Artificial intelligence (AI) can improve accuracy by up to 15% for novice ultrasound users when it comes to guiding regional anesthesia, according to a study published September 8 in the British Journal of Anaesthesia.
Researchers led by Dr. James Bowness from the University of Oxford found that AI helped practitioners identify more correct block views and sono-anatomical structures while also not significantly impacting scan times.
“The real-time nature of ultrasound provides opportunities for AI to support the practitioner whilst they are scanning,” Bowness told AuntMinnie.com. “This may influence the ongoing clinical procedure, in contrast to assistive AI for healthcare data that have already been acquired.”
Users of ultrasound-guided regional anesthesia must be able to visualize key landmark, target, and safety structures on ultrasound. This can be challenging for novice users since the anatomy of target areas can be varied and complex in nature.
AI's potential for medical imaging has been studied to the point of becoming mainstream, including for ultrasound. This includes ultrasound-guided regional anesthesia. Along with aiding in identifying and interpreting structures on images, AI has also been explored for educational purposes in medical imaging.
The researchers, however, noted a lack of data comparing scanning performance for ultrasound-guided regional anesthesia with and without AI.
Bowness and colleagues wanted to prospectively assess the impact of their preferred AI software (ScanNav, Intelligent Ultrasound) on improvement in acquiring correct block views when performing ultrasound scans for a peripheral nerve block. They also wanted to see whether AI could help novice users correctly identify anatomical structures on ultrasound, as well as improve confidence, expert global assessment of novice users' scan performance, and scan times.
The researchers looked at data from 21 novice anesthetists who assessed a total of 126 ultrasound scans from five healthy volunteers. The anesthetists went through a standard teaching session in ultrasound scanning for six peripheral nerve blocks. Afterward, they performed a scan for each block, with half being performed with AI assistance and half without.
| Anesthetist performance on ultrasound-guided regional anesthesia with and without AI | |||
| Without AI assistance | With AI assistance | p-value | |
| Correct block view | 75.1% | 90.3% | 0.031 |
| Correctly identifying anatomical structures | 77.4% | 88.8% | 0.002 |
The researchers, however, found no statistically significant differences in user confidence, expert global performance score, or scan time. The average scan time was about 75 seconds.
Bowness said that the enhanced performance in ultrasound scanning, when using the assistive AI device, was evident “immediately” after the teaching, on the same day.
“We have [unpublished] pilot data which shows that scanning performance degrades with increased time from teaching and the assistive AI mitigates this drop-off,” he told AuntMinnie.com. “This makes evaluation of such technologies more complex but does suggest that the long-term benefit may be greater than the initial benefit seen.”
The study authors wrote that the comparable scan times between the two groups shows that AI does not impede a scanner's workflow, which could help with user acceptance. They also added that improved user confidence could make way for more use by novice users in ultrasound-guided regional anesthesia and that expert users could be more readily able to supervise such procedures or let more novice users scan on their own.
"To support this widespread learning and practice, innovation in training and technology is required," Bowness and co-authors wrote. "These data provide initial evidence that AI technology might be useful for this purpose."
The team called for larger studies exploring AI's impact on longer-term retention of competence, as well as determining which clinician group would benefit the most. The group also suggested that point-of-care ultrasound (POCUS) can help implement ultrasound-guided regional anesthesia in nonanesthetic specialties like emergency medicine.
"Clinicians in these areas, often familiar with POCUS and interventional procedures but less so with ultrasound-guided regional anesthesia, could benefit from such technology to support their learning and practice," the researchers wrote.
Disclosure notice: This study was funded in part by a research grant from Intelligent Ultrasound.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
