Design and Implementation of a prototype robotic system for medical

ultrasound diagnosis

Mohammed A.Hussein Ahmed S.Ali F.A.ELmiserY R.Mostafa

Electronics Technology Dept.
Faculty of Industrial Education
Beni-Suef University
Beni-Suef, Egypt
Mohamed01176@techedu.bsu.edu.eg
Mechanical Engineering Dept.
Faculty of Engineering
Assuit University
Assuit, Egypt
a_saad01@aun.edu.eg
Electrical Dept. Automatic Control Dept.
Faculty of Engineering Faculty of Industrial Education
Beni-Suef University Beni-Suef University
Beni-Suef, Egypt Beni-Suef, Egypt
felmisery@eng.bsu.edu.eg r_mostafa05@yahoo.com

Abstract—the interest in robots and their applications has
increased recently, and one of the most important applications
is using robots in medical applications. This paper shows a
prototype robotic system for robot - aided radiologists in their
work, especially radiologists whom using ultrasound devices.
The system includes master device, slave robot and a computer
control system that lets the operator remotely position the
ultrasound probe on the patient, Master device is available
with the operator; Slave robot is located in the patient's
location with an ultrasound machine.
The proposed system composed of a new design of master
device and slave robot; both designs were designed based on
the shape, size and movements that radiologists used to do
during an ultrasound examination, the master device is used to
control the movement of ultrasound probe, the ultrasound
probe is fixed inside the slave robot and its contacted to the
patient body through a hole in the base at end of design.
Movement accuracy between master device and slave robot
was achieved. Ultrasound examination was tested by
homemade gelatin model.
Keywords—Master-Slave robot, ultrasound probe, gelatin model,
Robot-aided ultrasound imaging
I. INTRODUCTION
Ultrasound has become one of the extent medical
imaging techniques and is greatly used every for diagnostic
and interventional applications. Examples for these areas
e.g. vascular imaging of the carotid and abdominal arteries
with regard to diagnostic objectives, or needle insertion for
liver biopsy and ablation with regard to interventional
applications.. In general, clinical ultrasound is basically
depend on 2D image, demanding a manual navigation of the
ultrasound probe [1] .
The merits of ultrasound diagnosis are well considered
by its non invasiveness, low cost real time imaging and
applicability to diverse diagnostic examinations. However, a
lack of Ultrasound diagnostic prevents experts delivering
this high quality medical service to remote area with
dispersed population. To solve this dilemma, Robotic
ultrasound diagnostic System has been presented. A lot of
robot assisted ultrasound imaging system has master-slave
configuration for the remote control of ultrasound
transducer/probe movement by ultrasound diagnostic
specialists. This is because Ultrasound diagnosis is still very
difficult to be fully automated. Several researches have been
introduced for the development of robotic ultrasound
examination; Most of these projects introduced robots to fit
the medical requirements of ultrasound examination over
the abdominal area for the patient [2-5].
Robot assisted ultrasound system with Master-Slave
configuration was used to keep away of radiation effect [6].
a portable and wearable soft robotic system had been
introduced in[7]. The research aims to develop robot aided
radiologists, especially radiologists whom using ultrasound
devices.
The proposed system composed of a new design of
Master and Slave Robot as an integrated robotic system
which help radiologists in their work. This design is less
expensive, less weight, easy to operate and easy to
fabrication and assemble.
The design of master device and slave robot were
designed based on the shape, size and movements of the
ultrasound probe that radiologists used to do during an
ultrasound examination. controlling the movement of
ultrasound probe by master device, The Slave robot design
combined with ultrasound device to allow 3-degree of
freedom ultrasound probe movements of tilting scanning
(pitch angle), rocking scanning (roll angle) and Twisting
scanning (yaw angle).
II. ULTRASOUND TRANSDUCER/PROBE
A. Ultrasound Transducer/Probe Selection
Every ultrasound devices use the same main basics for
producing ultrasound waves and receiving the reflected
echoes. This principle is made possible by the fact that
quartz and some other compounds, both natural and
synthetic, process called the piezoelectric influence.
The Piezoelectric influence indicates to the generation of
a pressure wave when an applied voltage distorts a Crystal
Element. But, the crystal can also be distorted by returning
pressure waves reflected from target tissue. This reflected
distortion generates an electrical current that the device
translates into a pixel. As mentioned, this pixel’s gray shade
based on the intensity or capacity of the returning echo and
thus the intensity of the electrical current it produces.
A lot of different arrangements of this main piezoelectric
transducer/probe have been improved as shown in Figure 1.
For example, a convex ultrasound probe contains crystals
established in a curved shape, convex array. The more
frequent the travel, the greater the symptoms of ultrasound.
A linear array ultrasound probe contains crystals established
in a flat head. The phased-array ultrasound probe is useful in
this objective perfectly and is often used for scan the heart
and abdomen.
 TABLE I. ULTRASOUND TRANSDUCER/PROBE MOTIONS
Movements of Transducer/probe Details
Movement in the Long Axis of
the transducer through the patient
with a fixed Insonation angle at
90° to the objective

