To evaluate the feasibility and effectiveness of a novel automated scanning ultrasound robot in renal examination.

Consecutive patients scheduled for urinary system ultrasound examinations at Zhongshan Hospital (Xiamen), Fudan University, from March to May 2025 were enrolled. All participants underwent both automated scanning with the ultrasound robot and conventional manual examination by a sonographer. The paired t-test was used to analyze renal length measurements, which conformed to a normal distribution; the Wilcoxon signed-rank test was used to analyze examination time and image quality scores, which were not normally distributed or were ordinal data. Kappa analysis and the intraclass correlation coefficient (ICC) were employed to assess the agreement between the two methods in disease classification and renal length measurements, respectively. Spearman correlation analysis was used to evaluate the correlation between image quality scores. A P-value＜0.05 was considered statistically significant.

A total of 52 patients (103 kidneys) were enrolled, and all patients successfully completed both examinations. Questionnaire survey demonstrated favorable patient acceptance and experience with the robotic examination. The renal length measured by the robot (103.78±8.13) mm was significantly shorter than that measured manually (108.07±8.58) mm, with a mean difference of −4.3 mm (95%CI: −5.56~−3.02, t=−6.69, P＜0.01). The robotic examination required significantly longer scanning time compared to manual examination [(101.84±41.42) s vs (92.84±85.65) s, Z=−3.26, P＜0.01]. Static image quality scores obtained by the robot were lower than those of manual examination [median: 4 (4, 5) vs 5 (4, 5), Z=−5.892, P＜0.001], whereas no significant difference was observed in dynamic video image quality scores between the two methods [median: 4 (4, 5) vs 4 (4, 5), Z=−0.45, P=0.653]. For imaging diagnosis, the two methods showed high agreement in the diagnosis of most renal diseases (0.62≤κ≤1.00), with the lower limits of the 95% CIs all exceeding 0. Subgroup analysis demonstrated that the lesion detection efficacy of the robotic examination exhibited anatomic location-dependent differences, with lower sensitivity at the upper and lower poles (81.25% and 77.27%) compared to the mid-kidney (100.00%), whereas manual examination maintained consistently high sensitivity across all locations (93.75%~100.00%).

The automated ultrasound robot system demonstrates favorable patient acceptability and performs comparably to manual examination in terms of renal length measurement, examination time, image quality, and lesion detection. It shows promise in promoting automation, standardization, and tele-ultrasonography of renal ultrasound examinations, and may serve as a reliable adjunctive tool for ultrasonographers.