Method of controlling ultrasonic by touchless input

Abstract

To control an ultrasonic machine by using one or two or more touchless inputs.SOLUTION: A method of controlling an operation of an ultrasonic machine includes the steps of: acquiring one or two or more touchless inputs; determining one or two or more operations for controlling the ultrasonic machine on the basis of the one or two or more touch less inputs and a machine state of the ultrasonic machine; and controlling the ultrasonic machine by using one or two or more operations.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] One or more exemplary embodiments relate to ultrasound machines and methods of operating ultrasound machines, and more particularly, to ultrasound machines that use lip reading to generate, at least in part, actions for controlling the ultrasound machine. [Background technology]

[0002] An ultrasound system radiates ultrasound signals generated from an ultrasound probe to a subject, such as a patient, and receives echo signals reflected from an internal portion of the subject. An image of the interior of the subject is generated using the received echo signals. More specifically, an ultrasound diagnostic machine generates an ultrasound image by using ultrasound image data acquired from the ultrasound probe, and displays the generated ultrasound image on a screen to provide the ultrasound image to a user. The ultrasound machine may include a control panel for controlling the ultrasound machine and setting various functions.

[0003] Generally, an ultrasound machine has a number of function keys for receiving user inputs and an input device such as a keyboard that is part of a control panel. In order for a user to control an ultrasound system including an ultrasound probe, the user needs to operate various input units on the control panel, which may cause inconvenience when using the ultrasound system. In particular, when a clinician diagnoses a patient by using an ultrasound probe, it may be inconvenient for the user to operate a control panel that is located far away from the user and takes a long time to operate.

[0004] Furthermore, clinicians often need to adjust ultrasound machines during sterile procedures. However, adjustments cannot be made easily because clinicians are working in a sterile field with a non-sterile ultrasound machine and touching the ultrasound machine would violate sterility. Also, clinicians often have both hands occupied, one hand holding a probe and one hand holding an instrument such as an injection or biopsy needle, which leaves no free hand to reach the machine controls. Clinicians often deal with this by having a nurse or assistant adjust the machine for the physician, but this is inefficient and not always possible. Clinicians may use sterile devices such as cotton swabs to adjust the ultrasound machine, but this is cumbersome and requires disposal of the cotton swabs after each adjustment (as the dirty swabs should not be returned to the sterile field).

[0005] Some ultrasound machines use voice control of the ultrasound machine to address this issue. Typically, this does not work well because hospitals tend to be very noisy spaces, and it is difficult for voice control to extract commands from background noise or other conversations. This is particularly important in a hospital setting, as users do not want to change the state of the ultrasound machine when they have not specifically commanded it, especially at critical times in the procedure.

[0006] Some ultrasound machines have buttons on the probe to control the ultrasound machine. These can be awkward due to the various grip positions required by the buttons presented and the fact that the probe may be covered with a sterile sheet. Summary of the Invention [Means for solving the problem]

[0007] Disclosed herein are methods and apparatus for controlling an ultrasonic machine using one or more touchless inputs. In one embodiment, a method for controlling an operation of an ultrasonic machine includes obtaining one or more touchless inputs, determining one or more operations for controlling the ultrasonic machine based on the one or more touchless inputs and a machine state of the ultrasonic machine, and controlling the ultrasonic machine using at least one of the one or more operations.

[0008] The present invention will be more fully understood from the following detailed description and the accompanying drawings of various embodiments of the invention, which should not be construed as limiting the invention to the specific embodiments, but are merely for purposes of illustration and understanding. [Brief description of the drawings]

[0009] [Figure 1] 1 is a flow diagram illustrating one embodiment of a process for controlling an ultrasound machine using touchless input. [Diagram 2] 1 is a flow diagram illustrating one embodiment of a process for triggering lip reading. [Diagram 3] FIG. 1 is a block diagram illustrating one embodiment of an ultrasound system having a command generator. [Figure 4] 1 is a block diagram illustrating one embodiment of a recognizer having one or more recognition components for performing one or more recognition routines. [Diagram 5] FIG. 1 is a block diagram illustrating an embodiment of an ultrasound system having a command generator that includes artificial intelligence or machine learning. [Figure 6] 1 is a flow diagram illustrating one embodiment of a process for controlling an ultrasound machine using a neural network. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0010] In the following description, numerous details are set forth in order to provide a more thorough explanation of the present invention. However, it will be apparent to those skilled in the art that the present invention may be practiced without these specific details. In other instances, well-known structures and devices are shown in block diagram form, rather than in detail, in order to avoid obscuring the present invention.

[0011] A method and apparatus is disclosed for generating commands to control an ultrasound machine using lip reading and machine state information of the ultrasound machine. The use of lip reading to control an ultrasound machine allows for hands-free operation, which is highly advantageous, especially in a sterile machine environment. In one embodiment, the commands are determined using touchless commands. The touchless commands can be identified using video images and / or audio. In one embodiment, the touchless commands include a combination of lip reading and additional information, such as one or more of, but not limited to, the type of exam to be performed by the ultrasound machine, features from the ultrasound image, predictions that the user can make next with the ultrasound machine, etc. In one embodiment, the commands are determined using a command generator that includes a neural network (e.g., a deep learning neural network) or other artificial intelligence capabilities.

[0012] 1 is a flow diagram of one embodiment of a process for controlling an ultrasound machine using touchless input. The process is performed by processing logic, which may include hardware (circuitry, dedicated logic, etc.), software (running on a general purpose computer system or dedicated machine, etc.), firmware, or a combination of the three.

[0013] 1, the process begins by performing lip reading, which includes capturing lip movements with one or more cameras and performing lip recognition on these lip movements (processing block 101). Several techniques exist for performing lip reading by capturing an image of the lips, analyzing the image (e.g., measuring the height and width of the lips from an image captured by a camera and other features such as the shape of the ellipse that outlines the lips), determining the lip movements, recognizing the sequence of shapes formed by the mouth and then matching this to a particular word or sequence of words. In one embodiment, lip reading is performed using a neural network (e.g., a deep learning neural network).

[0014] The processing logic then determines actions to control the ultrasonic machine based on one or more touchless inputs and the ultrasonic machine's machine state information (processing block 102). In one embodiment, these actions are determined using a command generator in the ultrasonic machine. In one embodiment, the command generator is implemented by the processing logic, which may include hardware (circuitry, dedicated logic circuitry, etc.), software (running on a general purpose computer system or dedicated machine, etc.), firmware, or a combination of the three.