Movement in the Long Axis of

the transducer Along a fixed point
on the patient during change the
Insonation angle away from 90°

Movement in the Short Axis of

the transducer through the patient
with a fixed Insonation angle at
90° to the objective

Movement in the Short Axis of

the transducer Along a fixed point
on the patient during change the
Insonation angle away from 90°

Compression on the transducer

toward the patient by applying
force on the transducer

Movement around the

Fig. 1. Common types of ultrasound transducer/probe[8]
Finally, any ultrasound probe has a band width of
frequencies it is able to producing. Commonly, linear
ultrasound probes have a wider band width and convex
probes have a lower band width, it also uses higher
frequency to get high resolution images of smaller parts
close to the probe.
B. Ultrasound Transducer/Probe Motions
The AIUM (American Institute of US in Medicine) gave
definition for ultrasound transducer/probe movement in
1999, defined as slide, rock, tilt, rotate and pressure. But,
these definitions don't differentiate between motions that
change the probe’s position on the patient from those that
change the Insonation angle. The Insonation angle is
described as the angle of the ultrasound waves related to the
organ or tissue of importance as shown in Figure 2.
compression axis in a clockwise
or counterclockwise direction
C. Ultrasound Transducer/Probe Oriantations
Ultrasound transducer orientations is effective as the
ultrasound transducer may be readily rotated about 180
degree however the position of the screen remains without
change, which may cause disruption in the direction of
transducer manipulations and needles insertion. Thus, it’s
always important to assure which side of the transducer
agrees with the side of the monitor in order to distinguish
the right direction of the picture. Every ultrasound
transducers is equipped with a direction indicator that
matches to the indicator on the monitor as shown in Figure
3.

Fig. 3. Ultrasound Transducer/Probe Orientations [10]

D. Ultrasound Transducer/Probe Manipulations

Fig. 2. the angle of the ultrasound waves related to the organ or tissue[9]
The Ultrasound Transducer/Probe movements are
described as shown in table 1 and are relevant to the
motions of ultrasound probe in the space.
When working with ultrasound probe manipulations, the
mnemonic PART is useful as shown in Figure 4, All letters
of the word PART are abbreviated to (P) Pressure, (A)
Alignment, (R) Rotation and (T) Tilt . It is useful to know
that by manipulating the ultrasound transducer, we firstly
manipulate the direction of the waves, and by changing the
direction of the waves, alittle different ultrasound pictures
can be acquired for the same structure.

