Feasibility of real-time workflow segmentation for tracked needle interventions.
Computer-assisted training systems promote both training efficacy and patient health. An important component for providing automatic feedback in computer-assisted training systems is workflow segmentation: the determination of what task in the workflow is being performed. Our objective was to develop a workflow segmentation algorithm for needle interventions using needle tracking data. Needle tracking data were collected from ultrasound-guided epidural injections and lumbar punctures, performed by medical personnel. The workflow segmentation algorithm was tested in a simulated real-time scenario: the algorithm was only allowed access to data recorded at, or prior to, the time being segmented. Segmentation output was compared to the ground-truth segmentations produced by independent blinded observers. Overall, the algorithm was 93% accurate. It automatically segmented the ultrasound-guided epidural procedures with 81% accuracy and the lumbar punctures with 82% accuracy. Given that the manual segmentation consistency was only 84%, the algorithm's accuracy was 93%. Using Cohen's d statistic, a medium effect size (0.5) was calculated. Because the algorithm segments needle-based procedures with such high accuracy, expert observers can be augmented by this algorithm without a large decrease in ability to follow trainees in a workflow. The proposed algorithm is feasible for use in a computer-assisted needle placement training system.
Matthew Stephen
MS
Holden
Tamas
T
Ungi
Derek
D
Sargent
Robert C
RC
McGraw
Elvis C S
EC
Chen
Sugantha
S
Ganapathy
Terry M
TM
Peters
Gabor
G
Fichtinger
D000465:Algorithms; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D009339:Needles; D019047:Phantoms, Imaging; D013129:Spinal Puncture / Q000295:instrumentation* / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods*; D057188:Workflow