[0015] In one embodiment, the command generator receives various inputs and determines commands based on these inputs. In one embodiment, the command generator includes a recognizer or recognition engine that performs one or more recognition routines on the input data to generate recognition results and, in response, determine the command that the user wants or intends to perform. In one embodiment, the command generator uses a neural network (e.g., a deep learning neural network) as part of the process of determining the actions to be performed by the ultrasound machine. One such embodiment is described in detail below.

[0016] In one embodiment, the generated operations include commands to control operational parameters such as, for example, but not limited to, adjusting gain (e.g., increase gain, decrease gain) and adjusting depth (e.g., increase depth, decrease depth). Other operational parameters can also be generated, such as transducer selection, turn on / off mode (e.g., A-mode, B-mode or 2D-mode, B-flow, C-mode, M-mode, Doppler mode (e.g., color Doppler, continuous wave (CW) Doppler, pulsed wave (PW) Doppler, duplex, triplex, etc.), pulse inversion mode, harmonic mode, etc.), etc.

[0017] In one embodiment, the operations include freezing the ultrasound image being displayed by the ultrasound machine, saving the image being displayed by the ultrasound machine, adding and / or moving annotations (e.g., labels) or pictograms to the image being displayed by the ultrasound machine, and creating or filling out reports (e.g., billing records, medical reports, etc.) using information stored in or received by the ultrasound machine.

[0018] In one embodiment, the one or more touchless inputs include lip recognition results, captured voice information, image information of an ultrasound image being displayed by the ultrasound machine, an exam type of an exam being performed by an individual using the ultrasound machine, a list of actions being performed by a user of the ultrasound machine (e.g., a workflow), and / or a next action to be performed by a user of the ultrasound machine. In one embodiment, one or more of such inputs are included in state information fed back from an ultrasound control subsystem of the ultrasound machine for use in generating the commands.

[0019] In one embodiment, the ultrasound system uses the results of lip-reading recognition combined with speech data to improve the accuracy of control. In one embodiment, audio (e.g., the user's voice) is captured by a microphone and the captured audio is recognized for use in combination with the results of lip-reading recognition in determining which operational parameters to modify or other actions the user wishes to perform. In one embodiment, the audio is spoken by a user of the ultrasound machine. Thus, in this approach, both the audio and image recognition associated with the user dictating a command are used to determine which operational parameters to adjust or other actions the user wishes to perform.

[0020] In one embodiment, the selection of which input to use (e.g., touchless input) or the influence of all of these inputs on the command determination varies based on one or more factors. These factors can be environmental factors or other information obtained about the environment (e.g., sensed from the environment). For example, in one embodiment, the outputs from the lip reading recognition and the speech recognition are weighted so that each does not have the same influence or contribution to the determination of the action to be identified based on the information about the environment. In one embodiment, based on the noise in the environment, the system of the present invention determines the action the user wants to perform based more heavily on the results of the lip reading action than on the results of the speech recognition, or vice versa. In one embodiment, this is achieved by dynamically adjusting the weights on the outputs from the lip reading recognition and the speech recognition. Thus, if it is determined that the environment is too noisy (e.g., the noise level is above a threshold), then the results of the lip reading recognition can be weighted higher (or used alone) than the results of the speech recognition when determining the action the user wants to perform.

[0021] In one embodiment, the ultrasound system ignores touchless input to the ultrasound system until it is in a wake-up mode when it is woken up to accept touchless input. Until the ultrasound system is in the wake-up mode, the ultrasound system assumes that the user is looking directly into the camera. In this case, the ultrasound system ignores any speech utterances unless the user is looking directly into the camera when the ultrasound system is spoken to. This does not present any real limitation to the clinician since the user is generally looking at the machine when the user is making adjustments based on the command. In another embodiment, the wake-up mode of the ultrasound system requires a gesture, such as a facial cue to begin listening to speech utterances and / or learning visual data, for example, for lip reading. Examples of such facial cues include, but are not limited to, closing both eyes for a certain pre-determined period of time (i.e., a long blink), winking, nodding, etc.

[0022] It should be noted that other data, such as exam type, worklist, system login information, or other status information stored on and available to the ultrasound system, may be used by the lip reading recognition routine to determine the action the user wishes to perform. Similarly, image information associated with the image being displayed by the ultrasound machine may also be used by the lip reading recognition routine to determine the action the user wishes to perform.

[0023] After determining one or more actions based on the lip recognition results and the machine state of the ultrasound machine, in one embodiment, the processing logic generates and displays one or more user selectable actions that can be performed by the ultrasound machine (processing block 103). This initiates a confirmation mode process that allows the user to select and / or confirm the action that the ultrasound machine is to perform. This can be particularly advantageous in situations where the command generator cannot be sure with certainty which action the user wants to perform. The uncertainty can be due to the lip recognition results being less than 100% confident in the decision, due to some other recognition (e.g., speech recognition) results being less than 100% confident in the decision, and / or due to any other limitations in the accuracy of the inputs used in the command generation process (e.g., mismatch between speech-based commands and lip reading-based commands, etc.).

[0024] In one embodiment, the selectable actions are presented on a display of an ultrasound machine under control of the ultrasound imaging subsystem and / or using audio (e.g., computer-generated speech). In one embodiment, the selectable actions are presented in a list according to the identity (e.g., confidence) of the selectable action as it matches a user requested action as determined by a command generator of the ultrasound machine. In one embodiment, the list of selectable actions includes a confidence factor generated by the command generator for each action or other information to provide the user with an indication of the level of confidence associated with the action determination by the ultrasound machine.

[0025] It should be noted that the suggestion and / or confirmation actions are optional and not required. In an alternative embodiment, a single action is determined and a command is generated for execution by the ultrasound machine without selection and / or confirmation.

[0026] In one embodiment, the processing logic then controls the ultrasound machine using the actions generated based on the lip reading and control state information (processing block 104). In another embodiment, the actions are also generated based on the voice information. In one embodiment, the control is performed in response to selection and / or confirmation of the action, as appropriate. In one embodiment, the control is performed by a control subsystem of the ultrasound machine.