Fig. 4. ultrasound transducer/probe manipulations [11]
To properly display anatomy for picture shown on the
ultrasound device, the ultrasound probe must be
manipulated as shown in Figure 5. Ultrasound probe
manipulation can be represented into five main motions: (A)
Slide, (B) Tilt, (C and D) Rock, (E and F) Rotate, and (G)
Compress.
Fig. 5. ultrasound Transducer/Probe manipulations[12]
III. METHODES
A. Description of robotic ultrasound diagnosis system
Flow diagram for a signal and the present hardware
connection for the Robotic ultrasound diagnostic System are
explained in Figure 6. As usual, the ultrasound diagnosis,
the user (human operator) controls the ultrasound devices,
but uses a new master controller as alternative of the
ultrasound transducer. Master system transmits a signal for
slave robot control by Arduino microcontrollers. The master
movement was monitored and compared with the movement
of the slave using the position sensor this is explained in the
Experimental set up. In this system, doctor helper is wanted
for placement the slave robot to the patients and for to deal
with emergency cases. Ultrasound examination movement
of 3-degree of freedom is obtained by the master and it is
sent to the slave robot to control of the end effectors
movement for ultrasound probe.
Fig. 6. Robotic ultrasound diagnosis system diagrams
B. Slave robot design
The slave robot design shown in figure 7 is a design
which gives the ability to attach the convex ultrasound
transducer. A new design of slave robot combined with
ultrasound device is introduced to allow 3-degree of freedom
transducer movements of Tilting, Rocking and twisting
scanning. Ultrasound transducer is inserted inside the design
and contacts with the patient body through a hole at the end
of the base design. This design decreases the weight and
volume of slave robot thus that can be carried without any
additional cradles, it was designed on the AutoCAD program
and it was printed with a laser cutting machine. It consists of
a top gear with a diameter of 30mm for the movement of
rock, a gear in the middle with a diameter of 20mm for the
movement of the twist and a holder for ultrasound probe with
a gear for the movement of tilt. This design is a prototype,
and the motion was tracked using a gyroscope sensor.
Fig. 7. Slave Robot Design
IV. EXPERIMENTAL SET UP
A. Master Configuration
The master device shown in figure 8 is Convex Probe
blank from inside and it was selected because the physicians
used to carry, hold and move approximately an apparatus of
the same size while examining patients using ultrasound
device. So master device control circuit is designed and
inserted inside the master, and it transmitted the signal of
the movements to be executed to the Arduino
microcontrollers. The gyro sensor is placed on top of the
master to display the angles of the master during movement.
The master device has pitch angle (tilt scanning) around ±30
degree, roll angle (rocking scanning) around ±15 degree and
yaw angle (twist scanning).
Fig. 8. The master Configuration
B. Gelatin Model
First, a gelatin solution is prepared by placing 150 grams
of gelatin powder in a rectangular plastic food container and
adding 0.8 liters of hot water. Second, were mixed together
for two minutes and installed a plastic doll full of water
inside the food container using wax. Next, the mixture is
added to the food container, after that store the model in the
refrigerator at 4°C for an hour to get hardened[13]. Finally,
the model is ready for testing using ultrasound machine as
shown in figure 9.
Fig. 9. Gelatin model
V. RESULTS
A. Movement Tracking
Figure 10 shows the movement tracking between master
and slave. The tracking angles were registered in the control
software. The tracking results for rocking scanning is shown
in the Figure 10 (a) and Tilting scanning is shown in the
Figure 10 (b). Blue solid line (angle m) and orange solid line
(angle s) are the movement of the master and slave robot
device respectively.
Fig. 10. a) tracking Angle for (Rocking scanning), b) tracking Angle for
(Tilting scanning).
B. A prototype Robotic System
