Evaluate the perceptions of novel global robotic ultrasound techniques to create a sonographic degree field in Jordan

Evaluate the perceptions of novel global robotic ultrasound techniques to create a sonographic degree field in Jordan | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluate the perceptions of novel global robotic ultrasound techniques to create a sonographic degree field in Jordan Mahmoud Abufadda, Asem AL- Hiari This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5686254/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background We aim to create a bachelor's degree in sonography in radiology departments in the future, so we investigated Jordanian radiology residents and radiographers' attitudes toward global robotic ultrasound. Method By cross-sectional study using a 24-question questionnaire prepared by Google form platform delivered via participants emails and WhatsApp, we examined the opinions of 25 radiology residents and 25 radiographers at the largest eight governmental hospitals in Jordan. And they tested their knowledge of robotic sonography. We also use simple Simulink software to calculate the simulation of robotic ultrasound probe force in (N) and its tissue displacements in (mm). Results We found 43% of radiology residents had information and heard about robotic ultrasound, while 56% of radiographers heard about robotic sonography. And about 64% of radiographers believe that robotic ultrasound improves image quality and auto-diagnosis more than human work. However, compared to radiology residents, radiographers are noticeably more enthusiastic about robotic ultrasound (p-value <0.05). In addition to the Simulink results, we revealed the dynamic force of the robotic probe sensor attenuated to half when the tissue depth doubled. That, due to the acoustic impedances of tissues, low frequencies of ultrasound waves have better penetration than higher frequencies. Conclusions Robotic sonography in some radiology departments in sophisticated countries may open the door to creating a bachelor's degree in sonography in developing countries. Which reduces the time and workload for radiology residents and radiologists in Jordan. Robotic sonography robotic ultrasound sonographer tele-sonography ultrasound technology Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Background Medical imaging plays a pivotal role in the early diagnosis and treatment of various health conditions. Among the many imaging modalities available, ultrasound has gained widespread popularity due to its non-invasive nature and real-time imaging capabilities [ 1 , 2 ]. In recent years, integrating robotic technology with ultrasound has emerged as a groundbreaking advancement, offering enhanced precision, flexibility, and efficiency in medical diagnostics [ 2 ]. A significant number of published studies on ultrasound imaging scanning assistance address how to control the movement of a robot using an ultrasound transducer [ 3 , 4 ]. Research developed a system that combines a high-end ultrasound instrument, a robotic arm, and a fetal US phantom to imitate patient anatomy. Researchers say that the first attempts to establish control systems for robots that screen-specific organs were historically not entirely automated or sufficiently accurate [ 4 , 5 ]. Combining an ultrasound station with its probe fixed to the robot end-effector with a robotic system is known as robotic ultrasound. The combination may be able to overcome the restrictions of ultrasound through teleoperation, collaborative assistance, or even an autonomous system. The study specifies the technical standards and requirements for these systems, with a focus on ultrasonic imaging and robot privacy. The studied systems are categorized as teleoperation, collaborative support, and autonomous systems [ 6 ]. Over the last two decades, a variety of commercial and research systems have been developed for many medical fields; many of these systems were created in previous research [ 7 ]. The technological standards and requirements for these systems get overviewed in this study, with an emphasis on robot safety and ultrasonic imaging. Technical Standards Teleoperation System Because ultrasound imaging focuses on the operator, the availability of a qualified sonographer typically dictates the reliability of a diagnostic. Lack of skilled personnel may severely limit access to ultrasound imaging, especially in rural areas. Increasing travel and waiting periods could have an adverse effect on patient outcomes. Another difficulty is the physical strain from holding the probe by hand [ 8 ]. These challenges can be resolved by remotely controlling the ultrasound probe with robotic technology (LORA one and two). In this section, the latest systems are divided into two categories: custom build and commercial accessible robotic hardware [ 6 ]. Custom Fabrication Robots Initially, researchers concentrated on creating mechanical designs for lightweight, portable, and safe robotic manipulators for the slave manipulator. One of the latest research projects designed a six-degrees-of-freedom (DOF) counterbalanced robot arm with a 4-bar parallel linkage system for diagnostic ultrasound [ 9 ]. A shared-control technique enabled the robot to autonomously customize its configuration in response to the sonographers' mobility modifications [ 10 ]. An ultrasound robot called ARTHUR was created by the Danish firm ROPCA to examine rheumatoid arthritis patients. Without the help of a physician or nurse, the robot converses with the patient and scans up to 22 joints in 12 minutes. ARTHUR also evaluates the images it captures and provides an individual diagnostic for each joint. ROPCA received the KUKA Innovation Award 2022 for this groundbreaking invention shown in (Fig. 1 a) [ 11 ]. Commercial Fabrication Robots Developed a robotic ultrasound system. Kinova Startup Story: Wosler Diagnostics - A Remote Telerobotic Ultrasound Solution. After investigating and assessing several robotic arms, they chose Kinova's Gen3 robot as the best alternative for their purposes in (Fig. 1 b) by [ 12 ]. Furthermore, a diverse range of robotic systems were created, the bulk of which were designed for usage in medical settings. Table 1 also shows a variety of diagnostic robotic ultrasound models. Traditional ultrasound images are obtained by manually moving the transducer around the patient's body. This method may produce variances in image quality and necessitates the use of a trained operator. These challenges are addressed with robotic ultrasound technology, which automates the scanning process. Modern sensors and artificial intelligence algorithms enable robots to conduct reliable and accurate ultrasound tests [ 13 , 14 ]. Sonographers manage an ultrasound probe and change its positions/poses during the ultrasound examination, this is typically a time-consuming process required to produce the desired ultrasound images. The extended processing time and repeated operations lead to reduced operational precision, security, and a significant workload. Ultrasound robots provide advantages in medical ultrasound, including developed-probe autonomy, stable image acquisition, improved scanning accuracy and safety, and reduced workload for sonographers [ 15 , 16 ]. There is a lack of published papers describing the workload challenges that radiologists face in Jordan and the Middle East. This study concluded that sonographers have the ability and skills to carry on their expertise to trainees and colleagues in the UAE [ 17 ]. Robotic systems were therefore built to manipulate an ultrasound probe. These systems function in the conventional master-slave arrangement of robotic helper devices, with a slave-side robot mimicking the actions of a distant, master-side sonographer [ 18 ]. Furthermore, sonographers can control ultrasound robots from a distance, enabling remote treatments. Sonographers, who were previously only responsible for capturing ultrasound images, are now playing an increasingly crucial role in diagnostic imaging, challenging radiologists' longstanding supremacy in result interpretation. This paradigm change reflects developments in technology, broadening scopes of practice, and a rising emphasis on collaborative care [ 19 , 20 ]. In our study, we review the development of robotic ultrasound (RUS) in past international studies, which may lead to an improvement in the role of sonographers and the establishment of a sonographic technological field domestically. Table. 