Exploring the utility of assistive artificial intelligence for ultrasound scanning in regional anesthesia

James Simeon Bowness, Kariem El-Boghdadly, Glenn Woodworth, J Alison Noble, Helen Higham, David Burckett-St Laurent, James Simeon Bowness, Kariem El-Boghdadly, Glenn Woodworth, J Alison Noble, Helen Higham, David Burckett-St Laurent

Abstract

Introduction: Ultrasound-guided regional anesthesia (UGRA) involves the acquisition and interpretation of ultrasound images to delineate sonoanatomy. This study explores the utility of a novel artificial intelligence (AI) device designed to assist in this task (ScanNav Anatomy Peripheral Nerve Block; ScanNav), which applies a color overlay on real-time ultrasound to highlight key anatomical structures.

Methods: Thirty anesthesiologists, 15 non-experts and 15 experts in UGRA, performed 240 ultrasound scans across nine peripheral nerve block regions. Half were performed with ScanNav. After scanning each block region, participants completed a questionnaire on the utility of the device in relation to training, teaching, and clinical practice in ultrasound scanning for UGRA. Ultrasound and color overlay output were recorded from scans performed with ScanNav. Experts present during the scans (real-time experts) were asked to assess potential for increased risk associated with use of the device (eg, needle trauma to safety structures). This was compared with experts who viewed the AI scans remotely.

Results: Non-experts were more likely to provide positive and less likely to provide negative feedback than experts (p=0.001). Positive feedback was provided most frequently by non-experts on the potential role for training (37/60, 61.7%); for experts, it was for its utility in teaching (30/60, 50%). Real-time and remote experts reported a potentially increased risk in 12/254 (4.7%) vs 8/254 (3.1%, p=0.362) scans, respectively.

Discussion: ScanNav shows potential to support non-experts in training and clinical practice, and experts in teaching UGRA. Such technology may aid the uptake and generalizability of UGRA.

Trial registration number: NCT04918693.

Keywords: education; nerve block; regional anesthesia; technology; ultrasonography.

Conflict of interest statement

Competing interests: JSB is a Senior Clinical Advisor for Intelligent Ultrasound, receiving research funding and honoraria. KEB is an Editor for Anaesthesia and has received research, honoraria and educational funding from Fisher and Paykel Healthcare Lit, GE Healthcare and Ambu. DBSL is a Clinical Advisor for Intelligent Ultrasound, receiving honoraria. JAN is a Senior Scientific Advisor for Intelligent Ultrasound.

© American Society of Regional Anesthesia & Pain Medicine 2022. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.

Figures

Figure 1
Figure 1
Schematic of ScanNav connected to an ultrasound machine, displaying the same ultrasound image with a color overlay. US, ultrasound.

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