Figure 11 illustrates a prototype robotic system for
medical ultrasound diagnosis for gelatin model. Ultrasound
diagnostic machine (DP-10, with 35C50EB convex probe 3-
5 MHz; Mindray Medical Device Company) was combined
with the slave design. The master device used as a master
robot, and it was connected to master controller after that
transmitted the position and orientation to the slave robot. In
the tests, gelatin home model for ultrasound imaging was
used. To get smooth movement for ultrasound probe on the
model, EcoGel 200 is used to fill in the gap between the
frame of gelatin and ultrasound probe. The ultrasound image
was displayed on the monitor by Easy cap Video Adapter.
Fig. 11. a prototype robotic system and Gelatin experiments
VI. CONCLUSION
In this article, a prototype system for robot-aided remote
ultrasound diagnosis is introduced. The slave robot was
designed depend on the movement of convex ultrasound
probe. Ultrasound diagnosis device was edited and
combined with the Slave robot, ultrasound transducer/probe
is inserted inside of the slave design, and contacts with the
patient body through a hole in the base at the end of design.
This system will be introduced a fine ultrasound transducer
movement control by the master. The movement range of
the slave was examined with unit movement’s includes 3-
degree of freedom diagnosis movement. A prototype robotic
system ultrasound imaging was tested by gelatin home
model. The movement accuracy between master and slave
was achieved as well.
REFERENCES
[1] L. Beales, S. Wolstenhulme, J. Evans, R. West, and D. Scott,
"Reproducibility of ultrasound measurement of the abdominal
aorta," British Journal of Surgery, vol. 98, pp. 1517-1525, 2011.
[2] P. Vieyres, G. Poisson, F. Courrèges, O. Mérigeaux, and P.
Arbeille, "The TERESA project: from space research to ground
tele-echography," Industrial robot: an international journal,
vol. 30, pp. 77-82, 2003.
[3] P. Arbeille, J. Ayoub, V. Kieffer, P. Ruiz, B. Combes, A.
Coitrieux, et al., "Realtime tele-operated abdominal and fetal
 echography in 4 medical centres, from one expert center, using a
robotic arm & ISDN or satellite link," in Automation, Quality
and Testing, Robotics, 2008. AQTR 2008. IEEE International
Conference on, 2008, pp. 45-46.
[4] F. Courreges, P. Vieyres, and R. Istepanian, "Advances in
robotic tele-echography services-the OTELO system," in
Engineering in Medicine and Biology Society, 2004. IEMBS'04.
26th Annual International Conference of the IEEE, 2004, pp.
5371-5374.
[5] K. Boman, M. Olofsson, J. Forsberg, and S.-Å. Boström,
"Remote-controlled robotic arm for real-time echocardiography:
the diagnostic future for patients in rural areas?," Telemedicine
and e-Health, vol. 15, pp. 142-147, 2009.
[6] J. Schlosser, K. Salisbury, and D. Hristov, "Telerobotic system
concept for real‐time soft‐tissue imaging during radiotherapy
beam delivery," Medical physics, vol. 37, pp. 6357-6367, 2010.
[7] H. Ren, X. Gu, and K. L. Tan, "Human-compliant body-
attached soft robots towards automatic cooperative ultrasound
imaging," in Computer Supported Cooperative Work in Design
(CSCWD), 2016 IEEE 20th International Conference on, 2016,
pp. 653-658.
[8] N. J. Soni, R. Arntfield, and P. Kory, Point of Care Ultrasound
E-book: Elsevier Health Sciences, 2014.
[9] D. P. Bahner, J. M. Blickendorf, M. Bockbrader, E. Adkins, A.
Vira, C. Boulger, et al., "Language of transducer manipulation:
codifying terms for effective teaching," Journal of Ultrasound
in Medicine, vol. 35, pp. 183-188, 2016.
[10] V. E. Noble and B. P. Nelson, Manual of emergency and critical
care ultrasound: Cambridge University Press, 2011.
[11] B. Ihnatsenka and A. P. Boezaart, "Ultrasound: Basic
understanding and learning the language," International journal
of shoulder surgery, vol. 4, p. 55, 2010.
[12] A. T. Gray, Atlas of Ultrasound-Guided Regional Anesthesia E-
Book: Elsevier Health Sciences, 2018.
[13] S. Di Domenico, G. Santori, E. Porcile, M. Licausi, M.
Centanaro, and U. Valente, "Inexpensive homemade models for
ultrasound-guided vein cannulation training," Journal of clinical
anesthesia, vol. 19, pp. 491-496, 2007.