[0027] As described above, the determination of the command is based on performing lip reading and lip movement recognition. In one embodiment, the lip reading process is triggered in response to an activation mode, which involves the occurrence of one or more actions. In one embodiment, one of the actions is a determination that the user is looking at the camera when speaking a command or moving his lips to be executed by the ultrasound machine. In another embodiment, the lip movement recognition occurs in response to the user performing a gesture that is recognized by the ultrasound machine. In one embodiment, the gesture includes performing a facial cue. In one embodiment, the facial cue includes both eyes closed by the user for a pre-determined period of time, a wink by the user, a nod by the user, or any other facial gesture. FIG. 2 is a flow diagram of one embodiment of the process for triggering lip reading performed above. In one embodiment, the process is performed by a recognizer or recognition engine of a command generator of the ultrasound machine.

[0028] 2, the process begins by determining a user from whom to receive a touchless command (processing block 201). In one or more embodiments, this determination is made by at least one of the following steps: determining that the user is looking (e.g., looking directly) at the camera, determining that the user has performed a gesture, and through the use of a user identification or authentication process.

[0029] Determining that the user is looking (e.g., looking directly) at the camera or that the user has performed a gesture requires image data from a camera. Such a camera may be located on or integrated into the system, positioned on the ultrasound system probe, or attached to the ultrasound system. In one embodiment, the ultrasound machine determines that the user is looking at the camera using eye tracking, which uses a camera to record eye movements and processes these images to determine that the user is gazing in a manner known in the art. In one embodiment, the camera used to perform the eye tracking is the camera that is also used to capture lip movements for lip reading purposes, although a separate camera could be used. In one embodiment, eye tracking is augmented to enable the system of the present invention to determine individuals to track in the examination area. In one embodiment, this augmentation includes determining face orientation, face recognition based on who initiated the examination, and / or accessing information from a worklist that directs the sonographer, physician, or other health care practitioner that should use the ultrasound machine for the examination. It should be noted that more than one user of the ultrasound machine for the same examination can be identified in this manner.

[0030] In one embodiment, if the identified physician is a neonatologist, the ultrasound system settings are optimized to visualize small bones common to typical newborn exams. In one embodiment, after the exam has begun, the physician's identity is used as part of a machine learning process to accurately predict settings that the clinician or user may want to adjust. Initial system settings are also determined using the profile associated with the user login.

[0031] In one embodiment, the determination of whether a user has performed a gesture to trigger the lip reading recognition process is based on, for example, but not limited to, facial cues such as closing both eyes (i.e., a long blink) for a predetermined period of time, a wink, a nod, or other wake gestures performed by the user.

[0032] In response to either determining that the user is looking at the camera or determining that the user has performed a gesture, the processing logic performs lip reading (processing block 202) and the remainder of the command generation process described herein.

[0033] In an alternative embodiment, the system of the present invention performs facial recognition or any other user identification / authentication process on the individual and responds only to commands from the face of the individual initiating the test. That is, the system of the present invention identifies an individual positioned in proximity to the system, possibly from a group of individuals. This is done using a user identification operation (e.g., facial recognition, acquisition of ultrasound data such as a worklist or other information that identifies the individual administering the test, etc.).

[0034] After determining that the user is looking (e.g., looking directly) at the camera and that the user has performed a gesture, and through the use of a user identification / authentication process, the system of the present invention provides the identified individual with control of the ultrasound machine through the use of touchless input. In other words, the system of the present invention allows an individual to provide control of the system of the present invention using the touchless input of the system of the present invention.

[0035] In one embodiment, once the ultrasound system has determined which individuals will accept touchless commands for a particular exam, the ultrasound system will not accept touchless commands from any other individuals that may be present in the exam.

[0036] Figure 3 is a block diagram of one embodiment of an ultrasound system having the command generator described above. In one embodiment, the ultrasound machine includes a transducer probe that transmits and receives sound waves (echoes) in a manner known in the art that are processed to generate ultrasound images. The transducer probe is not shown in Figure 3 so as not to obscure the technology disclosed herein.

[0037] 3, the ultrasound control subsystem 332 includes one or more processors. One processor sends electrical current to the transducer probe to generate sound waves and also receives electrical pulses from the probe generated from the returning echoes. The processor processes raw data associated with the received electrical pulses to form an image. The processor sends the image data to the ultrasound imaging subsystem 332, which displays the image on the display 340. The display screen 340 thus displays an ultrasound image from the ultrasound data processed by the processor of the ultrasound control subsystem 332.

[0038] The ultrasound system of FIG. 3 also includes one or more cameras 301 to capture image or video information stored in memory 304. In an alternative embodiment, microphone 302 records audio information that is also stored in memory 304. In one embodiment, one or more other non-audio inputs can be received by command generator 306. In one embodiment, these other non-audio inputs include one or more of image information feedback 310 from an ultrasound imaging system 331 of the ultrasound machine and machine status feedback 311 from an ultrasound control subsystem 332 of the ultrasound machine. In one embodiment, the other non-audio input data includes workflow information for a given user or type of procedure or exam for use in predicting or helping to predict the next command or step of the exam or procedure. These can also be stored in memory 304. Although memory 304 is shown as a single block of storage in FIG. 3, in alternative embodiments, data from camera 301, microphone 302 and non-audio input 303 are stored in more than one memory. In additional alternative embodiments, the data is streamed directly via a network communications interface to a processor in a cloud or local server (e.g., cloud server 340) performing the operations described herein. In alternative embodiments, the data is sent directly to a neural network (e.g., a deep learning neural network, etc.) for processing.

[0039] The command generator 306 accesses the memory 304 and, in response, generates one or more actions (e.g., commands) 320 that control the ultrasound machine. In one embodiment, the command generator 306 is integrated into the ultrasound machine. In another embodiment, the command generator 306 is a stand-alone device that can be coupled to the ultrasound machine via a wired and / or wireless connection. In yet another embodiment, the command generator 306 is part of a cloud-based computing resource that can be coupled to the ultrasound machine via a wired and / or wireless connection.

[0040] In one embodiment, the command generator 306 includes one or more processors, a neural network (eg, a deep learning neural network, etc.) and controls the operation of the ultrasound system through the generation of control options or actions. In one embodiment, the command generator 306 includes a recognizer or recognition engine 305 that performs recognition on the image data and audio data captured by the camera 301 and microphone 302, respectively, as part of generating an action. For example, the recognizer 305 accesses image information captured from one or more cameras 301 in memory 304 and performs lip reading recognition on lip movements captured by the camera 301 to determine a particular command from an individual using the ultrasound machine. For example, a user may lip communicate a command to increase the gain of an image displayed by the ultrasound imaging subsystem 331. The command is recognized by the recognizer 305, and in response, the command generator 306 accesses the current gain value provided in the machine state information 311 and generates a command to increase the gain of the ultrasound machine from the current value to an increased value. In one embodiment, the gain increase is a preset amount. In another embodiment, the command provided by the user includes the amount of parameter change requested to "increase the gain by 10%." In another embodiment, the gain increase that occurs when the command is executed is specified by the user and recognized by the recognizer 305. In yet another embodiment, thanks to network machine learning image recognition features, an optimization delta is identified and the correct amount of gain is applied, thereby optimizing the displayed ultrasound image. After generating the command, the command is sent to the ultrasound control subsystem 332, which controls the ultrasound imaging subsystem 331, to increase the gain of the image displayed by the ultrasound imaging subsystem 331. In one embodiment, the same process is performed to decrease the gain, increase or decrease the depth, or control any other operating parameter.