1 shows the references [ 21 – 27 ]. We aim to establish a bachelor's degree in sonography in radiology departments in the future, so we investigate the perceptions of Jordanians radiology residents and radiographers about global robotic ultrasound. Table 1 A different modern robotic ultrasound models device used for diagnostics. Ref no. Country, year Organ diagnosed Ultrasound Model Robot AI system Accuracy percentage Chang, R.F et. al [ 21 ] China,2003 Breast ATL HDI 3000 7-DOF KUKA iiwa SVM 94.3% Bridge, C.P et. al [ 22 ] UK, 2016 Heart GE Voluson E8 6-DOF robotic arm RF Error < 20% Yaqub M, et al. [ 23 ] UAE, 2017 Fetal brain Several Not specified CNN 94.1% Jiang Z. et.al [ 24 ] Germany, 2020 Orthopedic Soft tissue Convex probe; C5-2/60 Serial; 7 DOF; LBR iiwa [KUKA] RF 99% Gao, Y. et al. [ 25 ] UK, 2020 Fetal head Konted GEN 1 C10R wireless portable probe CNN 86% Skelton E et al. [ 26 ] UK, 2021 Fetal brain Philips Healthcare EpiQ X6-1 MHz matrix transducer CNN (ITN) Translation error 3.4 mm Bamaarouf M. et al [ 27 ] France, 2024 Pregnancy Staubli TX2-60 6-axis industrial collaborative robot FTN GAMMA - P-value < 0.05 Methods Our study was carried out using two methods: a cross-sectional descriptive design for a quantitative result and simulation computation for a qualitative effect. Jordan currently lacks both robotic ultrasound and sonographers. We exchanged the sonographer's perception to the radiographer's opinion, and the lack of robotic ultrasonography was replaced with Simulink software calculations. Questionnaire In the cross-sectional approach, data were gathered by distributing a questionnaire consisting of (6) parts about professional history shown in Table 2, and (24) inquiries about the official study. After collecting the contact details about the involved persons, the survey was prepared by the Google Forms platform and sent to the participants via WhatsApp and email. (50) different responses were obtained from approximately 25 radiology residents in their second and third years of residency, and 25 radiographers work in separated radiology departments from eight of the largest governmental hospitals at Jordan Ministry of Health. The sample size was statistically calculated using the probability value error in an Excel sheet and was < 0.05. This study was approved under Jordanian Law No. 24 of 2023 on the Protection of Personal Data, and the Medical Liability Law No. 25 of 2018 of the Jordanian Ministry of Health, like our previous study [28]. A qualitative methodology proved suitable for this study because it permits the researchers to gain an in-depth overview of radiologists' and technologists' viewpoints on the future of the radiology profession with robotic sonography-based applications and to determine any variables that may affect its future application in Jordan. The questionnaire aims to explore the opinions of Jordanian Radiographers and Radiology residents on an international emerging healthcare trend: Robots in Ultrasound. It is a current research project in our department. The questionnaire consists of six parts: 1. Professional background in Radiology. 2. Understanding of Robots in Sonographic Radiology. 3. Perceptions toward the possible benefits and applications of robots in sonographic radiology. 4. Willingness to actively participate in Robotic Sonographic Radiology. 5. Considerations on integrating the Robot in Sonographic Radiology Training. 6. Describe the challenges and obstacles of robots in sonographic radiology. Simulations Simple software calculations to assess the performance of robotic ultrasound the proposed force measurement method, FEM-based simulations were carried out using Simulink software. The results section is explanation to those used in the calculations. The response performance for force measurement was tested by applying forces in the z- direction to the upper plate of the forces measuring mechanism in 2-N increments ranging from − 12N to 12N [13, 29]. To evaluate the ultrasonic robot's performance under disruption, we executed simulations with various perturbation forces on the US probe and observed the results. The simulations were conducted using the simple Simulink module, Simulink module, which is widely used to study the shifting behavior of vibrating systems. Statistical analysis In this research, a qualitative approach was utilized to learn about the perspectives of radiology residents and radiographers in Jordan on the possible impact of robotic ultrasound-based apps on the radiology profession. The goal was also to uncover potential factors influencing the adoption of these apps. Questions 5–8 and 21–24 provide "YES" or "NO" responses. Their respective percentages are 60%. The remaining questions have the following rating scale responses: "strongly agree," "agree," "neutral," and "disagree". The percentages chosen to signify strongly agree, agree, neutral, and dislike were 30% each. Each participant's response was gathered and rated according to the criteria that had been defined. Statistical Analyses were automatically downloaded and entered in an Excel spreadsheet. The student t-test and 1-way analyses of variance were used for comparing the means of the scores in 2 and more than 2 independent groups, respectively. Analyses were performed with SPSS Statistics version 25 software for Windows, and statistical significance was defined as P < 0.05 in Table 1. A Student's t-test (means: paired, two-sample equal variance) was used to statistically analyze the effect of the treatments. Results with p-values less than 0.02 and 0.05 were considered statistically significant in (Fig. 2 to 3). Results Our survey obtained 25 radiology residents who responded, (54%) of the respondents were male, the radiology residents from the 8 largest governmental hospitals in Jordan. And 25 radiographers received the survey; (46%) of the respondents were female from the same hospitals, The demographic information of the survey respondents is summarized in Table 2. The knowledge of radiology residents and radiographers in the radiology departments, 43% of residents have information and heard about robotic ultrasound, while more than half of radiographers about 56% of them are familiar with robotic sonography. And relatively close percent of radiology residents (52%), and radiographers (48%), know of using robotic sonography shown in (Fig. 2a). More than half of radiographers believe that robotic ultrasounds improve the auto-diagnosis and diseases detection. While less than 50% of radiology residents believe robotic ultrasound can detect diseases. The result reveals about 58% of radiographers agree with the benefits of using robotic ultrasound in Jordan. And just 41% of radiology residents believe the robotic sonograph can replace the humans' job, shown in (Fig. 2b). The challenges of using the robotic ultrasound, the results showed that 55% of radiology residents objected to the clinical use of robotic ultrasound, 66% of these residents believe there is a high risk of using robotic sonography, and 57% of residents feel the high costs of using robotic ultrasound with more accuracy images. While 34% of radiographers believe the fewer risks and ethics of robotic ultrasound. And more percent 53% of radiology residents agree with legal regulations of robotic sonography in Jordan shown in (Fig. 3a). The opinions on using robotic ultrasound in target organs, the results showed that 62% of radiology residents know robotic thyroid ultrasound uses and techniques, and 47% of these residents had a knowledge about robotic ultrasound in gynecology. On the other hand, about 57% of radiographers know how robotics use breast ultrasound. While 61% of radiology residents have more experience of robotic using doppler ultrasound than 38% radiographers in Jordan. With equal percentages of both residents and radiographers knowing robotic scrotal ultrasound shown in (Fig. 3b). Simulation results In this study, no robotic ultrasound model is used. Therefore, we postulated some monitors (controllers) M to control the postulated robotic ultrasound forces in (Fig. 4a), and by Simulink software with simple calculations of real force between the ultrasound probe and tissues in N is equal: $$\:{F}_{r}={k}_{i}\left({D}_{i}-D\right)\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:\:$$ 1 where \(\:{k}_{i}\) means the stiffness of the sensing unit and \(\:{D}_{i}\) is the position of robotic probe unit 𝑖. In addition, the photo reflector outputs voltages that scale linearly with the distance in the available zone [30, 31]. To simplify calculations and analysis, the four voltage parameters reduced from the sensing units to three that directly correlate to the measured forces/torque. The transformation is described as: $$\:\left[\begin{array}{c}\varDelta\:{V}_{z}\\\:\varDelta\:{V}_{x}\\\:\varDelta\:{V}_{y}\end{array}\right]\:=\:\left[\begin{array}{c}\varDelta\:{(V}_{1}+{V}_{2}+{V}_{3}+{V}_{4})\\\:\varDelta\:{(V}_{3}-{V}_{1})\\\:\varDelta\:({V}_{4}-{V}_{2})\end{array}\right]$$ 2 where V𝑧, V𝑥, and V𝑦 are the equivalent output voltages for force and torque calculation in around the z-, x-, and y- directions, respectively, and V𝑖|𝑖=1,2,3,4 mean the output voltages of the photo reflector in sensing unit 𝑖 [13]. The ultrasound robot generates forces based on the Eq. 1. The desired operating force was set to 2.0 N and the initial place position of the US probe was 0.5mm at time of 1s. Two types of forces, ramp signals (slope: ±0.5mm/s, maximum value: 4.9 N, and sine signals (y = 5sin(t) in (Fig. 4a), were employed to simulate the positions in (mm) and exerted on the US probe shown in (Fig. 4b). Self-powered piezoelectric sensor (PVDF) of simulated robotic ultrasound probe, the polyvinylidene fluoride (PVDF) piezoelectric sensor is an effective alternative to traditional strain gauges for measuring dynamic loads and monitoring structural health. PVDF sensors provide the advantage of preventing power to function, and they can be built to suit any size and geometry, decreasing the size and cost of the load monitoring device [32]. In this work we assumed the piezoelectric sensor strain by Simulink software to calculate the changes of robotic ultrasound probe forces on the tissues depth (displacement). When stimuli are applied, a voltage difference generates that may be calculated directly. The final output for PVDF for piezoelectric can be expressed as Eq. 3: $$\:Vout=\varDelta\:V.