the M1 segment of a transparent silicon phantom. Physiological hemodynamic conditions were maintained. The clots were retrieved by 6F aspiration catheter via 8F long sheath or 5F aspiration catheter via a flexible 8F BGC. Thrombectomy was performed under direct visual control. The primary endpoints were the number of passes and the number of distal emboli. Ten experiments were made with each clot model and thrombectomy technique (n = 40). Full recanalization could be achieved in every experiment. First pass mTICI 3 could be achieved by 6F ADAPT in 80 % of red clots and 90 % of white clots. Distal emboli were caused in 10 % and 20 %, respectively. When using 5F ADAPT combined with BGC, a first pass mTICI 3 rate of 90 % in red clots and 100 % in white clots could be achieved. A 10 % rate of distal emboli occurred in both groups. In almost all experiments (both techniques), the thrombi clogged the aspiration catheter. No statistically significant differences could be found between the techniques and clot models. 6F ADAPT without BGC was as effective as 5FADAPT combined with a flexible 8F BGC, with both techniques showing high first-pass recanalization rates and low distal emboli rates. Especially in the case of a tortuous anatomy, these setups should be considered as alternatives to a rigid 9F BGC. The thrombus compositions seemed to be irrelevant in this setting. · 6F ADAPT with no BGC and 5F ADAPT with BGC were very effective and performed equally.. · Both techniques should be considered in tortuous anatomy.. · In this setting the clot composition showed no effect on the recanalization rate.. · Madjidyar J, Nerkada L, Larsen N et al. Choosing an Effective and Safe Direct Aspiration Setup for Tortuous Anatomy in Acute Ischemic Stroke: In vitro Study in a Physiological Flow Model. Fortschr Röntgenstr 2021; 193: 544 - 550.

Real-time mapping of a whole heart chamber using a novel sparse ultrasonic catheter array.

Atrial fibrillation (AF), the most prevalent form of cardiac arrhythmia, afflicts millions worldwide. Here, we developed an imaging algorithm for the diagnosis and online guidance of radio-frequency ablation, which is currently the first line of treatment for AF and other arrhythmia. This requires the simultaneous mapping of the left atrium anatomy and the propagation of the electrical activation wave, and for some arrhythmia, within a single heartbeat. We constructed a multi-frequency ultrasonic system consisting of 64 elements mounted on a spherical basket, operated in a synthetic aperture mode, that allows instant localization of thousands of points on the endocardial surface and yields a MRI-like geometric reconstruction. The system and surface localization algorithm were extensively tested and validated in a series of in silico and in vitro experiments. We report considerable improvement over traditional methods along with theoretical results that help refine the extracted shape. The results in left atrium-shaped silicon phantom were accurate to within 4mm. A novel catheter system consisting of a basket of splines with multiple multi-frequency ultrasonic elements allows 3D anatomical mapping and real-time tracking of the entire heart chamber within a single heartbeat. These design parameters achieve highly acceptable reconstruction accuracy.

Evaluation of Artificial Tactile Sense in Mass Detection in Silicone Phantom for the Diagnosis of Prostate Tumor.

We analyzed the kinetic and kinematic variables of artificial tactile and artificial vibrotactile sensing test for mass detection in silicon phantom to determine tactile intensity and speed to obtain the best result in detecting the type and location of the mass. This study has utilized Artificial Tactile Sensing Instrument for Mass Detection (ATSIMD) in cylindrical silicone phantoms. The masses embedded in these samples were inserted in axial and environmental, deep and surface positions. The loading velocity, probe location, and the frequency of the applied force were considered as the independent variables in this study. It was found that for superficial mases the accuracy of detection at low speed 5 mm/sec, although dependent on the probe, but was 50% higher than under other conditions. For deep masses, with increasing mass depth, the accuracy of detection at medium speed of 8 mm/sec was 30% higher than at low speed. Mass detection by ATSIMD used in this study showed maximum efficiency at medium loading velocity. At low and high loading velocities, the dependence of mass detection on the probe location is related to the interaction of the testing method, tissue, and viscoelastic properties of the tissue.

Novel augmented physical simulator for the training of transcatheter cardiovascular interventions.

