A durable ultrasound phantom for trainees using common

materials
Poster No.:

R-0075

Congress:

2014 CSM

Type:

Scientific Exhibit

Authors:

W. Zhou, D. Glenn; KOGARAH/AU

Keywords:

Interventional vascular, Interventional non-vascular, Ultrasound,

Ultrasound-Colour Doppler, Arterial access, Equipment, Biopsy,
Education and training

DOI:

10.1594/ranzcr2014/R-0075

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Page 1 of 7

Aim
Interventional ultrasound is increasingly prevalent across many fields of medicine due
to its accessibility and the trend towards minimally invasive diagnosis and therapy.
Critical care residents are also expected to gain proficiency at ultrasound guided vascular
access. However exposure to ultrasound scanning or image guided procedures is
very limited for junior doctors. The steep initial learning curve creates an unnecessary
iatrogenic risk to patients, which can be reduced through adequate training with tissue
mimicking phantoms Fig. 1 on page 2.[1] However due to cost and durability issues,
commercial phantoms are infrequently adopted in the training of junior doctors. There is
thus the need for a good do-it-yourself method for making training ultrasound phantoms.
Existing DIY methods based on gelatin are fragile and perishable.[2] In this project we
demonstrate a phantom that is durable and imperishable, yet uses common materials,
and techniques applicable to a person of medical background.
Images for this section:

Fig. 1: A durable vascular phantom with doppler capability, made with common materials
and for interventional training.

Page 2 of 7

Methods and materials

Existing techniques in phantom construction were reviewed followed by experimentation
with various materials, additives and processing techniques.[3] Prototypes were verified
with imaging and needling to ensure good simulation of clinical procedures. A HDI5000
was used to optimise image quality for both low frequency and high frequency probes.
Materials and manufacturing techniques were then optimised for efficiency and simplicity
Fig. 2 on page 3. Phantoms were put to clinical use at the hospital radiology
department with ongoing audit of their impact to clinical practice.
Images for this section:

Fig. 2: Optimisation of the construction technique for a vascular ultrasound phantom.

Page 3 of 7

Results
A phantom based on gelatin can be made physically durable by forming a skin with flexible
polyurethane Fig. 3 on page 4. Room temperature storage was achieved through
optimised use of an antimicrobial such as chlorhexidine, chloroxylenol (e.g. Dettol) and
benzalkonium (e.g. Viraclean). Construction steps were refined to be simpler and less
technique dependent. A two-layer approach was adopted for creating phantoms with
inclusion, such as masses, cysts and vascular structures. The gelatin mixture consists of
15% gelatin, 5% metamucil, antimicrobial and water. Masses can use canned beetroot,
while vascular structures are best simulated by latex tubing.
Demonstration of a vascular phantom and a biopsy phantom Fig. 4 on page 5 to the
local hospital radiology department produced a positive response. Of 9 staff composed
of trainees, consultants and nurses, all agreed that these phantoms are useful tools for
junior trainees, 8 strongly agreed. 6 strongly agreed and 2 agreed that given the findings
of this project, more people will make phantoms to improve medical training in ultrasound
guided procedures.
Images for this section:

Page 4 of 7

Fig. 3: A 1.5mm skin was created using flexible polyurethane obtained from sculpting
and casting supplies. This significantly improves phantom durability.

Fig. 4: Biopsy phantom viewed under HDI5000 2-5MHz curvilinear transducer. The
masses are simulated with beetroots and olives.

Page 5 of 7

Conclusion
A durable ultrasound phantom based on gelatin can be constructed using a flexible
polyurethane skin combined with a common antimicrobial agent. The use of common
materials and simple techniques may improve uptake of ultrasound phantoms and
improve medical training in ultrasound-guided procedures.
Images for this section:

Fig. 4: Biopsy phantom viewed under HDI5000 2-5MHz curvilinear transducer. The
masses are simulated with beetroots and olives.

Page 6 of 7

Personal information
Senior resident at St George Hospital
Career goal is diagnostic and interventional radiology
Particular interest in ultrasound and MRI

References
1. Liberman L, Benton CL, Dershaw DD, Abramson AF, LaTrenta LR, Morris EA. Learning
curve for stereotactic breast biopsy: How many cases are enough? AJR American journal
of roentgenology. 2001;176(3):721-7.
2. Hocking G, Hebard S, Mitchell CH. A review of the benefits and pitfalls of phantoms
in ultrasound-guided regional anesthesia. Regional Anesthesia and Pain Medicine.
2011;36(2):162-70.
3. Culjat MO, Goldenberg D, Tewari P, Singh RS. A review of tissue substitutes for
ultrasound imaging. Ultrasound in medicine & biology. 2010;36(6):861-73.

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