[0041] To freeze the image being displayed by the ultrasound imaging subsystem 331, lip movements indicating a command are recognized by the recognizer 305 and, in response, the command generator 306 generates a command to the ultrasound control subsystem 332 that signals the ultrasound imaging subsystem 331 to freeze the image being displayed on the display screen 340. It should be noted that the step of freezing the ultrasound image may be part of the process of saving the ultrasound image.

[0042] When saving the image being displayed by the ultrasound imaging subsystem 331, lip movements indicating a command are recognized by the recognizer 305 and, in response, the command generator 306 generates a command to the ultrasound control subsystem 332 that signals the ultrasound imaging subsystem 331 to save the image being displayed on the display screen 340. Note that in one embodiment, the image data displayed by the ultrasound imaging subsystem 331 is from the ultrasound control subsystem 332. Thus, in response to a command to the ultrasound control subsystem 332 to save the image being displayed on the display screen 340, the ultrasound control subsystem 332 stores the image data of the image being displayed on the display screen 340 in memory (e.g., memory 304).

[0043] In one embodiment, a command is recognized by the recognizer 305, and in response the command generator 306 also accesses the history, workflow and / or examination data provided in the machine state information 311 to generate the command. For example, a user or physician may have a habit of freezing or saving an image frame after adjusting the image depth. Using the clinician or user's identity, for example as described above, an instruction or command may be automatically implemented to save or freeze the image after a command is given to change the image depth, thereby combining the optimization delta with the history data. The history data is not limited to actions performed only by one particular clinician (i.e., individual) but can be the actions of a group of individuals (e.g., other clinicians, physicians, individuals at a medical facility, etc.). Furthermore, the history data may include previously used settings, parameters, and / or configurations of the system of the present invention, data learned by the system of the present invention or other systems (e.g., data from machine learning or artificial intelligence processes, etc.), etc.

[0044] In the case of annotations, the recognizer 305 recognizes lip movements as a command by the user to generate annotations to be placed on the image displayed by the ultrasound imaging subsystem 331. In one embodiment, the lip movements recognized by the command generator 306 include not only commands to add annotations to the image displayed by the imaging subsystem 331, but also the actual annotations. It should be noted that a combination of two or more touchless inputs (e.g., lip reading and speech) can be used together to improve the accuracy of dictation recognition. In one embodiment, the beginning and end of annotations are also recognized by the recognizer 305. In one embodiment, the recognizer 305 determines the beginning and end of annotations by recognizing start and stop words spoken by the user with lip movements. In an alternative embodiment, the recognizer 305 recognizes one or more gestures (e.g., facial cues) made by the user to indicate the beginning and end of annotations.

[0045] In one embodiment, the recognizer 305 also recognizes lip-activated commands spoken by the user to move annotations on the display that are being displayed by the ultrasound imaging subsystem 331. In one embodiment, the recognizer 305 recognizes lip-activated commands indicating one or more commands to move annotations up, down, left, and right on the displayed image.

[0046] In one embodiment, the recognizer 305 also recognizes lip movements and generates commands to generate a report. In one embodiment, the report may be a billing record to be generated and includes a set of predefined information necessary to ensure that the claim is processed and paid. In another embodiment, the report includes a medical record report that includes information from an ultrasound examination performed. In one embodiment, generating the report includes dictating notes to the report. In one embodiment, dictating the notes is performed by instructing the ultrasound control subsystem 331 to cause an image of the report to be displayed on the display screen 340 by the ultrasound image subsystem 331 and instructing the recognizer 305 to recognize lip movements using the recognizer 305 to indicate one or more commands that move the note up, down, left, and right of the image displayed in a particular location on the report. Also, in one embodiment, the recognizer 305 determines the start and end of the dictated note by recognizing start and stop words spoken by the user with their lips.

[0047] In one embodiment, the command generator 306 generates actions 320 (e.g., increase gain, decrease gain, increase depth, decrease depth, freeze image, save image, etc.) in response to the recognition results and information received from other parts of the ultrasound machine. In one embodiment, the feedback includes feedback 301 of machine state information from the ultrasound control subsystem 332. In another embodiment, the feedback includes feedback 310 of image information from the ultrasound imaging subsystem 331. This image information may correspond to an image being displayed on the display screen 340. Using this information, the ultrasound system operates to determine an action that the user may wish to perform. For example, the ultrasound system may determine a feature that the user may be interested in viewing based on the worklist or exam type indicated in the control state information 311. Based on the appearance of this feature in the image, the ultrasound system may use this information to bias the commands that are generated based on the lip reading results. That is, the lip reading results are influenced by the image features or other image information present in the ultrasound system.

[0048] In one embodiment, the ultrasound system of the present invention also includes one or more user input devices (e.g., keyboard, cursor control device, etc.) for inputting data and enabling acquisition of measurements from the display of the ultrasound display subsystem, a disk storage device (e.g., hard, floppy, compact disk (CD), digital video disk (DVD)) for storing acquired images, and a printer for printing images from the displayed data. These are also not shown in FIG. 3 so as not to obscure the technology disclosed herein.

[0049] 4 illustrates a block diagram of one embodiment of recognizer 400. In one embodiment, recognizer 400 includes processing logic having hardware (such as circuitry, dedicated logic circuitry, etc.), software (such as running on a general-purpose computer system or dedicated machine), firmware, or a combination of the three.

[0050] With reference to FIG. 4, the recognizer 400 includes a lip recognition component 401 that performs lip recognition in response to lip movements captured by a camera of the ultrasound system.

[0051] In one embodiment, the recognizer 400 includes a speech recognition component 402 that performs speech recognition on speech captured by a microphone of the ultrasound system.