\frac{\epsilon\:}{d}$$ 3 Where ΔV = (V1 + V2 + V3 + V4) is the voltage difference. \(\:\epsilon\:\) where representative of strain and d is the tissues depth for selected piezoelectric sensor. The relationship between generated voltage and displacement of ultrasound waves in the body surface is critical because certain motion and displacement require precise voltage to achieve the desired displacement. However, this is the voltage per unit of depth (millimeters in our case). Strain is used to calculate the robotic probe longitudinal dynamic force \(\:{f}_{s}\) by hookes law in Eq. 4 and Eq. 5, where \(\:{k}_{e}\) is a longitudinal elastic coefficient, and \(\:{\varDelta\:l}_{x}\) longitudinal deformation shown in (Fig. 5a). $$\:{f}_{s}={k}_{e}.\:{\varDelta\:l}_{x}$$ 4 $$\:{\epsilon\:}_{l}=\frac{{\varDelta\:l}_{x}}{L}$$ 5 Where \(\:{\epsilon\:}_{l}\) is a longitudinal strain, and L is a tissues depth in (mm). In brief, we can apply these equations to calculate and see the voltage-displacement and force-displacement plots. This allows us to monitor voltage at 30V increases to 105V over tissues depth from 2mm to 10mm. We notice the displacement rose simultaneously. On other hand, the force at 5N decreases to 1.5N by tissues depth from 2mm to 10mm shown in (Fig. 5b). We revealed in these Simulink results that the dynamic force of the robotic probe sensor attenuated to half when the tissue depth doubled. That, due to the acoustic impedances of tissues, low frequencies of ultrasound waves have better penetration than higher frequencies. Moreover, as clarified by Hooke's equations, the force is directly proportional to vibrational frequency, and it increases with increasing frequency. While the voltage increased by tissues depth, we consider the voltage to be a qualitative energy that isn’t reduced by the material's depth. Discussion The development of robotic sonography is a significant advancement in medical imaging, particularly in out of Jordan, where the establishment of a bachelor's degree in sonography is proposed in Jordan. This article discusses the potential and challenges of integrating robotic ultrasound technology into radiology departments and its implications for the medical education system in Jordan. The study surveyed 25 radiology residents and 25 radiographers from the 8 largest hospitals in Jordan to gauge their knowledge and opinions on robotic sonography. Since sonographers are unavailable in Jordan. As a result, we specifically targeted radiographers and radiology residents. The survey also compared their perception attitudes on robotic ultrasonography. The US handling habits vary among expert sonographers and cannot be well described using handcrafted features. The latest study believes that in the near future, the development of advanced machine learning will allow for figuring out the underlying “language of sonography” based on expert demonstrations. This can not only allow for autonomous intelligent RUSS development but also for designing US education and training systems, and advanced methodologies for grading and evaluating the performance of human and robotic US examinations [ 33 ]. Future trends such as AI have the potential to increase autonomy of these platforms, with published work showing the promising capabilities of this technology in the fields of image understanding and robot navigation. Overall, current robotic ultrasound systems show the potential to provide improved examination and intervention quality as well as a more effective friendly work environment for sonographers with reduced workload [ 34 ]. In our research we revealed more than half percent of radiographers are familiar with robotic ultrasound, while 44% of radiology residents were unfamiliar with its applications. This knowledge gap underscores the need for enhanced training and education programs focusing on advanced imaging technologies. A different study reviewed the most recent advances in AI-assisted US scanning. And identified the primary areas where AI is being applied to facilitate US scanning, such as standard plane recognition and examining guidance for US acquisitions executed by humans or robots [ 14 ]. Therefore, we overview these novel robotic ultrasound studies. To build a role for the highly advanced technologies in radiological departments and institutions and to establish the future of sonographers in Jordan. Robotic ultrasound offers several benefits, including increased precision and consistency in imaging, which can reduce the workload on radiologists and improve diagnostic accuracy. The automation of the scanning process minimizes human error and enhances the reproducibility of results, which is particularly beneficial in busy clinical settings [ 35 , 36 ]. Another proposed study strategy can significantly improve the force control performance of a robotic US system in a soft uncertain environment. This is a meaningful study because it shows that the proposed system can partially play the role of a sonographer and act as a medical assistant to reduce the workload [ 30 ]. We noticed in this study that robotic ultrasound enhanced image accuracy more than human work and sonographers, which is related to a distinctive algorithm software which controls the robot. The study reveals that a majority of radiographers believe that robotic ultrasound can enhance image quality and assist in auto-diagnosis, although some concerns about job displacement were noted among radiology residents. However, the implementation of robotic sonography is not without challenges. High costs, potential clinical risks, and ethical considerations are significant barriers to its widespread adoption [ 36 , 37 ]. This study highlights that 66% of radiology residents perceive high risks associated with robotic ultrasound, and 57% are concerned about the costs involved. These challenges must be addressed through regulatory frameworks, cost-benefit analyses, and robust training programs to ensure the safe and effective use of robotic ultrasound. The survey also explored the willingness of radiologists and radiographers to engage with robotic ultrasound technology. While there is enthusiasm for integrating robots into sonographic practices, there is also a need for clear legal regulations and ethical guidelines to govern its use. Limitation This study has a few limitations. The major limitation with robotic arms is the increased setup and working cost. This cost is justified in the case of pandemic situations like the current one. However, it may take some time to become a routine method of performing ultrasound [ 38 ]. According to our study, over 50% of radiology residents recognized that it was costly to use robotic ultrasound technologists in the diagnostic medical area. This study also identified a significant level of risk feeling among radiology residents while examining human patients alone with robotic sonography. Teleoperated RUS systems have not yet been widely disseminated or commercialized. This is partly because of technical limitations such as transmission delays and significantly lengthened procedure times. The communication delay also presents a limitation as it must be shorter than 3s; otherwise, it is very difficult to follow the image changes corresponding to each movement of the dummy probe. In addition to their enhanced accuracy, these needle guidance systems can potentially perform complex insertions with greater speed, reduced deformation, and less tissue damage than conventional techniques [ 16 , 39 , 40 ]. This work has also indicated that the robotic ultrasound was more accurate images by radiology residents’ perception. Furthermore, radiographers predicted robotic ultrasound was less hazardous on the patients than human conventional approaches. After exhibiting all these evidences on revolution of robotic ultrasound in previous studies compared with our study. The findings revealed that robotic ultrasound enhanced image accuracy, saving time and efforts on the sonographers and radiologists. These global results were the best motivation to establish the bachelor’s degree of sonographer. And that before reach the novel robotic ultrasound to Jordan. Conclusions The introduction of robotic sonography in Jordan holds promise for improving diagnostic imaging and reducing the workload on radiologists. However, it requires significant investment in education, training, and infrastructure, alongside the development of appropriate regulatory and ethical frameworks. 