Training in transcatheter cardiovascular skills today represents a significant challenge because of the complexity of the interventions and an extensive use of multiple live imaging technologies. We describe the design, the face validation, and content validation of a newly developed physical transseptal puncture (TSP) simulator using additive manufacturing techniques and novel imaging simulation solutions. The TSP simulator contains a femoral vein catheterization pad, silicon phantoms of the venous system, a replaceable interatrial septum, and cameras to mimic live fluoroscopic and echocardiographic imaging. A validation study was conducted at the University Hospital of Zurich. A total of 14 interventional cardiologists and cardiac surgeons assessed the TSP simulator. Participants performed a TSP on the simulator using standard interventional tools. Face and content validity was demonstrated using a 5-point Likert scale. The TSP simulator is a new training tool for transcatheter cardiovascular interventions. All interventional cardiologists and cardiac surgeons completed the training exercise and scoring. Overall impression was rated (out of 5) 4.04 ± 1.03, haptic feedback scored 4.13 ± 0.82, and the realism of fluoroscopy simulation 4.39 ± 0.79. Usability was rated 4.50 ± 0.63 by the participants, indicating that the simulator could be suitable for training. We demonstrated face and content validity of a new simulator for transcatheter cardiovascular interventions. The TSP simulator's usability, haptic feedback, imaging solutions, and the overall impression of its usage were reported as very realistic. The TSP simulator represents a promising tool for simulation-based training using real interventional toolkits in a mimicked radiological environment.

A Novel Inductive Tactile Probe Design for Lump Detection in Soft Tissue Phantoms

The purpose of this study is the development of a novel tactile probe for detection of lumps in soft tissue. The tactile probe includes an inductive sensor inside of an artificial tissue-like silicon rubber cushioning and a square shaped multi-metal-array to increase sensitivity. Firstly, a thermoplastic polymer probe was fabricated for housing and the mechanical compression test was executed by material testing machine. Secondly, the tactile sensor was calibrated between 2.5N-25N by 2.5N incremental steps and showed 99.49% linear behavior. In order to measure probe’s performance, 16 cylindrical silicon phantoms were used in three different scenarios. Each phantom was embedded by hard plastic inclusions at different depths and sizes. Finally, human palpation experiments were conducted by 10 naive subjects for the same scenarios above. The comparison results showed that especially for deep inclusions at low forces, human subjects had high false diagnose rates, while the tactile sensor could detect the deep inclusions at all force levels (ANOVA, p

Real-Time Vision-Based Stiffness Mapping †.

This paper presents new findings concerning a hand-held stiffness probe for the medical diagnosis of abnormalities during palpation of soft-tissue. Palpation is recognized by the medical community as an essential and low-cost method to detect and diagnose disease in soft-tissue. However, differences are often subtle and clinicians need to train for many years before they can conduct a reliable diagnosis. The probe presented here fills this gap providing a means to easily obtain stiffness values of soft tissue during a palpation procedure. Our stiffness sensor is equipped with a multi degree of freedom (DoF) Aurora magnetic tracker, allowing us to track and record the 3D position of the probe whilst examining a tissue area, and generate a 3D stiffness map in real-time. The stiffness probe was integrated in a robotic arm and tested in an artificial environment representing a good model of soft tissue organs; the results show that the sensor can accurately measure and map the stiffness of a silicon phantom embedded with areas of varying stiffness.

Developing a compact multiple laser diode combiner with a single fiber stub output for handheld IoT devices

Many biomedical applications require an efficient combination and localization of multiple discrete light sources (e.g., fluorescence and absorbance imaging). We present a compact 6 channel combiner that couples the output of independent solid-state light sources into a single 400-μm-diameter fiber stub for handheld Internet of Things (IoT) devices. We demonstrate average coupling efficiencies > 80% for each of the 6 laser diodes installed into the prototype. The design supports the use of continuous wave and intensity-modulated laser diodes. This fiber-stub-type beam combiner could be used to construct custom multi-wavelength sources for tissue oximeters, microscopes and molecular imaging technologies. In order to validate its suitability, we applied the developed fiber-stub-type beam combiner to a multi-wavelength light source for a handheld IoT device and demonstrated its feasibility for smart healthcare through a tumor-mimicking silicon phantom.

VELOCITY MEASUREMENTS IN NASAL CAVITIES BY MEANS OF STEREOSCOPIC PIV - PRELIMINARY TESTS

The prediction of detailed flow patterns in human nasal cavities using computational fluid dynamics (CFD) can provide essential information on the potential relationship between patient-specific geometrical characteristics of the nasal anatomy and health problems, and ultimately led to improved surgery. The complex flow structure and the intricate geometry of the nasal cavities make achieving such goals a challenge for CFD specialists. The need for experimental data to validate and improve the numerical simulations is particularly crucial. To this aim an experimental set-up based on Stereo PIV and a silicon phantom of nasal cavities have been designed and realized at Politecnico di Milano. This work describes the main features and challenges of the set-up along with some preliminary results.

