Automated Real Time Delineation of Supraclavicular Brachial Plexus in Neck Ultrasonography Videos: A Deep Learning Approach

Peripheral nerve blocks are crucial to treatment of post-surgical pain and are associated with reduction in perioperative opioid use and hospital stay. Accurate interpretation of sono-anatomy is critical for the success of ultrasound (US) guided peripheral nerve blocks and can be challenging to the new operators. This prospective study enrolled 227 subjects who were systematically scanned for supraclavicular and interscalene brachial plexus in various settings using three different US machines to create a dataset of 227 unique videos. In total, 41,000 video frames were annotated by experienced anaesthesiologists using partial automation with object tracking and active contour algorithms. Four baseline neural network models were trained on the dataset and their performance was evaluated for object detection and segmentation tasks. Generalizability of the best suited model was then tested on the datasets constructed from separate US scanners with and without fine-tuning. The results demonstrate that deep learning models can be leveraged for real time segmentation of supraclavicular brachial plexus in neck ultrasonography videos with high accuracy and reliability. Model was also tested for its ability to differentiate between supraclavicular and adjoining interscalene brachial plexus. The entire dataset has been released publicly for further study by the research community.