3D Optic Nerve Sheath Elastography for Reliable TBI Detection
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Solution Overview
Problem
Existing methods for detecting traumatic brain injury (TBI) using optic nerve sheath diameter (ONS) measurements are limited by poor correlation with intracranial pressure (ICP) due to variations in baseline ONSD across individuals and lack of consideration for tissue properties, making it difficult to accurately classify patients without compromising sensitivity or specificity.
Innovation Solution
A 3D ONS modeling combined with shear wave elastography is used to capture strain values within the ONS wall tissue, accounting for both geometry and material distribution, providing a more reliable assessment of TBI through the use of a portable H-transducer system and machine-learning decision-support system.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If 2D ONSD measurements are used to detect TBI, then the method is simple and quick, but the correlation with intracranial pressure is poor due to baseline variations and lack of tissue property consideration
Solution Approach 1:
The patent transitions from 2D ONSD measurements to 3D ONS volume and shape analysis. By capturing the optic nerve sheath in three dimensions and calculating volume metrics, the system obtains more comprehensive geometric information that better correlates with intracranial pressure changes, resolving the limitation of 2D measurements.
Solution Approach 2:
The patent introduces elastography to measure tissue stiffness and elasticity parameters of the ONS wall. By adding material property parameters (Young's modulus, strain values) to the geometric parameters, the system compensates for individual baseline variations and improves the reliability of ICP correlation.
2Measurement precision
If 3D ONS modeling with elastography is implemented, then TBI detection accuracy improves, but the measurement and analysis complexity increases
Solution Approach 1:
The patent implements automated image processing and analysis algorithms that automatically segment the ONS, calculate 3D volume, and compute elastography parameters from raw ultrasound images. This automation reduces the need for manual measurement and complex manual analysis, making the sophisticated 3D+elastography approach more practical despite its inherent complexity.
Solution Approach 2:
The patent develops an integrated system that combines B-mode ultrasound imaging, 3D volume rendering, and elastography measurement capabilities in a single platform. This multi-functional approach allows the same system to perform multiple measurements (geometric and material properties) simultaneously, reducing overall system complexity compared to using separate devices for each measurement type.
3Loss of information
If only ONS diameter is measured, then the measurement process is quick and simple, but it cannot account for asymmetric structure and volume changes
Solution Approach 1:
The patent measures the complete 3D volume of the ONS by acquiring multiple 2D ultrasound slices and reconstructing the sheath in three dimensions. This volumetric measurement captures asymmetric structures and shape changes that single-plane 2D diameter measurements miss, providing comprehensive structural information.
Solution Approach 2:
The patent combines multiple 2D ultrasound images taken at different positions along the ONS length to reconstruct the full 3D structure. By merging these sequential 2D measurements into a unified 3D model, the system efficiently captures complete structural information without requiring excessively long measurement times.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach improves the accuracy of TBI detection by correlating ONS shape and elasticity changes with transient ICP changes, enabling real-time, non-invasive monitoring and predicting recovery time points, reducing dependency on technicians, and providing a comprehensive TBI diagnosis.
Implementation Method 1
H-Transducer: A custom-built portable ultrasound (US) device (Fusion Imaging, Inc., Bothell, WA) with a phased-array transducer (H-transducer) was used to image the ONS
Implementation Method 2
3D ONS Rigidity (Elasticity)_analysis: Our expectation is that by accounting for both geometry (volume) and material (elasticity) distribution of the ONS, one can acquire a robust indicator which can predict elevated, or transient increase in ICP with greater accuracy
Data Source
AI summary
The present disclosure describes a unique method and system for combining 3D ONS modeling with an elastography measurement (shear wave pulse measurement at a fixed depth) to capture strain values within the ONS wall tissue giving a more reliable assessment of both prior and current TBI, preferably without maneuvers to artificially increase intracranial pressure (ICP). Imaging for the 3D modeling and the elastography utilizes he same H-transducer to obtain B-Mode and shear wave pulse images. The combined data is used in a discriminatory Machine Learning system to provide a discriminatory outcome of TBI.