Software Suite Training Tool for MSK Exploration and Botulinum Toxin Infiltration Based on Ultrasound Imaging for the Spasticity Treatment

Moreno, Vidal; Curto, Belén; García-Esteban, Juan Alberto; Serrano, Francisco J. González; Hernández, Pablo Alonso; Zaballos, Felipe Hernández; Juanes, Juan A.

doi:10.1007/s10916-019-1331-4

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…There is level 1 evidence that instrumented guidance is superior to injections relying on manual guidance for deeper muscles (Heinen et al 2006;Alter et al 2012;Albanese et al 2015), where US was highlighted for precise and painless identification of target muscles with readily available equipment. Recently, simulation platforms have been developed to train sonographers in BTX-A muscle injection and infiltration (Moreno et al 2019). So far, US guidance has been primarily used to identify the muscle areas that need to be punctured and to correctly position the injection needle.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Imaging of Injections in Masseter Muscle without Contrast Agent Using Strain Elastography and a Novel B-Mode Spatiotemporal Filter

Sanabria

Ruby

Kuonen

et al. 2020

Ultrasound in Medicine & Biology

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Botulinum toxin type A (BTX-A) injections in masseter muscle can alleviate muscle tightness and aching pain caused by idiopathic masticatory myalgia, a subform of the myofascial pain syndrome. Yet the injection procedure (number, amount) is currently empirical. In this ex vivo study, we determined the feasibility of using contrast-free ultrasound imaging to visualize the short-term injectate propagation. Ultrasound annotations of BTX-A injectate spread in N = 12 porcine masseter muscles were compared with the histopathology of the excised masseter. BTX-A presence was automatically detected in the ultrasound cine by: compensating tissue motion and deformation during injection with a novel spatiotemporal filtering (SF) algorithm, and by imaging tissue swelling strains with strain elastography (SE). BTX-A injectate introduced 6.5% (standard deviation = 5.0%) echogenicity contrast and 13.9% (standard deviation = 3.7%) tissue swelling strain. Muscle fasciae were a border for BTX-A distribution. The SF algorithm achieved significantly higher noise rejection (contrast-to-noise ratio = 4.63) than SE (2.56, p = 0.01), and state-of-the-art 2-D digital image correlation (1.81, p < 0.001) and direct image subtraction (1.29, p < 0.001) methods. Histopathology agreed well with ultrasound (Dice coefficient = 0.48), with deviations mainly explained by the three-dimensional inhomogeneous distribution of BTX-A. Preliminary in vivo patient results indicated that SF and SE discard artifactual BTX-A detection outside the injection region. The proposed methods contribute to objectivize ultrasound-guided injections, with additional applications, for instance, to monitor injectate spread of local anesthetics.

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Section: Discussionmentioning

confidence: 99%

Ultrasound Imaging of Injections in Masseter Muscle without Contrast Agent Using Strain Elastography and a Novel B-Mode Spatiotemporal Filter

Sanabria

Ruby

Kuonen

et al. 2020

Ultrasound in Medicine & Biology

View full text Add to dashboard Cite

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Healthcare E-Learning Ecosystem for the Use of Ultrasound in Interventional Procedures

Curto

Moreno

Serrano

et al. 2022

Technological Adoption and Trends in Health Sciences Teaching, Learning, and Practice

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Ultrasound imaging (USI) has become a disruptive element in medicine. To achieve a safer USI application, professionals need sound practical training. This chapter presents the keynotes in the development of a teaching-learning ecosystem, where students (future specialist physicians) and teachers participate, with the concrete educational contents. The ecosystem is supported by a LMS that includes recourses and activities for collaboration, implemented by a multidisciplinary team of health and ICT experts. Practical skills are acquired through a computer-based simulator for the training of the USI-based interventional procedures that the student can handle autonomously at any time and is highly realistic. As a main result, the ecosystem is applied to a real experience, focusing on the treatment of spasticity by botulinum toxin infiltration. Learning outcomes have been evaluated through academic grades and a survey of students who have participated in a specialist course.

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Software Suite Training Tool for MSK Exploration and Botulinum Toxin Infiltration Based on Ultrasound Imaging for the Spasticity Treatment

Cited by 2 publications

References 11 publications

Ultrasound Imaging of Injections in Masseter Muscle without Contrast Agent Using Strain Elastography and a Novel B-Mode Spatiotemporal Filter

Ultrasound Imaging of Injections in Masseter Muscle without Contrast Agent Using Strain Elastography and a Novel B-Mode Spatiotemporal Filter

Healthcare E-Learning Ecosystem for the Use of Ultrasound in Interventional Procedures

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