Prawal Shrimal1, Nirmal Thakur1, Bharath Gopinath1, Prakash Ranjan Mishra1, Ranjan Rajalekshmi1, Sanjeev Bhoi1, Praveen Aggarwal1, Nayer Jamshed1, Ashish Datt Upadhyay2

1Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
2Department of Biostatisics, All India Institute of Medical Sciences, New Delhi, India

Keywords: Gelatin, low- and middle-income countries, needle tracking, phantom, ultrasound

Abstract

OBJECTIVES: The objective of this study was to devise a low-cost indigenous gelatin-based vascular phantom and to compare this newly constructed phantom with a commercially available phantom.

METHODS: This was a randomized crossover study conducted at a tertiary care hospital of India. The aim of the study was to develop a prototype low-cost gelatin-based vascular phantom and compare it with a commercially available phantom. Gelatin, psyllium husk, corn starch, antiseptic liquid, food-coloring agent, latex balloons, and metallic containers were used to prepare the gelatin phantom. The newly prepared gelatin model was labeled “Model A” and the commercially available gelatin model was labeled “Model B.” Emergency medicine residents (n = 34) who routinely perform ultrasound (USG)-guided invasive procedures were asked to demonstrate USG-guided in-plane and out-of-plane approach of needle-tracking in both the models and fill out a questionnaire on a Likert scale (1–5). An independent supervisor assessed the image quality.

RESULTS: The cost of our phantom was USD 6–8 (vs. USD 1000–1200 for commercial phantom). The participants rated the ease of performance and tissue resemblance as 4 (interquartile range [IQR]: 4–5) for both the models “A” and “B.” The supervisor rated the overall performance as 4 (IQR: 3–4) for both the models. In all the parameters assessed, model A was noninferior to model B.

CONCLUSION: The indigenously developed vascular phantom was noninferior to the commercially available phantom in terms of tissue resemblance and overall performance. The cost involved was a fraction of that incurred with the currently available commercial model. The authors feel that gelatin-based models can be easily prepared in resource-constraint settings which may be used for USG-guided training and medical education in low- and middle-income countries.

How to cite this article: Shrimal P, Thakur N, Gopinath B, Mishra PR, Rajalekshmi R, Bhoi S, et al. Comparing commercial versus low-cost gelatinous phantoms for ultrasound-guided needle tracking: A randomized crossover trial, among emergency medicine residents. Turk J Emerg Med 2024;24:103-10.

Ethics Committee Approval

The study was approved by the ethics committee of our institute vide. Reference number AIIMS IEC-924/04.09.2020, RP-33/2020 (dated November 26, 2020), All India Institute of Medical Sciences, New Delhi, India.

Author Contributions

• PRM – conceptualization (equal); methodology (lead); writing original draft (equal); formal analysis (equal); resources (equal); funding acquisition (lead)
• PS – Methodology; validation; writing original draft(equal); formal analysis (equal); investigation (lead)
• NT – Conceptualization (equal); methodology; investigation; resources (equal)
• JN – Validation (equal); supervision (lead); project administration
• SB – conceptualization (equal); methodology; investigation; supervision; project administration (lead)
• PA – Methodology; resources (equal); supervision; project administration
• BG – writing – review and editing (equal)
• RR – writing – review and editing (equal)
• ADU – Statistical analysis (equal).

Conflict of Interest

None declared.

Financial Disclosure

This study was financially supported by AIIMS, New Delhi [Early career Intramural research grant].

Acknowledgments

The authors would like to thank Dr. Amit Mehndiratta, Associate Professor, Department of Bio-medical engineering, AIIMS, New Delhi for his valuable inputs during designing the project. The authors would also like to acknowledge the efforts of Dr. Ashish Suri, Assistant professor, Department of Biostatistics, AIIMS, Delhi with respect to the analysis of the data and providing valuable statistical inputs.