Smart ultrasound

Fraunhofer IGD has been developing new ultrasound applications since the 1990s, to the benefit of many patients. In the future, its ECHOMICS project will enable physicians to identify malignant lymph nodes in the throat by means of ultrasound imaging, potentially obviating the need for invasive biopsies. The new sonAR method allows medical professionals to take advantage of augmented-reality headsets to view ultrasound images at the right sectional plane—for simpler examination and improved safety for closed biopsies.

Ultrasound imaging, or sonography, has been used for medical purposes since the late 1940s. In essence, it transmits sound waves into the body; these bounce off the different tissues, creating “echoes” that manifest as various gray tones on screen. Ultrasound is now firmly established in medicine, especially as an initial diagnostic tool. It is relatively inexpensive, there is no exposure to radiation as there is with X-rays, and it is easy to use.
 

ECHOMICS recognizes malignant lymph nodes in the throat without an invasive biopsy

Many organs can be examined using ultrasound technology. The soft parts of the throat are readily accessible—and this is exactly where the ECHOMICS technology currently being developed by Fraunhofer IGD is deployed. The aim is to harness ultrasound to detect neck lymph nodes where the malignant cells of a squamous cell carcinoma have spread. Carcinoma is the most common form of oral and throat cancer. “The ECHOMICS software enables rapid analysis without the need for tissue samples,” explains Matthias Noll, Deputy Head of the Visual Healthcare Technologies Competence Center. ECHOMICS leverages radiomics, biomarkers, and visual markers extracted from images of the lymph nodes. They form the basis for identifiable signatures, allowing a known tissue type to be categorized in relation to a cancer diagnosis. In addition, IT experts at Fraunhofer IGD are testing up to 4000 additional ultrasound-specific markers. Ultrasound examinations could potentially make biopsies unnecessary, sparing patients an invasive procedure and allowing treatment to commence sooner.
 

sonAR enables doctors to view the right ultrasound image plane

The use of sonAR improves diagnostics and treatments. It enables medical staff to view ultrasound images in the right slice of a 3D space. An AR headset with semi-transparent mirrors displays the ultrasound image in the doctor’s field of vision—instead of on-screen, as is typically the case. The sectional plane of the body appears precisely on top of the depicted structures. As Noll explains: “This allows the doctor to perform the examination directly on the patient; they do not have to repeatedly turn to face the screen of the ultrasound system.” This approach offers a number of advantages: sonAR can improve the success rate of ultrasound-guided biopsies by making the process less dependent on the skill of the physician. To date, around ten percent of closed biopsies have to be repeated or changed to open biopsies because they were not successful. “sonAR shows the ultrasound plane directly on the patient, so the doctor can see exactly where their cannula is and better adjust the puncture channel,” says Noll. The sonAR developers also believe the technology can enhance the safety of other surgical procedures.