[0052] Optionally, recognizer 400 in one embodiment includes an eye tracking component 403 that performs eye tracking. In one embodiment, eye tracking component 403 determines that a user is looking directly at a camera which triggers lip reading recognition component 401 to operate and perform recognition of lip movements captured by the ultrasound system's camera.

[0053] In another embodiment, the recognizer 400 includes a gesture recognition component 404 that performs gesture recognition and triggers the operation of the lip reading recognition component 401 and / or the speech recognition component 402. In one embodiment, the gesture recognition component 404 recognizes one or more facial cues to trigger the operation of the lip reading recognition component 401. In one embodiment, these facial cues include a user closing both of the user's eyes for a predefined period of time, a user winking, a user nodding, or any other predefined facial movement.

[0054] Figure 5 is a block diagram of an embodiment of an ultrasound system having a command generator that includes artificial intelligence or machine learning. With respect to Figure 5, only a subset of the ultrasound system components of Figure 3 are shown, such as the camera 301, microphone 302, ultrasound imaging subsystem 331, and ultrasound control subsystem 332, to avoid obscuring the command generator 501 that uses artificial intelligence or machine learning to generate commands. In one embodiment, the artificial intelligence includes a neural network, such as, for example, but not limited to, a deep learning neural network.

[0055] In one embodiment, the command generator 501 receives captured image data from the camera 301, and optionally captured audio data 302, image information 310 feedback from the ultrasound imaging subsystem 331, and machine state information 311 feedback from the ultrasound control subsystem 332, and uses a neural network to bias the determination of actions or commands that correlate with the lip movements of the individual using the ultrasound machine.

[0056] In one embodiment, the command generator 501 uses a deep learning neural network or other neural network to generate the actions. Deep learning is a machine learning technique that uses a surrogate learning method to allow a machine to be fed raw data and determine the surrogates necessary to classify the data. Deep learning determines the structure of the data set using a backpropagation algorithm that is used to change the internal parameters (e.g., node weights) of the deep learning machine. Deep learning machines can utilize a wide variety of multi-layer architectures and algorithms to process raw data and identify features of interest without external input specifying the features of interest.

[0057] Deep learning in a neural network environment includes many interconnected nodes called neurons. At startup, input neurons activate other neurons based on their connections with these other neurons governed by machine parameters. Learning adjusts these machine parameters as well as the connections between neurons in the network, thereby making the neural network behave in a desired manner. In one embodiment, a deep learning network uses a convolutional neural network (CNN) that processes data using convolutional filters to locate and identify learned observable features in the data. Each filter or layer of the CNN architecture transforms the input data to increase the selectability and invariance of the data. This abstraction of the data allows the network to focus on the features of the data it is trying to classify and ignore irrelevant background information.

[0058] In one embodiment, deep learning networks identify features in ultrasound images using convolutional neural networks for image analysis as part of recognition for lip reading and / or medical image analysis. In one embodiment, CNN architectures are used for face recognition in natural images, and for identifying users of ultrasound machines for eye tracking purposes and determining if the user is looking at the ultrasound machine as described above. In one embodiment, CNN architectures are also used for audio (e.g., speech) and video (e.g., lip reading) processing.

[0059] In one embodiment, the deep learning neural network includes multiple layers connected to the neural network. Data flows forward through the inputs from the input layer to the output layer and then to the output of the deep learning neural network. The input layer, which includes multiple nodes, is followed by one or more hidden layers, which also include nodes. The hidden layers are followed by an output layer, which includes at least one node with an output. In one embodiment, each input corresponds to a node in the input layer, and each node in the input layer has a connection with each node in the hidden layer. Each node in one hidden layer has a connection with each node in the next hidden layer, and each node in the last hidden layer has a connection with the output layer. The output layer has an output to provide an output.

[0060] The CNN architecture of the deep learning neural network feeds a structure for storing temporal information, whereby the feature information identified by the CNN architecture is processed as a sequence of information. For example, lip reading and speech information may include sequences of information having different lengths, and previously identified information is used as context information for the current information to enable identification of the user's command. In one embodiment, the structure includes one or more of a recurrent neural network (RNN), a long short-term memory (LSTM), and a gated recurrent unit (GRU).

[0061] In one embodiment, the nodes are fed with feature data obtained from lip movements captured by a camera in the ultrasound system.

[0062] Certain exemplary connections can be given additional weighting while other exemplary connections can be given less weighting in the neural network. Input nodes are activated via the receipt of input data via the inputs. Hidden layer nodes are activated by the forward flow of data through the network via the connections. Output layer nodes are activated after data processed in the hidden layer is sent over the connections. When an output node in the output layer is activated, it outputs an appropriate value based on the processing accomplished in the hidden layer of the neural network.

[0063] In one embodiment, the neural network includes an image analysis convolutional neural network (CNN) with an RNN, LSTM, GRU, or other such memory-based structure to lip read and / or determine one or more features of an ultrasound image. The convolutional neural network receives an input image and generates image features in the form of vectors. The LSTM, RNN, GRU, or other such structure network receives the image feature vectors from the CNN and generates state and output vectors that are decoded into characters. The characters are used to determine whether lip movements in the image represent commands.

[0064] Thus, the use of artificial intelligence in conjunction with the ultrasound machine's camera enables the system of the present invention to read the user's lips to determine if the user is giving commands to the ultrasound machine.

[0065] In one embodiment, the command generator 501 uses a deep learning neural network to generate commands for the ultrasound imaging subsystem 331 to display one or more selectable commands. The selectable commands have associated confidence indications indicating a level of confidence that each of the one or more commands is a desired command. In one embodiment, the confidence indications include confidence levels. Such confidence levels are generated using a neural network in a manner known in the art. The confidence levels are affected by dynamic weighting of the various touch inputs used to generate the commands.

[0066] In one embodiment, artificial intelligence is used not just to determine if a user is giving a command, but also to predict commands that the user may give to the system in the future. Thus, using machine state and image information 310 feedback from the ultrasound imaging subsystem, the neural network of the command generator 501 determines the action or biases the selection of the commands that are generated.

[0067] For example, if a nerve in an ultrasound image is not centered on the display screen and a clinician is inserting a needle near the nerve to inject anesthesia, the neural network recognizes the needle in the image and the exam type dictated by the machine state information 311 fed back from the ultrasound control system. Once the nerve is identified, the neural network biases the command decision toward commands that change the depth and center the nerve on the display screen, thereby providing ease of use in the anesthesia area. That is, the lipreading command recognition correlates what is recognized via lipreading with what is displayed in the ultrasound image to bias the command generation process toward commands that change the depth. In this way, workflow knowledge is used to improve lipreading accuracy.

