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Current teleultrasound methods include audiovisual guidance and robotic teleoperation, which constitute tradeoffs between precision and latency versus flexibility and cost. We present a novel concept of "human teleoperation" which bridges the gap between these two methods. In the concept, an expert remotely teloperates a person (the follower) wearing a mixed-reality headset by controlling a virtual ultrasound probe projected into the person's scene. The follower matches the pose and force of the virtual device with a real probe. The pose, force, video, ultrasound images, and 3-dimensional mesh of the scene are fed back to the expert. This control framework, where the actuation is carried out by people, allows more precision and speed than verbal guidance, yet is more flexible and inexpensive than robotic teleoperation. The purpose of this paper is to introduce this concept as well as a prototype teleultrasound system with limited haptics and local communication. The system was tested to show its potential, including mean teleoperation latencies of 0.32 ± 0.05 seconds and steady-state errors of 4.4 ± 2.8 mm and 5.4 ± 2.8 $^ \circ $ ∘ in position and orientation tracking respectively. A preliminary test with an ultrasonographer and four patients was completed, showing lower measurement error and a completion time of 1:36 ± 0:23 minutes using human teleoperation compared to 4:13 ± 3:58 using audiovisual teleguidance. [ABSTRACT FROM AUTHOR]

Simple Summary: Radiomics analysis of positron emission tomography (PET) images can provide objective measurements of tumor heterogeneity and spatial patterns. However, the relatively low resolution, high noise, and limited longitudinal data availability make it difficult to systematically investigate the relationship between the microscopic tumor phenotypes and corresponding PET radiomics signatures. To address this challenge, we use a multiscale, stochastic mathematical model of tumor growth to generate cross-sections of tumors in vascularized normal tissue on a microscopic level. By varying the biological parameters of the model, distinct tumor phenotypes are obtained, and their corresponding PET images are generated. The simulated data are then used to find the optimal combination of PET radiomics features that can reliably distinguish visually similar tumor phenotypes. In addition, we study the longitudinal changes in the discriminative power of radiomics features with tumor growth from a single cell to approximately one million cells. Cancers can manifest large variations in tumor phenotypes due to genetic and microenvironmental factors, which has motivated the development of quantitative radiomics-based image analysis with the aim to robustly classify tumor phenotypes in vivo. Positron emission tomography (PET) imaging can be particularly helpful in elucidating the metabolic profiles of tumors. However, the relatively low resolution, high noise, and limited PET data availability make it difficult to study the relationship between the microenvironment properties and metabolic tumor phenotype as seen on the images. Most of previously proposed digital PET phantoms of tumors are static, have an over-simplified morphology, and lack the link to cellular biology that ultimately governs the tumor evolution. In this work, we propose a novel method to investigate the relationship between microscopic tumor parameters and PET image characteristics based on the computational simulation of tumor growth. We use a hybrid, multiscale, stochastic mathematical model of cellular metabolism and proliferation to generate simulated cross-sections of tumors in vascularized normal tissue on a microscopic level. The generated longitudinal tumor growth sequences are converted to PET images with realistic resolution and noise. By changing the biological parameters of the model, such as the blood vessel density and conditions for necrosis, distinct tumor phenotypes can be obtained. The simulated cellular maps were compared to real histology slides of SiHa and WiDr xenografts imaged with Hoechst 33342 and pimonidazole. As an example application of the proposed method, we simulated six tumor phenotypes that contain various amounts of hypoxic and necrotic regions induced by a lack of oxygen and glucose, including phenotypes that are distinct on the microscopic level but visually similar in PET images. We computed 22 standardized Haralick texture features for each phenotype, and identified the features that could best discriminate the phenotypes with varying image noise levels. We demonstrated that "cluster shade" and "difference entropy" are the most effective and noise-resilient features for microscopic phenotype discrimination. Longitudinal analysis of the simulated tumor growth showed that radiomics analysis can be beneficial even in small lesions with a diameter of 3.5–4 resolution units, corresponding to 8.7–10.0 mm in modern PET scanners. Certain radiomics features were shown to change non-monotonically with tumor growth, which has implications for feature selection for tracking disease progression and therapy response. [ABSTRACT FROM AUTHOR]