Artificial Intelligence: Innovation to Assist in the Identification of Sono-anatomy for Ultrasound-Guided Regional Anaesthesia

James Lloyd, Robert Morse, Alasdair Taylor, David Phillips, Helen Higham, David Burckett-St Laurent, James Bowness (Lead / Corresponding author)

Research output: Chapter in Book/Report/Conference proceedingChapter (peer-reviewed)peer-review

2 Citations (Scopus)

Abstract

Ultrasound-guided regional anaesthesia (UGRA) involves the targeted deposition of local anaesthesia to inhibit the function of peripheral nerves. Ultrasound allows the visualisation of nerves and the surrounding structures, to guide needle insertion to a perineural or fascial plane end point for injection. However, it is challenging to develop the necessary skills to acquire and interpret optimal ultrasound images. Sound anatomical knowledge is required and human image analysis is fallible, limited by heuristic behaviours and fatigue, while its subjectivity leads to varied interpretation even amongst experts. Therefore, to maximise the potential benefit of ultrasound guidance, innovation in sono-anatomical identification is required.Artificial intelligence (AI) is rapidly infiltrating many aspects of everyday life. Advances related to medicine have been slower, in part because of the regulatory approval process needing to thoroughly evaluate the risk-benefit ratio of new devices. One area of AI to show significant promise is computer vision (a branch of AI dealing with how computers interpret the visual world), which is particularly relevant to medical image interpretation. AI includes the subfields of machine learning and deep learning, techniques used to interpret or label images. Deep learning systems may hold potential to support ultrasound image interpretation in UGRA but must be trained and validated on data prior to clinical use.Review of the current UGRA literature compares the success and generalisability of deep learning and non-deep learning approaches to image segmentation and explains how computers are able to track structures such as nerves through image frames. We conclude this review with a case study from industry (ScanNav Anatomy Peripheral Nerve Block; Intelligent Ultrasound Limited). This includes a more detailed discussion of the AI approach involved in this system and reviews current evidence of the system performance.The authors discuss how this technology may be best used to assist anaesthetists and what effects this may have on the future of learning and practice of UGRA. Finally, we discuss possible avenues for AI within UGRA and the associated implications.

Original languageEnglish
Title of host publicationBiomedical Visualisation
EditorsPaul M. Rea
Place of PublicationSwitzerland
PublisherSpringer
Chapter6
Pages117-140
Number of pages24
Volume11
Edition1
ISBN (Electronic)9783030877798
ISBN (Print)9783030877781 (hbk), 9783030877811 (pbk)
DOIs
Publication statusPublished - 2022

Publication series

NameAdvances in Experimental Medicine and Biology
Volume1356
ISSN (Print)0065-2598
ISSN (Electronic)2214-8019

Keywords

  • Anatomy
  • Artificial intelligence
  • Blocks
  • Computer vision
  • Convolutional neural network
  • Machine learning
  • Regional anaesthesia
  • Sono-anatomy
  • Ultrasound

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