[0068] 6 is a flow diagram of one embodiment of a process for controlling an ultrasound machine using a neural network. In one embodiment, the process is performed by processing logic that includes a neural network implemented by the processing logic, which may include hardware (circuitry, dedicated logic, etc.), software (running on a general purpose computer system or dedicated machine, etc.), firmware, or a combination of the three.

[0069] With reference to FIG. 6, the process begins by performing lip reading, which includes capturing lip movements with one or more cameras and performing recognition on the lip movements (processing block 601).

[0070] The processing logic also identifies one or more image characteristics of the image being displayed by the ultrasound imaging subsystem that are not optimized (processing block 602) and correlates operational parameters that will modify the image to help improve, and optionally optimize, the image characteristics (processing block 603), which can occur prior to or simultaneously with lip reading.

[0071] After correlating the operational parameters that will change the image in response to the lip reading performance, the processing logic circuitry uses a neural network (e.g., a deep learning neural network) to determine an action to control the ultrasound machine (processing block 604). The neural network determines an action based on the results of the lip reading recognition, machine state information of the ultrasound machine, and based on the correlation of the operational parameters to change the image. In one embodiment, the change in the image is an optimization, refinement, fixation, or other modification of the image. That is, in one embodiment, the neural network correlates the operational parameters of the optimization, refinement, fixation, or other modification of the image as part of the process of determining the action.

[0072] In one embodiment, after determining one or more actions based on the results of lip reading recognition, machine state information of the ultrasound machine, and a correlation of operational parameters for altering the image, the processing logic displays one or more user selectable actions that may be performed by the ultrasound machine (processing block 605). Note that this is an optional step and is not required. In an alternative embodiment, a single action is determined and a command is generated for execution by the ultrasound machine without selection or confirmation.

[0073] Displaying the action that will be determined based on the input allows the user to select and / or confirm the action that the ultrasound machine is intended to perform, which is advantageous in situations where the command generator cannot be sure with certainty that the action the user wanted to perform. This is the Confirmation Mode.

[0074] In one embodiment, selectable actions are presented on a display of the ultrasound machine under control of the ultrasound imaging subsystem. In one embodiment, the selectable actions are presented in a list according to their likelihood of matching a user requested action as determined by a command generator of the ultrasound machine. In one embodiment, the list of selectable actions includes a confidence factor generated by the command generator for each action or other information to provide the user with an indication of the level of confidence associated with the action determination by the ultrasound machine.

[0075] The processing logic then controls the ultrasound machine using the action (processing block 606). In one embodiment, this control is responsive to the selection and / or confirmation of the action as appropriate. In one embodiment, this control is performed by a control subsystem of the ultrasound machine.

[0076] It should be noted that actions other than those indicated in FIG. 6 may be determined and used to control an ultrasound machine, for example as described above.

[0077] There are several exemplary embodiments described herein.

[0078] Example 1 is a method for controlling operation of an ultrasonic machine, the method including the steps of obtaining one or more touchless inputs, determining one or more operations for controlling the ultrasonic machine based on the one or more touchless inputs and a machine state of the ultrasonic machine, and controlling the ultrasonic machine using at least one of the one or more operations.

[0079] Example 2 is the method of Example 1 which may optionally include a step of performing lip reading, including a step of capturing lip movements of the individual using at least one camera, and the step of determining one or more actions for controlling the ultrasound machine is based on a result of performing the lip reading.

[0080] Example 3 is the method of example 1, optionally including determining the one or more movements further based on ultrasound data.

[0081] Example 4 is the method of example 1 which can optionally include that the ultrasound data includes one or more of ultrasound image data, an exam type being performed by the ultrasound machine, and a list of operations being performed by the ultrasound machine.

[0082] Example 5 is the method of example 1, which can optionally include, in which the step of determining one or more actions further includes a step of predicting actions that the individual is likely to perform based on the historical data.

[0083] Example 6 is the method of Example 1, which may optionally include the step of determining one or more actions based on captured voice information of the individual and dynamically adjusting weights associated with the results of lip reading recognition and voice recognition based on the environment in which the ultrasound machine is located to determine one or more actions for controlling the ultrasound machine.

[0084] Example 7 is the method of example 1 which may optionally include that the step of performing lip reading is triggered in response to a determination that the individual looks directly at one of the one or more cameras or in response to a determination that the individual closes at least one eye, winks, nods, or performs another facial cue or other gesture for a predetermined period of time.

[0085] Example 8 is the method of Example 1, which can optionally include identifying one or more image characteristics, and determining the one or more operations is further based on a correlation between the operation parameters and the one or more image characteristics, and controlling the ultrasound machine using at least one of the one or more operations further includes varying the operation parameters to alter the image.

[0086] Example 9 is the method of Example 1 which may optionally include receiving, in the neural network, at least one of: feedback of ultrasound data from the ultrasound imaging subsystem; feedback of machine states from the ultrasound control subsystem; and one or more touchless inputs, wherein determining one or more actions for controlling the ultrasound machine based on the one or more touchless inputs and the machine states of the ultrasound machine is performed by the neural network.

[0087] Example 10 is the method of Example 1, where the step of determining one or more actions to control the ultrasound machine may optionally include the steps of generating and displaying one or more selectable commands, capturing information from the individual, and interpreting the captured information as confirming selection of at least one of the one or more selectable commands before controlling the ultrasound machine using the at least one action.

[0088] Example 11 is the method of example 1, which may optionally include at least one step selected from the group consisting of adjusting gain, adjusting depth, freezing the image displayed by the ultrasound machine, saving the image displayed by the ultrasound machine, adding an annotation at a user-specified location on the image displayed by the ultrasound machine, and generating a report comprising one or more images displayed by the ultrasound machine.

[0089] Example 12 is the method of example 1, which may optionally include, in which the step of determining one or more actions to control the ultrasound machine includes a step of annotating an image displayed by the ultrasound machine based on at least one of the one or more touchless inputs.

[0090] Example 13 is the method of Example 12, which may optionally include, in which the step of determining one or more actions to control the ultrasound machine further includes the step of recognizing a start of an annotation command, an end of an annotation command, and one or more annotation movement commands based on at least one touchless input.

[0091] Example 14 is the method of example 12 which can optionally include recognizing one or more annotation movement commands from the eye tracking information.

[0092] Example 15 is the method of example 1 which may optionally include identifying an individual from a group of individuals positioned in proximity to the ultrasound machine based on a user identification action, and providing the identified individual with control of the ultrasound machine through use of a touchless input.

