Last updated: May 8, 11:03 PM

• Students: Keshuai Xu, Christian Hernandez
• Mentor(s): Emad Boctor

Lumbar puncture (spinal tap) is the process by which physicians insert an epidural needle between the bone structures of the vertebra in order to collect cerebrospinal fluid. A lumbar puncture can help diagnose serious infections, such as meningitis; other disorders of the central nervous system, such as Guillain-Barre syndrome and multiple sclerosis; or cancers of the brain or spinal cord. However, physicians must avoid blood vessels, nerves, and bone without visibility. The physician palpates to locate the interspace between L2-L3, L3-L4, or L4-L5, then inserts the needle slightly cephalad into the interspace. The physician slowly advances the needle until they sees the fluid return. The position and angle to insert the needle are especially difficult to determine on obese patients. Error in the position and angle of the needle results in reattempt and sometimes complications. Conventional ultrasound guidance requires the practitioner to search for the gaps between vertebrae using an ultrasound transducer, mark insertion point, then insert blindly. Our goal is to make a device that can image the spinal column, allow us to determine the insertion point, and track the needle throughout insertion all in real time.

• Minimum: (Expected by 4/12/2019)
  1. Documentation: Image Collection and Position Sensing Software
  2. Documentation: Schematics of Rail and Moving Parts
  3. Documentation: Selection of ideal Ultrasound configuration
  4. Image of Spine Phantom

• Expected: (Expected by 4/26/19)
  1. Documentation: Video & Pictures of Needle Insertion
  2. Demo of insertion into spine phantom

• Maximum: (Expected by 5/15/2019)
  1. Documentation: Design of FPGA-based ultrasound transmit/receive interface
  2. Documentation: Needle Tracking Software
  3. Tool tracking of needle tip insertion
  4. Animal Demo

In our work, we will extend upon the single element ultrasound needle guidance system proposed by Zhang et. al. To maintain image update during needle insertion, we move the imaging element out of the needle onto two parallel rails that are parallel to the image plane. We will continue to use the backpropagation-based synthetic tracked aperture focusing, which mitigates the low frame-rate problem by updating the image as soon as each new A-line is acquired. To address the low visibility of the needle in B-mode image, we will keep an ultrasound source (PZT/PA) on the tip of the needle to enable triangulation with the ultrasound elements on the rails. Each of the rails contains one large (5mm dia) and sensitive ultrasound element with 5 MHz center frequency or a low-element-count (~8) array facing the skin of the patient. The rails are parallel to the spine and centered on the midline of the patient. The element or array can move in 1 degree of freedom.

describe dependencies and effect on milestones and deliverables if not met

1. Milestone name: xxxxx
   • Planned Date: xxxx
   • Expected Date: xxx
   • Status: xxx
2. Milestone name: xxxxx
   • Planned Date: xxxx
   • Expected Date: xxx
   • Status: xxx
3. Milestone name: xxxxx
   • Planned Date: xxxx
   • Expected Date: xxx
   • Status: xxx

• Project Plan
  • Project plan presentation
  • Project plan proposal
• Project Background Reading
  • See bibliography below for links
• Project Checkpoint
  • Project checkpoint presentation
• Paper Seminar Presentations
  • Paper Seminar Presentation
  • Paper Summary - Christian Hernandez
  • Paper Summary - Keshuai Xu
• Project Final Presentation Slides
  • Final Teaser
• Project Final Presentation
  • PDF of Poster
• Project Final Report
  • Final Report

• Haichong K. Zhang​, ​Alexis Cheng,​ ​Nick Bottenus​, ​Xiaoyu Guo​, ​Gregg E. Trahey,​ and Emad M. Boctor "Synthetic tracked aperture ultrasound imaging: design, simulation, and experimental evaluation," Journal of Medical Imaging 3(2), 027001 (8 April 2016).
• Zhang, Haichong K., et al. “Toward dynamic lumbar puncture guidance using needle-based single-element ultrasound imaging.” Journal of Medical Imaging 5(2), 021224 (Apr–Jun 2018)
• Zhang, H. K., et al. “Single-element needle-based ultrasound imaging of the spine: An in vivo feasibility study.” Simulation, Image Processing, and Ultrasound Systems for Assisted Diagnosis and Navigation - International Workshops, POCUS 2018, BIVPCS 2018, CuRIOUS 2018, and CPM 2018, Held in Conjunction with MICCAI 2018, Proceedings (pp. 82-89).
• Cheng, Alexis, et al. "Fusing acoustic and optical sensing for needle tracking with ultrasound." Medical Imaging 2018: Image-Guided Procedures, Robotic Interventions, and Modeling. Vol. 10576. International Society for Optics and Photonics, 2018.

Here give list of other project files (e.g., source code) associated with the project. If these are online give a link to an appropriate external repository or to uploaded media files under this name space (2019-02).