Informatics in Radiology: Developing a Touchless User Interface for Intraoperative Image Control during Interventional Radiology Procedures

Abstract

Review of prior and real-time patient images is critical during an interventional radiology procedure; however, it often poses the challenge of efficiently reviewing images while maintaining a sterile field. Although interventional radiologists can "scrub out" of the procedure, use sterile console covers, or verbally relay directions to an assistant, the ability of the interventionalist to directly control the images without having to touch the console could offer potential gains in terms of sterility, procedure efficiency, and radiation reduction. The authors investigated a potential solution with a low-cost, touch-free motion-tracking device that was originally designed as a video game controller. The device tracks a person's skeletal frame and its motions, a capacity that was adapted to allow manipulation of medical images by means of hand gestures. A custom software program called the Touchless Radiology Imaging Control System translates motion information obtained with the motion-tracking device into commands to review images on a workstation. To evaluate this system, 29 radiologists at the authors' institution were asked to perform a set of standardized tasks during a routine abdominal computed tomographic study. Participants evaluated the device for its efficacy as well as its possible advantages and disadvantages. The majority (69%) of those surveyed believed that the device could be useful in an interventional radiology practice and did not foresee problems with maintaining a sterile field. This proof-of-concept prototype and study demonstrate the potential utility of the motion-tracking device for enhancing imaging-guided treatment in the interventional radiology suite while maintaining a sterile field. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.332125101/-/DC1.

Use of commercial off-the-shelf devices for detection of manual gestures in surgery. A Systematic Literature Review (Preprint)

“…The system is based on the TOF principle [70]. The depth sensor works at a distance of between 0.8 m and 3.5 m, and the interface allows tracking of the skeleton of the system operator.…”

Touchless computer interfaces in hospitals: A review

“…Sterility is the most commonly cited motivation for touchless control (27 papers). Complications and infections caused by non-sterile interactions can be very costly, 4 with both financial and human costs. It is noted by Wachs et al 5 that the current most prevalent means of HCI in hospitals remains the mouse and keyboard.…”

“…As can be seen, the most common system application for touchless, gesture-driven interfaces has been various forms of image navigation, closely aligned with the OR and interventional radiology contexts listed above. Medical image navigation is the goal in seventeen papers, [4][5][6][7][8][9]11,14,[16][17][18][19][20][21][22][23][24] with the more specific subset of magnetic resonance imaging (MRI) image navigation being the goal in six papers. 5,7,8,9,14,16 Task context was also significant in identifying tasks for testing the systems implemented, such as measuring a lesion on MRI images.…”

“…26 In terms of fine detail performance, depth cameras can now track fine motions of hands and fingers. 15 Tan et al 4 flagged issues with hand tracking and inconsistent responsiveness as issues, along with their stylistic choice of requiring two hands for gestures. Wachs et al 36 discussed the issue of lexicon size and multi-hand systems where the challenge is to detect and recognise as many hands as possible.…”

“…Tan et al 4 also say that ample space is required to operate their touchless system. Sufficient operational space is one of the factors affecting user comfort.…”