[0093] Example 16 is an apparatus comprising a display screen, an ultrasound imaging subsystem coupled to the display for generating an ultrasound image on the display screen, an ultrasound control subsystem coupled to control the imaging subsystem, one or more cameras for capturing images of an individual's lip movements, a microphone for capturing speech, a recognizer coupled to the one or more cameras for performing lip reading routines on images captured from the one or more cameras to perform lip reading, and a command generator coupled to the recognizer and control subsystem for determining one or more actions based on one or more touchless inputs from the recognizer and microphone and a machine state of the ultrasound machine received from the ultrasound control subsystem, and transmitting at least one of the one or more actions to control the ultrasound control subsystem.

[0094] Example 17 is the apparatus of example 16, optionally including where the command generator includes a neural network.

[0095] Example 18 is the apparatus of example 16, optionally including the command generator further operative to determine one or more actions based on the ultrasound data.

[0096] Example 19 is the apparatus of example 18, which can optionally include that the ultrasound data includes one or more of ultrasound image data, an exam type being performed by the ultrasound machine, and a list of operations being performed by the ultrasound machine.

[0097] Example 20 is the apparatus of example 16, which can optionally include the command generator operating to determine the one or more actions by predicting actions the individual is likely to perform based on historical data.

[0098] Example 21 is the device of example 16, which may optionally include the command generator operating to determine one or more actions further based on captured voice information of the individual and dynamically adjust weightings associated with lip reading recognition and voice recognition results based on the environment in which the ultrasound machine is present to determine one or more actions for controlling the ultrasound machine.

[0099] Example 22 is the device of example 16, which can optionally include the recognizer operating to trigger a touchless input control for use by the individual in response to a determination that the individual is looking at at least one of the one or more cameras or in response to facial cues, the facial cues including one of the group consisting of closing at least one eye for a predetermined period of time, winking, and nodding.

[0100] Example 23 is the apparatus of Example 16, which may optionally include a neural network operative to receive at least one of ultrasound data feedback from the ultrasound imaging subsystem, machine state feedback from the ultrasound control subsystem, and one or more individual touchless inputs from the recognizer, in response to which the command generator operative to determine one or more actions for controlling the ultrasound control subsystem.

[0101] Example 24 is the apparatus of Example 16, which may optionally include at least one selected from the group consisting of adjusting gain, adjusting depth, freezing the image displayed by the ultrasound machine, saving the image displayed by the ultrasound imaging subsystem, adding an annotation at a user-specified location on the image displayed by the ultrasound imaging subsystem, and generating a report comprising one or more images displayed by the ultrasound imaging subsystem.

[0102] Example 25 is the apparatus of Example 16, which can optionally include a step of annotating an image displayed by the ultrasound imaging subsystem based on one or more touchless inputs, including a step of recognizing a start of an annotation command, an end of an annotation command, and one or more annotation movement commands based on information captured from the individual.

[0103] Example 26 is an article of manufacture having one or more computer readable storage media storing instructions that, when executed by a system, cause the system to perform a method of controlling operation of an ultrasonic machine, the method including obtaining one or more touchless inputs, determining one or more actions for controlling the ultrasonic machine based on the one or more touchless inputs and a machine state of the ultrasonic machine, and controlling the ultrasonic machine using at least one of the one or more actions.

[0104] Some portions of the above detailed descriptions are presented in terms of algorithms and symbolic representations of operations on data bits within a computer memory. These algorithmic descriptions and representations are the means used by those skilled in the data processing arts to most effectively convey the substance of their work to others skilled in the art. An algorithm is herein, and generally, conceived to be a self-consistent sequence of steps leading to a desired result. These steps require physical manipulations of physical quantities. Usually, although not necessarily, these quantities take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated. It has proven convenient, principally for reasons of common usage, to refer to these signals as bits, values, elements, symbols, characters, terms, numbers, or the like.

[0105] It should be recalled, however, that all of these and similar terms are associated with the appropriate physical quantities and are merely convenient labels applied to these quantities. As will be apparent from the discussion that follows, unless specifically stated otherwise, discussions throughout this specification using terms such as "processing" or "computing" or "calculating" or "determining" or "displaying" should be understood to refer to operations and processes of a computer system, or similar electronic computing device, that manipulates and transforms data represented as physical (electrical) quantities in the computer system's registers and memory into other data that is similarly represented as physical quantities in the computer system's memory or registers or other such information storage, transmission or display device.

[0106] The present invention also relates to an apparatus for performing the operations herein. This apparatus may be specially constructed for the required purposes, or may include a general purpose computer selectively activated or reconfigured by a computer program stored in the computer. Such a computer program may be stored on a computer-readable storage medium such as any type of disk, including, but not limited to, floppy disks, optical disks, CD-ROMs, and magneto-optical disks, read-only memory (ROM), random access memory (RAM), EPROM, EEPROM, magnetic or optical cards, or any type of medium suitable for storing electronic instructions, each coupled to a computer system bus.

[0107] The algorithms and displays presented herein are not inherently related to any particular computer or other apparatus. Various general-purpose systems may be used with programs in accordance with the teachings herein, or it may prove convenient to construct specialized apparatus to perform the required method steps. The required structure for a variety of these systems will be apparent from the description below. In addition, the invention is not described with reference to any particular programming language. It will be appreciated that a wide variety of programming languages ​​may be used to implement the teachings of the invention as described herein.

[0108] A machine-readable medium includes any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer). For example, machine-readable media include read-only memory ("ROM"), random access memory ("RAM"), magnetic disk storage media, optical storage media, flash memory devices, etc.

[0109] Although many alternatives and modifications of the present invention will no doubt become apparent to those skilled in the art after reading the foregoing description, it should be understood that any particular embodiments shown and described by way of illustration should not be regarded as limiting, and therefore reference to details of various embodiments is not intended to limit the scope of the claims, which recite only those features regarded as essential to the invention. [Explanation of symbols]

[0110] 101 Perform lip reading (including capturing lip movements with one or more cameras) 102 determines an action (e.g., adjust gain, adjust depth, freeze image, save image, add / move annotation, generate report, etc.) to control the ultrasound machine based on one or more touchless inputs (e.g., results of lip reading recognition, one or more of captured speech, ultrasound image information, exam type, workflow, expected user actions, etc.) and a machine state of the ultrasound machine. 103 Generate and display one or more actions (e.g., commands) to be performed from actions selected and / or confirmed by the user (optional) 104 Control the ultrasound machine using actions (and, if necessary, in response to selections / confirmations)

Claims

1. 1. A method of controlling operation of an ultrasound machine, comprising: obtaining one or more touchless inputs; determining one or more actions for controlling the ultrasonic machine based on the one or more touchless inputs and a machine state of the ultrasonic machine; controlling the ultrasound machine with at least one of the one or more actions; The method includes:

2. performing lip reading, the lip reading including capturing lip movements of the individual using at least one camera, and determining the one or more actions to control the ultrasound machine is based on a result of performing the lip reading. The method of claim 1.

