A novel approach for remote ultrasonography of knee osteoarthritis

In this study, we propose innovative technologies and a novel standardized procedure, enabling at-home, periodic and reliable ultrasound monitoring of knee osteoartrithis. Anatomical and ultrasound data were collected on a population of 27 volunteers with different anthropometric features, leading to the development of two technological solutions: i) three probe positioning systems (wearable brace, adhesive film, temporary tattoo), provided with predefined openings to ensure accurate and repeatable placement of an ultrasound probe; ii) an image selection algorithm for automatic identification of the correct ultrasound images acquired by non-expert users. The effectiveness and usability of these solutions were tested on 20 volunteers and 20 caregivers, with no prior experience in ultrasound imaging. In the first step, an expert radiologist acquired reference ultrasound images. In the second step, all volunteers exploited the positioning systems to place the probe and acquire informative images (automatically extracted by the algorithm from a video). The average usability percentage score was highest for the wearable brace (98.7%), followed by the tattoo (94.8%), and film (89.6%). Overall, the three positioning systems proved to be effective in guiding ultrasound acquisitions for inexperienced subjects. The highest average rate of informative images successffully acquired among all volunteers was achieved by using the brace (70%), while the highest average score among the caregivers was obtained using the tattoo (76%). These findings highlight the possibility to perform reliable remote ultrasound acquisitions for non-expert users and opens the way to novel tele-ultrasound procedures, enabling a precise, asynchronous, and repeatable monitoring of knee osteoarthritis.