Robotic Lung Ultrasound for Triage of COVID-19 Patients in a Resource-Limited Environment

PROJECT SUMMARYNovel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already taken on a pandemic of epicproportions, affecting over 8 million humans in an estimated 100 countries. A global response to prepare healthsystems worldwide is of utmost importance. Respiratory symptoms are the primary manifestation of COVID-19,and the disease caused by SARS-CoV-2 can range from mild illness to severe, acute and fulminant respiratorydistress. This varying severity in the face of a worldwide pandemic necessitates rapid diagnosis to provide theproper triage and disposition of patients. Diagnostic testing such as plain-film radiography (x-ray) and chestcomputed tomography (CT) are considered the mainstay of diagnostic imaging in the detection of lung-relateddisease. Lung ultrasound (LUS) has emerged as an alternative to x-ray and chest CT for rapid diagnosis ofCOVID-19 affected patients with major advantages include safety, absence of radiation, low cost, and itsportability for ease of bedside diagnosis. Guidelines for LUS imaging in COVID-19 patients have been proposed.However, LUS imaging is highly operator dependent. In resource-limited areas, the accessibility is limited by thesmall number of physicians and sonographers who are properly trained in providing accurate diagnosis.Additionally, LUS imaging requires close physical proximity between the operator and patient, which could leadto an increased risk of COVID-19 transmission. Therefore, there is a unmet need to develop a more accessibleLUS system for COVID-19 patients, whereby reducing physical contact between the operator and patient. In this proposal, we aim to develop a safe, low-cost, and easy-to-use robotic LUS platform to 1) maximize theaccessibility in a resource-limited environment and 2) minimize the risk of COVID-19 transmission betweenpatients and healthcare workers. This robotic platform will be designed to conduct LUS procedures followingestablished diagnostic workflows, while ensuring adequate safety. The proposed gantry-based robot platformallows the operator to tele-operatively manipulate the ultrasound probe based on visual information fromcameras. Thus, the operator is not required to be present with the patient, improving accessibility. An optimaltissue-probe contact pressure will be maintained by an electronics-free passive mechanical configuration toavoid excessive contact forces and ensure patient safety. The gantry system is structurally simple, low-cost, andeasy to implement in a research-limited environment. Specifically, we propose to evaluate the robotic LUSplatform with the active-passive hybrid control (Aim 1), demonstrate the safety and cross-validation in healthyvolunteers (Aim 2), and demonstrate the system reliability and performance in COVID19 patients (Aim 3). Thisproposed robotic LUS platform (1) makes the LUS procedure more accessible in a resource-limited environment,(2) minimizes the risk of contagion between patients and healthcare workers and, (3) establishes standardizeddata collection of LUS to improve the efficacy. The proposed system has the potential to play a critical role inmaximizing healthcare function via triaging of patients suspected to or have been diagnosed with COVID-19.