Force-controlled robotic ultrasound elastography enhances diagnostic consistency for thyroid nodules

Area of Science:

• Medical Imaging
• Robotics in Medicine
• Diagnostic Ultrasound

Background:

• Thyroid nodules require accurate differentiation between benign and malignant types.
• Manual ultrasound elastography (SE and SWE) can suffer from inter-operator variability.
• Standardization is crucial for reliable diagnostic performance in thyroid nodule assessment.

Purpose of the Study:

• To evaluate a force-controlled robotic arm for thyroid nodule elastography.
• To compare robotic-assisted elastography with manual scanning by physicians.
• To assess improvements in image quality, consistency, and diagnostic accuracy.

Main Methods:

• Prospective study of 131 thyroid nodules using a force-controlled robotic arm and manual scanning by junior and senior physicians.
• Image quality assessed using SSIM, PSNR, MSE, and MOS.
• Consistency evaluated with DSC and ICC for SWE-derived Emax.
• Diagnostic performance analyzed using ROC curves and AUC.

Main Results:

• The robotic arm achieved superior image quality (SSIM up to 0.94, PSNR 42.25 dB, MSE 3.06) and MOS scores (SE: 4.1, SWE: 4.3).
• Robotic elastography demonstrated enhanced consistency (DSC up to 0.90, ICC up to 0.94).
• Diagnostic accuracy was significantly improved with robotic assistance (AUC 0.90 for SE, 0.95 for SWE).

Conclusions:

• A force-controlled robotic arm provides standardized and reproducible thyroid elastography.
• Robotic assistance yields superior image quality, consistency, and diagnostic accuracy over manual methods.
• This technology enhances the differentiation of benign from malignant thyroid nodules.