Capacitive charge approach to diffuse optical tomography systems

In this study the capacitive charge model approach has been explored to evaluate depth information of continuous wave (CW) diffuse optical tomography (DOT) systems. CW DOT systems have two geometric data acquisition structures depending on the laser source and photo-detector placements on the device surfaces. These geometries are transmission through and back reflection types. Most of the scanning geometries do not allow transmission through measurements. Hence, researchers had been trying to make more reliable back reflected CW DOT imaging systems for almost 30 years. Some researchers and companies had been using the mixture of transmission through and back reflection geometry models which is also equivalent to ring model. Ring model has been normally used for breast and newborn head imaging. The exponentially decaying nature of light gives less information about depth of scanning view for back reflected DOT devices. Diffusing light loses its energy along the depth profile. Back reflected escaping diffuse light involves less information about deeper voxels of interesting tissue or tissue like phantoms. On the other hand transmission through geometry uses only one depth surface thus giving more accurate information. In this work back reflected DOT geometry has been mimicked as a capacitor. Instead of electron accumulation versus time we used photon accumulation versus depth. The forward model transport matrix was built according to the time independent diffusion equation. One source and five different detector position’s experimental measurement data were acquired by multifiber spectrometers and simultenously acquired from homogenous and heterogenous multilayered, solid, sylindirical, silicon phantoms. Five different distance, heterogenous multilayer, detector's data have been divided over five homogenous detector's data to generate perturbation data. Perturbation data and the forward model weight matrix have been used to recover heterogenous, absorption differences from the homogenous medium and then two dimensional image has been constructed.

Shear-scaling-based approach for irreversible energy loss estimation in stenotic aortic flow – An in vitro study

Today, the functional and risk assessment of stenosed arteries is mostly based on ultrasound Doppler blood flow velocity measurements or catheter pressure measurements, which rely on several assumptions. Alternatively, blood velocity including turbulent kinetic energy (TKE) may be measured using MRI. The aim of the present study is to validate a TKE-based approach that relies on the fact that turbulence production is dominated by the flow’s shear to determine the total irreversible energy loss from MRI scans. Three-dimensional particle tracking velocimetry (3D-PTV) and phase-contrast magnetic resonance imaging (PC-MRI) simulations were performed in an anatomically accurate, compliant, silicon aortic phantom. We found that measuring only the laminar viscous losses does not reflect the true losses of stenotic flows since the contribution of the turbulent losses to the total loss become more dominant for more severe stenosis types (for example, the laminar loss is 0.0094±0.0015W and the turbulent loss is 0.0361±0.0015W for the Remax=13,800 case, where Remax is the Reynolds number based on the velocity in the vena-contracta). We show that the commonly used simplified and modified Bernoulli’s approaches overestimate the total loss, while the new TKE-based method proposed here, referred to as “shear scaling” approach, results in a good agreement between 3D-PTV and simulated PC-MRI (mean error is around 10%). In addition, we validated the shear scaling approach on a geometry with post-stenotic dilatation using numerical data by Casas et al. (2016). The shear scaling-based method may hence be an interesting alternative for irreversible energy loss estimation to replace traditional approaches for clinical use. We expect that our results will evoke further research, in particular patient studies for clinical implementation of the new method.

Reduced variability and execution time to reach a target with a needle GPS system: Comparison between physicians, residents and nurse anaesthetists

Ultrasound (US) guided needle positioning is safer than anatomical landmark techniques for central venous access. Hand–eye coordination and execution time depend on the professional's ability, previous training and personal skills. Needle guidance positioning systems (GPS) may theoretically reduce execution time and facilitate needle positioning in specific targets, thus improving patient comfort and safety.Three groups of healthcare professionals (41 anaesthesiologists and intensivists, 41 residents in anaesthesiology and intensive care, 39 nurse anaesthetists) were included and required to perform 3 tasks (positioning the tip of a needle in three different targets in a silicon phantom) by using successively a conventional US-guided needle positioning and a needle GPS. We measured execution times to perform the tasks, hand–eye coordination and the number of repositioning occurrences or errors in handling the needle or the probe.Without the GPS system, we observed a significant inter-individual difference for execution time (P<0.05), hand–eye coordination and the number of errors/needle repositioning between physicians, residents and nurse anaesthetists. US training and video gaming were found to be independent factors associated with a shorter execution time.Use of GPS attenuated the inter-individual and group variability. We observed a reduced execution time and improved hand–eye coordination in all groups as compared to US without GPS. Neither US training, video gaming nor demographic personal or professional factors were found to be significantly associated with reduced execution time when GPS was used.US associated with GPS systems may improve safety and decrease execution time by reducing inter-individual variability between professionals for needle-handling procedures.