Abstract Details

Title uSINE-PAMS Artificial Intelligence Driven, Ultrasound-guided Lumbar Puncture to Improve Procedural Accuracy—A Pilot Usability Study

Topic General Neurology

Presentation(s) S3 - General Neurology 1 (2:24 PM-2:36 PM)

Poster/Presentation
Number 008

Objective

To test the usability of uSINE-PAMS for Lumbar Puncture (LP)

Background Lumbar puncture (LP) is an invasive diagnostic procedure. The traditional landmark-based method is associated with a failure rate of up to 50%, leading to complications, diagnostic delay and increased healthcare costs. Ultrasound-guided LP has improved the procedural success rate. However, ultrasound use has not been widespread due to inadequate neuraxial-ultrasound training and inability to reliably translate information derived from ultrasonography to LP procedure. uSINE-PAMS was designed to address these challenges: uSINE is a machine-learning software to aid in ultrasound-guided LP; PAMS is a two-part hardware to translate data from ultrasonography to accurate needle insertion.

Design/Methods A single-arm, prospective study of uSINE-PAMS was planned. Two trained neurologists performed the uSINE-PAMS-guided LP. Patients slated to undergo LP for their clinical care and able to provide informed consent were recruited. Number of successful first-pass, number of needle redirections, peri-procedural pain score and complications, cerebrospinal fluid (CSF) red blood cells (RBC) and patients’ demographics were collected. Descriptive statistics was performed.

Results

Ten patients (6 men, 4 women) were recruited from May to August 2023. Median age was 43 (range 30-63) years; median body mass index was 24.5 (16.1-34.3) kg/m². uSINE-PAMS-guided LP was successfully performed with first pass in 8 patients, 2 of whom required needle redirections. The remaining 2 patients had LP performed successfully at second and third attempts respectively; first pass failure in these 2 patients was felt to be related to initial inexperience with PAMS use. Median pain score (range 0-10) was 4 and there were no LP-related complications. Three patients had CSF RBC >5 (range 9-4200) cells/uL.

Conclusions

This first-in-human study of PAMS showed that uSINE-PAMS is feasible for LP. First-pass success rate was promising at 80% in this pilot study. A phase 2 study of uSINE-PAMS-guided LP is ongoing. (NCT05824546)

Authors/Disclosures
Xuling Lin, MD (National Neuroscience Institute) PRESENTER	The institution of Dr. Lin has received research support from National Health Innovation Center.
Ding Fang Chuang, MBBS (National Neuroscience institute)	Dr. Chuang has nothing to disclose.
Liqing Fu	No disclosure on file
Seyed Ehsan Saffari (National University of Singapore)	Seyed Ehsan Saffari has nothing to disclose.
Christen Lim, MBBS (National Neuroscience Institute)	Dr. Lim has nothing to disclose.
Yulin Wong (Tan Tock seng)	No disclosure on file
Joanne Yuen	No disclosure on file
Valerie Jun Zhi Teh (National Neuroscience Institute)	No disclosure on file
AYNUL MARLIYA MOHAMED SULTAN	No disclosure on file
Carissa Lam	No disclosure on file
Christopher Seet, MBBS (National Neuroscience Institute)	Dr. Seet has nothing to disclose.

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