3. determining the one or more movements further comprises: The method of claim 1.

4. the ultrasound data includes one or more of ultrasound image data, an exam type being performed by the ultrasound machine, and a list of operations being performed by the ultrasound machine; The method of claim 1.

5. determining the one or more actions includes predicting actions that the individual is likely to perform based on historical data; The method of claim 1.

6. determining the one or more actions based on the individual's captured voice information and further comprising dynamically adjusting weights associated with lip reading recognition and voice recognition results based on an environment in which the ultrasound machine resides to determine the one or more actions for controlling the ultrasound machine. The method of claim 1.

7. the step of performing the lip reading is triggered in response to a determination that the individual is looking directly into one of the one or more cameras or in response to a determination that the individual has closed at least one eye, winked, nodded, or performed another facial cue or other gesture for a predetermined period of time. The method of claim 1.

8. and identifying one or more image characteristics, wherein determining the one or more operations is further based on a correlation between an operation parameter and the one or more image characteristics, and controlling the ultrasound machine using at least one of the one or more operations includes varying the operation parameter to alter the image. The method of claim 1.

9. and further comprising receiving, in a neural network, one or more of ultrasound data feedback from an ultrasound imaging subsystem, machine state feedback from an ultrasound control subsystem, and at least one of the one or more touchless inputs, wherein determining one or more actions for controlling the ultrasound machine based on the one or more touchless inputs and machine states of the ultrasound machine is performed by the neural network. The method of claim 1.

10. Determining one or more actions to control the ultrasound machine includes: generating and displaying one or more selectable commands; capturing information from an individual; interpreting the captured information as confirming selection of at least one command of the one or more selectable commands before using the at least one action to control the ultrasound machine; 2. The method of claim 1, comprising:

11. the one or more actions include at least one selected from the group consisting of adjusting gain, adjusting depth, freezing an image displayed by the ultrasound machine, saving an image displayed by the ultrasound machine, adding an annotation at a user-specified location on an image displayed by the ultrasound machine, and generating a report comprising one or more images displayed by the ultrasound machine. The method of claim 1.

12. determining one or more actions to control the ultrasound machine includes annotating an image displayed by the ultrasound machine based on at least one of the one or more touchless inputs. The method of claim 1.

13. determining one or more actions to control the ultrasound machine further includes recognizing a start of an annotation command, an end of an annotation command, and one or more annotation movement commands based on at least one touchless input. The method of claim 12.

14. the one or more annotation movement commands are recognized from eye tracking information; The method of claim 12.

15. identifying an individual from a group of individuals positioned proximate to the ultrasound machine based on a user identification action; providing control of the ultrasound machine to the identified individual through the use of touchless input; The method of claim 1 further comprising:

16. A display screen; an ultrasound imaging subsystem coupled to the display for generating an ultrasound image on the display screen; an ultrasound control subsystem coupled to control the imaging subsystem; one or more cameras for capturing images of an individual's lip movements; A microphone for capturing audio; a recognizer coupled to the one or more cameras for performing lip recognition routines on images captured from the one or more cameras to perform lip reading; a command generator coupled to the recognizer and to the control subsystem, the command generator determining one or more actions based on one or more touchless inputs from the recognizer and the microphone and a machine state of the ultrasonic machine received from the ultrasonic control subsystem, and transmitting at least one of the one or more actions to control the ultrasonic control subsystem; An apparatus comprising:

17. the command generator includes a neural network; 17. The apparatus of claim 16.

18. The command generator is further operative to determine the one or more actions based on the ultrasound data.

17. The apparatus of claim 16.

19. the ultrasound data includes one or more of ultrasound image data, an exam type to be performed by the ultrasound machine, and a list of operations to be performed by the ultrasound machine; 20. The apparatus of claim 18.

20. the command generator is operative to determine the one or more actions by predicting actions the individual is likely to perform based on historical data; 17. The apparatus of claim 16.

21. the command generator is operable to determine the one or more actions further based on captured voice information of the individual and dynamically adjust weights associated with lip reading recognition and voice recognition results based on an environment in which the ultrasound machine resides to determine one or more actions for controlling the ultrasound machine.

17. The apparatus of claim 16.

22. the recognizer is operative to trigger a touchless input control for use by the individual in response to a determination that the individual is looking at one of the one or more cameras or in response to a facial cue, the facial cue including one of the group consisting of closing at least one eye for a predetermined period of time, winking, and nodding; 17. The apparatus of claim 16.

23. the command generator includes a neural network operative to receive at least one of ultrasound data feedback from the ultrasound imaging subsystem, machine state feedback from the ultrasound control subsystem, and one or more touchless inputs of the individual from the recognizer, in response to which the command generator is operative to determine one or more actions for controlling the ultrasound control subsystem.

17. The apparatus of claim 16.

24. the one or more actions include at least one selected from the group consisting of adjusting gain, adjusting depth, freezing an image displayed by the ultrasound machine, saving an image displayed by the ultrasound imaging subsystem, adding an annotation at a user-specified location on an image displayed by the ultrasound imaging subsystem, and generating a report comprising one or more images displayed by the ultrasound imaging subsystem.

17. The apparatus of claim 16.

25. the one or more operations include annotating an image displayed by the ultrasound imaging subsystem based on the one or more touchless inputs, the one or more operations including recognizing a start of an annotation command, an end of an annotation command, and one or more annotation movement commands based on information captured from the individual.

17. The apparatus of claim 16.

26. 1. An article of manufacture having one or more computer readable storage media storing instructions that, when executed by a system, cause the system to perform a method for controlling operation of an ultrasound machine, comprising: The method further comprising: obtaining one or more touchless inputs; determining one or more actions for controlling the ultrasonic machine based on the one or more touchless inputs and a machine state of the ultrasonic machine; controlling the ultrasound machine with at least one of the one or more actions; Including, articles of manufacture.

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