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Suligoj F, Heunis C. M, Sikorski J, Misra S. (2021) RobUSt-An Autonomous Robotic Ultrasound System for Medical Imaging. IEEE Access 9:67456-67465 Von Haxthausen F, Böttger S, Wulff D, Hagenah J, García-Vázquez V, Ipsen S. (2021) Medical Robotics for Ultrasound Imaging: Current Systems and Future Trends. Curr Robot Rep 2:55-71 Rubin DL. (2019) Artificial Intelligence in Imaging: The Radiologist's Role. J Am Coll Radiol 16:1309-1317 Bi Y, Jiang Z, Duelmer F, Huang D, Navab N. (2024) Machine Learning in Robotic Ultrasound Imaging: Challenges and Perspectives. Annu. Rev. Control. Robotics Auton. Syst 7:335-357 Chandrashekhara SH, Rangarajan K, Agrawal A, et al (2022) Robotic ultrasound: An initial feasibility study. World J Methodol. Jul 20;12(4):274-284 P. Arbeille, J. Ruiz, P. Herve, M. Chevillot, G. Poisson, and F. Perrotin (2005) “Fetal tele-echography using a robotic arm and a satellite link,” Ultrasound Obstet. Gynecol. 26(3): 221–226 Arbeille, P., Chaput, D., Zuj, K. et al (2018). Remote Echography between a Ground Control Center and the International Space Station Using a Tele-operated Echograph with Motorized Probe. Ultrasound in medicine & biology , 44 (11), 2406–2412 Additional Declarations No competing interests reported. Supplementary Files Figuresdata.docx Questionaredeveloped08182024.docx thesoftwarecalculationsandimages.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5686254","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":435927193,"identity":"c70f4dcf-55ab-447c-8bb5-f3023243c282","order_by":0,"name":"Mahmoud Abufadda","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABDUlEQVRIiWNgGAWjYFACHhDBzMAgwcDwgYGNmYGfGSTAxsDA2EBYC+MMkBbJZpK1GByAasEFdNvPHt3wsc2agX92j2HDjzJreePjPAYMH8oOMzC3Y7fG7Exe2s2ZbekMEnfOGDb2nEs33HaYx4BxxrnDDIw9B7BrOZBjdpu37TADw40c8wdABiNICzNIhHFGAnYt599AtMjfyDFs/Nt22H5zM1DLX3xabkBtMQBqaQYyEjcwA7Uw4tXyxuzmjHPpPIZ3jhU2y5xLT55xmK3gINBTPDj9cj7H7MaHMms5udvNGxvflFnb9vcf3vgAGHRyhjhCDAZ4UHgg43kM8evABuRJ1jEKRsEoGAXDFAAANRpj7y1UMSkAAAAASUVORK5CYII=","orcid":"","institution":"Isra University","correspondingAuthor":true,"prefix":"","firstName":"Mahmoud","middleName":"","lastName":"Abufadda","suffix":""},{"id":435927194,"identity":"d323df18-d34b-407e-a9b2-d1e94be47c88","order_by":1,"name":"Asem AL- Hiari","email":"","orcid":"","institution":"Isra University","correspondingAuthor":false,"prefix":"","firstName":"Asem","middleName":"AL-","lastName":"Hiari","suffix":""}],"badges":[],"createdAt":"2024-12-20 18:38:04","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5686254/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5686254/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":79582378,"identity":"9a9e1474-fa7a-4049-a79d-fe543fcb2672","added_by":"auto","created_at":"2025-03-31 12:07:36","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":327255,"visible":true,"origin":"","legend":"\u003cp\u003eArthur, by Robca, an Arthritis Ultrasound Robot for the examination of patients suffering from rheumatoid arthritis (\u003cstrong\u003ea\u003c/strong\u003e) [11]. Wosler’s SonoBot performing a deep vein thrombosis (DVT) ultrasound scan on an artificial leg (\u003cstrong\u003eb\u003c/strong\u003e) [12].\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-5686254/v1/e9f1cf80595bd819382d87df.png"},{"id":79584051,"identity":"790f1bb4-f030-4a1b-bebd-03ad439c1dc9","added_by":"auto","created_at":"2025-03-31 12:15:36","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":363050,"visible":true,"origin":"","legend":"\u003cp\u003eKnowledge of radiology residents and radiographers on robotic sonograph (\u003cstrong\u003ea\u003c/strong\u003e). Attitude of residents, radiographers toward robotic sonography in radiology (\u003cstrong\u003eb\u003c/strong\u003e).\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-5686254/v1/4a67396248b07adbbade2092.png"},{"id":79582380,"identity":"306a5336-31ea-4ed0-85e8-29d958744f6d","added_by":"auto","created_at":"2025-03-31 12:07:36","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":336026,"visible":true,"origin":"","legend":"\u003cp\u003eChallenges of robotic ultrasound in radiology (\u003cstrong\u003ea\u003c/strong\u003e). Opinion of using robotic ultrasound types by radiology residents and radiographers (\u003cstrong\u003eb\u003c/strong\u003e).\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-5686254/v1/6313635df6ed44c2f3069fab.png"},{"id":79582382,"identity":"ee43ee72-4c5f-4ea8-affd-183b672f031b","added_by":"auto","created_at":"2025-03-31 12:07:36","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":271425,"visible":true,"origin":"","legend":"\u003cp\u003eSimulation results: Force of robotic probe implementing on sine waveform (\u003cstrong\u003ea\u003c/strong\u003e). Prob position implementing on sine waveform in the tissues (\u003cstrong\u003eb\u003c/strong\u003e).\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-5686254/v1/01067188257aab659baee95b.png"},{"id":79584053,"identity":"e37e2b18-09a2-48a5-8fa4-fd889fb6740d","added_by":"auto","created_at":"2025-03-31 12:15:36","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":241701,"visible":true,"origin":"","legend":"\u003cp\u003eThe calculated relationship between voltage and displacement (\u003cstrong\u003ea\u003c/strong\u003e). The relationship between robotic ultrasound longitudinal force and displacement waves in the tissues (\u003cstrong\u003eb\u003c/strong\u003e).\u003c/p\u003e","description":"","filename":"floatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-5686254/v1/0d9003c42afa8c317d0df842.png"},{"id":79846143,"identity":"29779ab9-6eca-43d2-8f98-ce4a9ddf1639","added_by":"auto","created_at":"2025-04-03 13:46:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2132764,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5686254/v1/16a3ce32-98d7-4844-b8c2-fca714b4941a.pdf"},{"id":79585215,"identity":"6a535e27-003c-4933-bd9b-996343b57f9c","added_by":"auto","created_at":"2025-03-31 12:23:36","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":268555,"visible":true,"origin":"","legend":"","description":"","filename":"Figuresdata.docx","url":"https://assets-eu.researchsquare.com/files/rs-5686254/v1/1953b6e27d857f5f718cedce.docx"},{"id":79585211,"identity":"f52786cc-6d86-41bf-b817-b704a9509384","added_by":"auto","created_at":"2025-03-31 12:23:36","extension":"docx","order_by":5,"title":"","display":"","copyAsset":false,"role":"supplement","size":31262,"visible":true,"origin":"","legend":"","description":"","filename":"Questionaredeveloped08182024.docx","url":"https://assets-eu.researchsquare.com/files/rs-5686254/v1/f7b529c36060b68012d0fbc9.docx"},{"id":79582383,"identity":"555f8fa6-8774-4d21-9fd7-3e7002121949","added_by":"auto","created_at":"2025-03-31 12:07:36","extension":"docx","order_by":6,"title":"","display":"","copyAsset":false,"role":"supplement","size":71154,"visible":true,"origin":"","legend":"","description":"","filename":"thesoftwarecalculationsandimages.docx","url":"https://assets-eu.researchsquare.com/files/rs-5686254/v1/f7cf8e6148694f2cc159a793.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Evaluate the perceptions of novel global robotic ultrasound techniques to create a sonographic degree field in Jordan","fulltext":[{"header":"Background","content":"\u003cp\u003eMedical imaging plays a pivotal role in the early diagnosis and treatment of various health conditions. Among the many imaging modalities available, ultrasound has gained widespread popularity due to its non-invasive nature and real-time imaging capabilities [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn recent years, integrating robotic technology with ultrasound has emerged as a groundbreaking advancement, offering enhanced precision, flexibility, and efficiency in medical diagnostics [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. A significant number of published studies on ultrasound imaging scanning assistance address how to control the movement of a robot using an ultrasound transducer [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Research developed a system that combines a high-end ultrasound instrument, a robotic arm, and a fetal US phantom to imitate patient anatomy. Researchers say that the first attempts to establish control systems for robots that screen-specific organs were historically not entirely automated or sufficiently accurate [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCombining an ultrasound station with its probe fixed to the robot end-effector with a robotic system is known as robotic ultrasound. The combination may be able to overcome the restrictions of ultrasound through teleoperation, collaborative assistance, or even an autonomous system. The study specifies the technical standards and requirements for these systems, with a focus on ultrasonic imaging and robot privacy. The studied systems are categorized as teleoperation, collaborative support, and autonomous systems [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Over the last two decades, a variety of commercial and research systems have been developed for many medical fields; many of these systems were created in previous research [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The technological standards and requirements for these systems get overviewed in this study, with an emphasis on robot safety and ultrasonic imaging.\u003c/p\u003e\n\u003ch3\u003eTechnical Standards\u003c/h3\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eTeleoperation System\u003c/h2\u003e \u003cp\u003eBecause ultrasound imaging focuses on the operator, the availability of a qualified sonographer typically dictates the reliability of a diagnostic. Lack of skilled personnel may severely limit access to ultrasound imaging, especially in rural areas. Increasing travel and waiting periods could have an adverse effect on patient outcomes. Another difficulty is the physical strain from holding the probe by hand [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. These challenges can be resolved by remotely controlling the ultrasound probe with robotic technology (LORA one and two). In this section, the latest systems are divided into two categories: custom build and commercial accessible robotic hardware [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eCustom Fabrication Robots\u003c/h3\u003e\n\u003cp\u003eInitially, researchers concentrated on creating mechanical designs for lightweight, portable, and safe robotic manipulators for the slave manipulator. One of the latest research projects designed a six-degrees-of-freedom (DOF) counterbalanced robot arm with a 4-bar parallel linkage system for diagnostic ultrasound [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. A shared-control technique enabled the robot to autonomously customize its configuration in response to the sonographers' mobility modifications [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAn ultrasound robot called ARTHUR was created by the Danish firm ROPCA to examine rheumatoid arthritis patients. Without the help of a physician or nurse, the robot converses with the patient and scans up to 22 joints in 12 minutes. ARTHUR also evaluates the images it captures and provides an individual diagnostic for each joint. ROPCA received the KUKA Innovation Award 2022 for this groundbreaking invention shown in (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003ea) [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eCommercial Fabrication Robots\u003c/h3\u003e\n\u003cp\u003eDeveloped a robotic ultrasound system. Kinova Startup Story: Wosler Diagnostics - A Remote Telerobotic Ultrasound Solution. After investigating and assessing several robotic arms, they chose Kinova's Gen3 robot as the best alternative for their purposes in (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003eb) by [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Furthermore, a diverse range of robotic systems were created, the bulk of which were designed for usage in medical settings. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e also shows a variety of diagnostic robotic ultrasound models. Traditional ultrasound images are obtained by manually moving the transducer around the patient's body. This method may produce variances in image quality and necessitates the use of a trained operator. These challenges are addressed with robotic ultrasound technology, which automates the scanning process. Modern sensors and artificial intelligence algorithms enable robots to conduct reliable and accurate ultrasound tests [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSonographers manage an ultrasound probe and change its positions/poses during the ultrasound examination, this is typically a time-consuming process required to produce the desired ultrasound images. The extended processing time and repeated operations lead to reduced operational precision, security, and a significant workload. Ultrasound robots provide advantages in medical ultrasound, including developed-probe autonomy, stable image acquisition, improved scanning accuracy and safety, and reduced workload for sonographers [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. There is a lack of published papers describing the workload challenges that radiologists face in Jordan and the Middle East. This study concluded that sonographers have the ability and skills to carry on their expertise to trainees and colleagues in the UAE [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRobotic systems were therefore built to manipulate an ultrasound probe. These systems function in the conventional master-slave arrangement of robotic helper devices, with a slave-side robot mimicking the actions of a distant, master-side sonographer [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Furthermore, sonographers can control ultrasound robots from a distance, enabling remote treatments. Sonographers, who were previously only responsible for capturing ultrasound images, are now playing an increasingly crucial role in diagnostic imaging, challenging radiologists' longstanding supremacy in result interpretation. This paradigm change reflects developments in technology, broadening scopes of practice, and a rising emphasis on collaborative care [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In our study, we review the development of robotic ultrasound (RUS) in past international studies, which may lead to an improvement in the role of sonographers and the establishment of a sonographic technological field domestically. Table. 1 shows the references [\u003cspan additionalcitationids=\"CR22 CR23 CR24 CR25 CR26\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. We aim to establish a bachelor's degree in sonography in radiology departments in the future, so we investigate the perceptions of Jordanians radiology residents and radiographers about global robotic ultrasound.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eA different modern robotic ultrasound models device used for diagnostics.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRef no.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCountry, year\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOrgan diagnosed\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUltrasound\u003c/p\u003e \u003cp\u003eModel\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRobot\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAI system\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAccuracy percentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChang, R.F et. al [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChina,2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBreast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eATL HDI 3000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7-DOF KUKA iiwa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSVM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e94.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBridge, C.P et. al [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK, 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHeart\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGE Voluson E8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6-DOF robotic arm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eError\u0026thinsp;\u0026lt;\u0026thinsp;20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYaqub M, et al. 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Jordan currently lacks both robotic ultrasound and sonographers. We exchanged the sonographer's perception to the radiographer's opinion, and the lack of robotic ultrasonography was replaced with Simulink software calculations.\u003c/p\u003e\n\u003ch3\u003eQuestionnaire\u003c/h3\u003e\n\u003cp\u003eIn the cross-sectional approach, data were gathered by distributing a questionnaire consisting of (6) parts about professional history shown in Table\u0026nbsp;2, and (24) inquiries about the official study. After collecting the contact details about the involved persons, the survey was prepared by the Google Forms platform and sent to the participants via WhatsApp and email. (50) different responses were obtained from approximately 25 radiology residents in their second and third years of residency, and 25 radiographers work in separated radiology departments from eight of the largest governmental hospitals at Jordan Ministry of Health. The sample size was statistically calculated using the probability value error in an Excel sheet and was \u0026lt; 0.05. This study was approved under Jordanian Law No. 24 of 2023 on the Protection of Personal Data, and the Medical Liability Law No. 25 of 2018 of the Jordanian Ministry of Health, like our previous study [28].\u003c/p\u003e\n\u003cp\u003eA qualitative methodology proved suitable for this study because it permits the researchers to gain an in-depth overview of radiologists' and technologists' viewpoints on the future of the radiology profession with robotic sonography-based applications and to determine any variables that may affect its future application in Jordan.\u003c/p\u003e\n\u003cp\u003eThe questionnaire aims to explore the opinions of Jordanian Radiographers and Radiology residents on an international emerging healthcare trend: Robots in Ultrasound.\u003c/p\u003e\n\u003cp\u003eIt is a current research project in our department.\u003c/p\u003e\n\u003cp\u003eThe questionnaire consists of six parts:\u003c/p\u003e\n\u003cp\u003e1. Professional background in Radiology.\u003cbr\u003e2. Understanding of Robots in Sonographic Radiology.\u003cbr\u003e3. Perceptions toward the possible benefits and applications of robots in sonographic radiology.\u003cbr\u003e4. Willingness to actively participate in Robotic Sonographic Radiology.\u003cbr\u003e5. Considerations on integrating the Robot in Sonographic Radiology Training.\u003cbr\u003e6. Describe the challenges and obstacles of robots in sonographic radiology.\u003cbr\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003cdiv align=\"left\"\u003e\u003cimg 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\"\u003e\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\"\u003e\n \u003ch2\u003eSimulations\u003c/h2\u003e\n \u003cp\u003eSimple software calculations to assess the performance of robotic ultrasound the proposed force measurement method, FEM-based simulations were carried out using Simulink software. The results section is explanation to those used in the calculations. The response performance for force measurement was tested by applying forces in the z- direction to the upper plate of the forces measuring mechanism in 2-N increments ranging from − 12N to 12N [13, 29]. To evaluate the ultrasonic robot's performance under disruption, we executed simulations with various perturbation forces on the US probe and observed the results. The simulations were conducted using the simple Simulink module, Simulink module, which is widely used to study the shifting behavior of vibrating systems.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\"\u003e\n \u003ch2\u003eStatistical analysis\u003c/h2\u003e\n \u003cp\u003eIn this research, a qualitative approach was utilized to learn about the perspectives of radiology residents and radiographers in Jordan on the possible impact of robotic ultrasound-based apps on the radiology profession. The goal was also to uncover potential factors influencing the adoption of these apps. Questions 5–8 and 21–24 provide \"YES\" or \"NO\" responses. Their respective percentages are 60%. The remaining questions have the following rating scale responses: \"strongly agree,\" \"agree,\" \"neutral,\" and \"disagree\". The percentages chosen to signify strongly agree, agree, neutral, and dislike were 30% each. Each participant's response was gathered and rated according to the criteria that had been defined. Statistical Analyses were automatically downloaded and entered in an Excel spreadsheet. The student t-test and 1-way analyses of variance were used for comparing the means of the scores in 2 and more than 2 independent groups, respectively. Analyses were performed with SPSS Statistics version 25 software for Windows, and statistical significance was defined as P \u0026lt; 0.05 in Table\u0026nbsp;1. A Student's t-test (means: paired, two-sample equal variance) was used to statistically analyze the effect of the treatments. Results with p-values less than 0.02 and 0.05 were considered statistically significant in (Fig.\u0026nbsp;2 to 3).\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eOur survey obtained 25 radiology residents who responded, (54%) of the respondents were male, the radiology residents from the 8 largest governmental hospitals in Jordan. And 25 radiographers received the survey; (46%) of the respondents were female from the same hospitals, The demographic information of the survey respondents is summarized in Table 2. The knowledge of radiology residents and radiographers in the radiology departments, 43% of residents have information and heard about robotic ultrasound, while more than half of radiographers about 56% of them are familiar with robotic sonography. And relatively close percent of radiology residents (52%), and radiographers (48%), know of using robotic sonography shown in (Fig. 2a).\u003c/p\u003e\n\u003cp\u003eMore than half of radiographers believe that robotic ultrasounds improve the auto-diagnosis and diseases detection. While less than 50% of radiology residents believe robotic ultrasound can detect diseases. The result reveals about 58% of radiographers agree with the benefits of using robotic ultrasound in Jordan. And just 41% of radiology residents believe the robotic sonograph can replace the humans' job, shown in (Fig.\u0026nbsp;2b).\u003c/p\u003e\n\u003cp\u003eThe challenges of using the robotic ultrasound, the results showed that 55% of radiology residents objected to the clinical use of robotic ultrasound, 66% of these residents believe there is a high risk of using robotic sonography, and 57% of residents feel the high costs of using robotic ultrasound with more accuracy images. While 34% of radiographers believe the fewer risks and ethics of robotic ultrasound. And more percent 53% of radiology residents agree with legal regulations of robotic sonography in Jordan shown in (Fig. 3a).\u003c/p\u003e\n\u003cp\u003eThe opinions on using robotic ultrasound in target organs, the results showed that 62% of radiology residents know robotic thyroid ultrasound uses and techniques, and 47% of these residents had a knowledge about robotic ultrasound in gynecology. On the other hand, about 57% of radiographers know how robotics use breast ultrasound. While 61% of radiology residents have more experience of robotic using doppler ultrasound than 38% radiographers in Jordan. With equal percentages of both residents and radiographers knowing robotic scrotal ultrasound shown in (Fig. 3b).\u003c/p\u003e\n\u003cdiv id=\"Sec11\"\u003e\n \u003ch2\u003eSimulation results\u003c/h2\u003e\n \u003cp\u003eIn this study, no robotic ultrasound model is used. Therefore, we postulated some monitors (controllers) M to control the postulated robotic ultrasound forces in (Fig. 4a), and by Simulink software with simple calculations of real force between the ultrasound probe and tissues in N is equal:\u003c/p\u003e\n \u003cdiv id=\"Equ1\"\u003e\n \u003cdiv id=\"FileID_Equ1\" name=\"EquationSource\"\u003e$$\\:{F}_{r}={k}_{i}\\left({D}_{i}-D\\right)\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:\\:$$\u003c/div\u003e\n \u003cdiv\u003e1\u003c/div\u003e\n \u003c/div\u003e\n \u003cp\u003ewhere \\(\\:{k}_{i}\\) means the stiffness of the sensing unit and \\(\\:{D}_{i}\\) is the position of robotic probe unit 𝑖. In addition, the photo reflector outputs voltages that scale linearly with the distance in the available zone [30, 31]. To simplify calculations and analysis, the four voltage parameters reduced from the sensing units to three that directly correlate to the measured forces/torque. The transformation is described as:\u003c/p\u003e\n \u003cdiv id=\"Equ2\"\u003e\n \u003cdiv id=\"FileID_Equ2\" name=\"EquationSource\"\u003e$$\\:\\left[\\begin{array}{c}\\varDelta\\:{V}_{z}\\\\\\:\\varDelta\\:{V}_{x}\\\\\\:\\varDelta\\:{V}_{y}\\end{array}\\right]\\:=\\:\\left[\\begin{array}{c}\\varDelta\\:{(V}_{1}+{V}_{2}+{V}_{3}+{V}_{4})\\\\\\:\\varDelta\\:{(V}_{3}-{V}_{1})\\\\\\:\\varDelta\\:({V}_{4}-{V}_{2})\\end{array}\\right]$$\u003c/div\u003e\n \u003cdiv\u003e2\u003c/div\u003e\n \u003c/div\u003e\n \u003cp\u003ewhere V𝑧, V𝑥, and V𝑦 are the equivalent output voltages for force and torque calculation in around the z-, x-, and y- directions, respectively, and V𝑖|𝑖=1,2,3,4 mean the output voltages of the photo reflector in sensing unit 𝑖 [13].\u003c/p\u003e\n \u003cp\u003eThe ultrasound robot generates forces based on the Eq. 1. The desired operating force was set to 2.0 N and the initial place position of the US probe was 0.5mm at time of 1s. Two types of forces, ramp signals (slope: ±0.5mm/s, maximum value: 4.9 N, and sine signals (y = 5sin(t) in (Fig. 4a), were employed to simulate the positions in (mm) and exerted on the US probe shown in (Fig. 4b).\u003c/p\u003e\n \u003cp\u003eSelf-powered piezoelectric sensor (PVDF) of simulated robotic ultrasound probe, the polyvinylidene fluoride (PVDF) piezoelectric sensor is an effective alternative to traditional strain gauges for measuring dynamic loads and monitoring structural health. PVDF sensors provide the advantage of preventing power to function, and they can be built to suit any size and geometry, decreasing the size and cost of the load monitoring device [32].\u003c/p\u003e\n \u003cp\u003eIn this work we assumed the piezoelectric sensor strain by Simulink software to calculate the changes of robotic ultrasound probe forces on the tissues depth (displacement). When stimuli are applied, a voltage difference generates that may be calculated directly. The final output for PVDF for piezoelectric can be expressed as Eq. 3:\u003c/p\u003e\n \u003cdiv id=\"Equ3\"\u003e\n \u003cdiv id=\"FileID_Equ3\" name=\"EquationSource\"\u003e$$\\:Vout=\\varDelta\\:V.\\frac{\\epsilon\\:}{d}$$\u003c/div\u003e\n \u003cdiv\u003e3\u003c/div\u003e\n \u003c/div\u003e\n \u003cp\u003eWhere ΔV = (V1 + V2 + V3 + V4) is the voltage difference. \\(\\:\\epsilon\\:\\) where representative of strain and d is the tissues depth for selected piezoelectric sensor. The relationship between generated voltage and displacement of ultrasound waves in the body surface is critical because certain motion and displacement require precise voltage to achieve the desired displacement. However, this is the voltage per unit of depth (millimeters in our case). Strain is used to calculate the robotic probe longitudinal dynamic force \\(\\:{f}_{s}\\) by hookes law in Eq. 4 and Eq. 5, where \\(\\:{k}_{e}\\) is a longitudinal elastic coefficient, and \\(\\:{\\varDelta\\:l}_{x}\\) longitudinal deformation shown in (Fig. 5a).\u003c/p\u003e\n \u003cdiv id=\"Equ4\"\u003e\n \u003cdiv id=\"FileID_Equ4\" name=\"EquationSource\"\u003e$$\\:{f}_{s}={k}_{e}.\\:{\\varDelta\\:l}_{x}$$\u003c/div\u003e\n \u003cdiv\u003e4\u003c/div\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Equ5\"\u003e\n \u003cdiv id=\"FileID_Equ5\" name=\"EquationSource\"\u003e$$\\:{\\epsilon\\:}_{l}=\\frac{{\\varDelta\\:l}_{x}}{L}$$\u003c/div\u003e\n \u003cdiv\u003e5\u003c/div\u003e\n \u003c/div\u003e\n \u003cp\u003eWhere \\(\\:{\\epsilon\\:}_{l}\\) is a longitudinal strain, and L is a tissues depth in (mm). In brief, we can apply these equations to calculate and see the voltage-displacement and force-displacement plots. This allows us to monitor voltage at 30V increases to 105V over tissues depth from 2mm to 10mm. We notice the displacement rose simultaneously. On other hand, the force at 5N decreases to 1.5N by tissues depth from 2mm to 10mm shown in (Fig. 5b).\u003c/p\u003e\n \u003cp\u003eWe revealed in these Simulink results that the dynamic force of the robotic probe sensor attenuated to half when the tissue depth doubled. That, due to the acoustic impedances of tissues, low frequencies of ultrasound waves have better penetration than higher frequencies. Moreover, as clarified by Hooke's equations, the force is directly proportional to vibrational frequency, and it increases with increasing frequency. While the voltage increased by tissues depth, we consider the voltage to be a qualitative energy that isn’t reduced by the material's depth.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe development of robotic sonography is a significant advancement in medical imaging, particularly in out of Jordan, where the establishment of a bachelor's degree in sonography is proposed in Jordan. This article discusses the potential and challenges of integrating robotic ultrasound technology into radiology departments and its implications for the medical education system in Jordan. The study surveyed 25 radiology residents and 25 radiographers from the 8 largest hospitals in Jordan to gauge their knowledge and opinions on robotic sonography.\u003c/p\u003e \u003cp\u003eSince sonographers are unavailable in Jordan. As a result, we specifically targeted radiographers and radiology residents. The survey also compared their perception attitudes on robotic ultrasonography. The US handling habits vary among expert sonographers and cannot be well described using handcrafted features. The latest study believes that in the near future, the development of advanced machine learning will allow for figuring out the underlying \u0026ldquo;language of sonography\u0026rdquo; based on expert demonstrations. This can not only allow for autonomous intelligent RUSS development but also for designing US education and training systems, and advanced methodologies for grading and evaluating the performance of human and robotic US examinations [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFuture trends such as AI have the potential to increase autonomy of these platforms, with published work showing the promising capabilities of this technology in the fields of image understanding and robot navigation. Overall, current robotic ultrasound systems show the potential to provide improved examination and intervention quality as well as a more effective friendly work environment for sonographers with reduced workload [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. In our research we revealed more than half percent of radiographers are familiar with robotic ultrasound, while 44% of radiology residents were unfamiliar with its applications. This knowledge gap underscores the need for enhanced training and education programs focusing on advanced imaging technologies.\u003c/p\u003e \u003cp\u003eA different study reviewed the most recent advances in AI-assisted US scanning. And identified the primary areas where AI is being applied to facilitate US scanning, such as standard plane recognition and examining guidance for US acquisitions executed by humans or robots [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Therefore, we overview these novel robotic ultrasound studies. To build a role for the highly advanced technologies in radiological departments and institutions and to establish the future of sonographers in Jordan.\u003c/p\u003e \u003cp\u003eRobotic ultrasound offers several benefits, including increased precision and consistency in imaging, which can reduce the workload on radiologists and improve diagnostic accuracy. The automation of the scanning process minimizes human error and enhances the reproducibility of results, which is particularly beneficial in busy clinical settings [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Another proposed study strategy can significantly improve the force control performance of a robotic US system in a soft uncertain environment. This is a meaningful study because it shows that the proposed system can partially play the role of a sonographer and act as a medical assistant to reduce the workload [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWe noticed in this study that robotic ultrasound enhanced image accuracy more than human work and sonographers, which is related to a distinctive algorithm software which controls the robot. The study reveals that a majority of radiographers believe that robotic ultrasound can enhance image quality and assist in auto-diagnosis, although some concerns about job displacement were noted among radiology residents. However, the implementation of robotic sonography is not without challenges. High costs, potential clinical risks, and ethical considerations are significant barriers to its widespread adoption [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. This study highlights that 66% of radiology residents perceive high risks associated with robotic ultrasound, and 57% are concerned about the costs involved. These challenges must be addressed through regulatory frameworks, cost-benefit analyses, and robust training programs to ensure the safe and effective use of robotic ultrasound. The survey also explored the willingness of radiologists and radiographers to engage with robotic ultrasound technology. While there is enthusiasm for integrating robots into sonographic practices, there is also a need for clear legal regulations and ethical guidelines to govern its use.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eLimitation\u003c/h2\u003e \u003cp\u003eThis study has a few limitations. The major limitation with robotic arms is the increased setup and working cost. This cost is justified in the case of pandemic situations like the current one. However, it may take some time to become a routine method of performing ultrasound [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. According to our study, over 50% of radiology residents recognized that it was costly to use robotic ultrasound technologists in the diagnostic medical area. This study also identified a significant level of risk feeling among radiology residents while examining human patients alone with robotic sonography.\u003c/p\u003e \u003cp\u003eTeleoperated RUS systems have not yet been widely disseminated or commercialized. This is partly because of technical limitations such as transmission delays and significantly lengthened procedure times. The communication delay also presents a limitation as it must be shorter than 3s; otherwise, it is very difficult to follow the image changes corresponding to each movement of the dummy probe. In addition to their enhanced accuracy, these needle guidance systems can potentially perform complex insertions with greater speed, reduced deformation, and less tissue damage than conventional techniques [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. This work has also indicated that the robotic ultrasound was more accurate images by radiology residents\u0026rsquo; perception. Furthermore, radiographers predicted robotic ultrasound was less hazardous on the patients than human conventional approaches. After exhibiting all these evidences on revolution of robotic ultrasound in previous studies compared with our study. The findings revealed that robotic ultrasound enhanced image accuracy, saving time and efforts on the sonographers and radiologists. These global results were the best motivation to establish the bachelor\u0026rsquo;s degree of sonographer. And that before reach the novel robotic ultrasound to Jordan.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe introduction of robotic sonography in Jordan holds promise for improving diagnostic imaging and reducing the workload on radiologists. However, it requires significant investment in education, training, and infrastructure, alongside the development of appropriate regulatory and ethical frameworks. The creation of a bachelor's degree in sonography could play a pivotal role in bridging the knowledge gap and preparing the next generation of medical professionals for the challenges and opportunities presented by advanced imaging technologies. Finally, further studies of robotic sonographic technologies may be conducted in Jordan in the future.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003e\"Mahmoud Abufadda collected the data and wrote the main manuscript text and Asem Al-Hiari prepared tables and the statistics. All authors reviewed the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003ePanayides A. S, Amini A, Filipovic N. D et al (2020) AI in Medical Imaging Informatics: Current Challenges and Future Directions. IEEE Journal of Biomedical and Health Informatics 24:1837–1857\u003c/li\u003e\n \u003cli\u003eReddy K, Gharde P, Tayade H, Patil M, Reddy LS, Surya D (2023) Advancements in Robotic Surgery: A Comprehensive Overview of Current Utilizations and Upcoming Frontiers. Cureus 15:12.\u003c/li\u003e\n \u003cli\u003eToporek G, Wang H, Balicki M, Xie H. (2018) Autonomous Image-Based Ultrasound Probe Positioning via Deep Learning; Conference: The Hamlyn Symposium 12263:583-592\u003c/li\u003e\n \u003cli\u003eMustafa A.S.B, Ishii T, Matsunaga Y et al (2013) Development of robotic system for autonomous liver screening using ultrasound scanning device. IEEE International Conference on Robotics and Biomimetics (ROBIO) 804-809 \u003c/li\u003e\n \u003cli\u003eWang, Shuangyi ; Housden, James ; Noh, Yohan et al (2019) Robotic-assisted ultrasound for fetal imaging : Evolution from single-arm to dual-arm system. Towards Autonomous Robotic Systems - 20th Annual Conference, TAROS 2019, Proceedings. editor / Kaspar Althoefer ; Jelizaveta Konstantinova ; Ketao Zhang. Springer Verlag, pp. 27-38\u003c/li\u003e\n \u003cli\u003eVon Haxthausen F, Böttger S, Wulff D, Hagenah J, García-Vázquez V, Ipsen S. (2021) Medical Robotics for Ultrasound Imaging: Current Systems and Future Trends. 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(2023) Recent Advances in Artificial Intelligence-Assisted Ultrasound Scanning. Appl. Sci 13:6-3693\u003c/li\u003e\n \u003cli\u003eDhyani M, Roll SC, Gilbertson MW, Orlowski M, Anvari A, Li Q, Anthony B, Samir AE (2017) A pilot study to precisely quantify forces applied by sonographers while scanning: A step toward reducing ergonomic injury. Work. 58(2):241-247.\u003c/li\u003e\n \u003cli\u003eA. M. Priester, S. Natarajan, and M. O. Culjat. (2013) Robotic ultrasound systems in medicine, IEEE Trans. Ultrason. Ferroelectr. Freq. Control 60:507-23\u003c/li\u003e\n \u003cli\u003eAbuzaid, M.M. 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T, Noble J. A. (2020) Label efficient localization of fetal brain biometry planes in ultrasound through metric learning. International Workshop on Preterm, Perinatal and Paediatric Image Analysis 126–135\u003c/li\u003e\n \u003cli\u003eSkelton E., Matthew, J., Li, Y., Khanal, B. et al (2021) Towards Automated Extraction of 2D Standard Fetal Head Planes from 3D Ultrasound Acquisitions: A Clinical Evaluation and Quality Assessment Comparison. Radiography 27: 519–526.\u003c/li\u003e\n \u003cli\u003eBamaarouf, M., Paccot, F., Sarry, L., \u0026amp; Chanal, H. (2024) Development of a Robotic Ultrasound System to Assist Ultrasound Examination of Pregnant Women. \u003cem\u003eIEEE Transactions on Medical Robotics and Bionics\u003c/em\u003e.\u003c/li\u003e\n \u003cli\u003eM. Abufadda, K. Radaideh, A. Al-Hiari, A-R Al-Hinnawi. (2024) Perspectives of artificial intelligence in radiology in Jordan: CROSS-SECTIONAL study by radiologists and residents’ sides. 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Syst 7:335-357\u003c/li\u003e\n \u003cli\u003eChandrashekhara SH, Rangarajan K, Agrawal A, et al (2022) Robotic ultrasound: An initial feasibility study. World J Methodol. Jul 20;12(4):274-284\u003c/li\u003e\n \u003cli\u003eP. Arbeille, J. Ruiz, P. Herve, M. Chevillot, G. Poisson, and F. Perrotin (2005) “Fetal tele-echography using a robotic arm and a satellite link,” Ultrasound Obstet. Gynecol. 26(3): 221–226\u003c/li\u003e\n \u003cli\u003eArbeille, P., Chaput, D., Zuj, K. et al (2018). Remote Echography between a Ground Control Center and the International Space Station Using a Tele-operated Echograph with Motorized Probe. \u003cem\u003eUltrasound in medicine \u0026amp; biology\u003c/em\u003e, \u003cem\u003e44\u003c/em\u003e(11), 2406–2412\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Robotic sonography, robotic ultrasound, sonographer, tele-sonography, ultrasound technology","lastPublishedDoi":"10.21203/rs.3.rs-5686254/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5686254/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground \u003c/strong\u003eWe aim to create a bachelor's degree in sonography in radiology departments in the future, so we investigated Jordanian radiology residents and radiographers' attitudes toward global robotic ultrasound.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod \u003c/strong\u003eBy cross-sectional study using a 24-question questionnaire prepared by Google form platform delivered via participants emails and WhatsApp, we examined the opinions of 25 radiology residents and 25 radiographers at the largest eight governmental hospitals in Jordan. And they tested their knowledge of robotic sonography. We also use simple Simulink software to calculate the simulation of robotic ultrasound probe force in (N) and its tissue displacements in (mm).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults \u003c/strong\u003eWe found 43% of radiology residents had information and heard about robotic ultrasound, while 56% of radiographers heard about robotic sonography. And about 64% of radiographers believe that robotic ultrasound improves image quality and auto-diagnosis more than human work. However, compared to radiology residents, radiographers are noticeably more enthusiastic about robotic ultrasound (p-value \u0026lt;0.05). In addition to the Simulink results, we revealed the dynamic force of the robotic probe sensor attenuated to half when the tissue depth doubled. That, due to the acoustic impedances of tissues, low frequencies of ultrasound waves have better penetration than higher frequencies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions \u003c/strong\u003eRobotic sonography in some radiology departments in sophisticated countries may open the door to creating a bachelor's degree in sonography in developing countries. Which reduces the time and workload for radiology residents and radiologists in Jordan.\u003c/p\u003e","manuscriptTitle":"Evaluate the perceptions of novel global robotic ultrasound techniques to create a sonographic degree field in Jordan","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-31 12:07:31","doi":"10.21203/rs.3.rs-5686254/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0b9455b7-728d-489b-b630-4ae93b323ed8","owner":[],"postedDate":"March 31st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-06-30T11:53:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-03-31 12:07:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5686254","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5686254","identity":"rs-5686254","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}