Subscribe to RSS
DOI: 10.1055/a-2416-1080
Acceptance and feasibility of an augmented reality-based navigation system with optical tracking for percutaneous procedures in interventional radiology – a simulation-based phantom study
Article in several languages: English | deutsch
Abstract
Purpose
Augmented reality (AR) projects additional information into the user’s field of view during interventions. The aim was to evaluate the acceptance and clinical feasibility of an AR system and to compare users with different levels of experience. A system was examined that projects a CT-generated 3D model of a phantom into the field of view using a HoloLens 2, whereby the tracked needle is displayed and navigated live. A projected ultrasound image is used for live control of the needle positioning. This should minimize radiation exposure and improve orientation.
Materials and Methods
The acceptance and usability of the AR navigation system was evaluated by 10 physicians and medical students with different levels of experience by performing punctures with the system in a phantom. The required time was then compared and a questionnaire was completed to assess clinical acceptance and feasibility. For statistical analysis, frequencies for qualitative characteristics, location and dispersion measures for quantitative characteristics and Spearman rank correlations for correlations were calculated.
Results
9 out of 10 subjects hit all 5 target regions in the first attempt, taking an average of 29:39 minutes for all punctures. There was a significant correlation between previous experience in interventional radiology, years in the profession, and the time required. Overall, the time varied from an average of 43:00 min. for medical students to 15:00 min. for chief physicians. All test subjects showed high acceptance of the system and rated especially the potential clinical feasibility, the simplification of the puncture, and the image quality positively. However, the majority require further training for sufficient safety in use.
Conclusion
The system offers distinct advantages for navigation and orientation, facilitates percutaneous interventions during training and enables professionally experienced physicians to achieve short intervention times. In addition, the system improves ergonomics during the procedure by making important information always directly available in the field of view and has the potential to reduce the radiation exposure of staff in particular by combining AR and sonography and thus shortening CT-fluoroscopy times.
Key Points
-
AR navigation offers advantages for orientation during percutaneous radiological interventions.
-
The subjects would like to use the AR system in everyday clinical practice on patients.
-
AR improves ergonomics by making important information directly available in the field of view.
-
The combination of AR and sonography can significantly reduce radiation exposure for staff.
Citation Format
-
Rohmer K, Becker M, Georgiades M et al. Acceptance and feasibility of an augmented reality-based navigation system with optical tracking for percutaneous procedures in interventional radiology - a simulation-based phantom study. Fortschr Röntgenstr 2024; DOI 10.1055/a-2416-1080
Keywords
interventional procedures - biopsy - ultrasound - interventional radiology - augmented realityPublication History
Received: 08 April 2024
Accepted after revision: 05 September 2024
Article published online:
04 October 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Moosburner S, Remde C, Tang P. et al. Real world usability analysis of two augmented reality headsets in visceral surgery. Artificial Organs 2019; 43: 694-698
- 2 Elmi-Terander A, Nachabe R, Skulason H. et al. Feasibility and Accuracy of Thoracolumbar Minimally Invasive Pedicle Screw Placement With Augmented Reality Navigation Technology. Spine (Phila Pa 1976) 2018; 43: 1018-1023
- 3 Scherl C, Stratemeier J, Rotter N. et al. Augmented Reality with HoloLens in Parotid Tumor Surgery: A Prospective Feasibility Study. ORL J Otorhinolaryngol Relat Spec 2021; 83: 439-448
- 4 Al Janabi HF, Aydin A, Palaneer S. et al. Effectiveness of the HoloLens mixed-reality headset in minimally invasive surgery: a simulation-based feasibility study. Surg Endosc 2020; 34: 1143-1149
- 5 Jiang T, Yu D, Wang Y. et al. HoloLens-Based Vascular Localization System: Precision Evaluation Study With a Three-Dimensional Printed Model. J Med Internet Res 2020; 22: e16852
- 6 Okachi S, Matsui T, Sakurai M. et al. Real-time ultrasound-guided thoracentesis simulation using an optical see-through head-mounted display: a proof-of-concept study. J Ultrason 2024; 24: 20240012
- 7 Wauben LSGL, van Veelen MA, Gossot D. et al. Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons. Surg Endosc 2006; 20: 1268-1274
- 8 El Shallaly G, Cuschieri A. Optimum view distance for laparoscopic surgery. Surg Endosc 2006; 20: 1879-1882
- 9 HoloLens 2—Overview, Features, and Specs | Microsoft HoloLens. o. J..
- 10 Park BJ, Hunt SJ, Nadolski GJ. et al. Augmented reality improves procedural efficiency and reduces radiation dose for CT-guided lesion targeting: a phantom study using HoloLens 2. Sci Rep 2020; 10: 18620
- 11 Solbiati M, Passera KM, Rotilio A. et al. Augmented reality for interventional oncology: proof-of-concept study of a novel high-end guidance system platform. Eur Radiol Exp 2018; 2: 18
- 12 Bettati P, Chalian M, Huang J. et al. Augmented Reality-Assisted Biopsy of Soft Tissue Lesions. Proc SPIE Int Soc Opt Eng 2020; 11315: 113150W
- 13 Damm R, El-Sanosy S, Omari J. et al. Ultrasound-assisted catheter placement in CT-guided HDR brachytherapy for the local ablation of abdominal malignancies: Initial experience. Fortschr Röntgenstr 2019; 191: 48-53
- 14 Farshad-Amacker NA, Kubik-Huch RA, Kolling C. et al. Learning how to perform ultrasound-guided interventions with and without augmented reality visualization: a randomized study. Eur Radiol 2023; 33: 2927-2934
- 15 Costa N, Ferreira L, de Araújo ARVF. et al. Augmented Reality-Assisted Ultrasound Breast Biopsy. Sensors (Basel) 2023; 23: 1838
- 16 Pfefferle M, Shahub S, Shahedi M. et al. Renal biopsy under augmented reality guidance. Proc SPIE Int Soc Opt Eng 2020; 11315: 113152W
- 17 Li H, Yan W, Zhao J. et al. Navigate biopsy with ultrasound under augmented reality device: Towards higher system performance. Computers in Biology and Medicine 2024; 174: 108453
- 18 Bettati P, Young J, Rathgeb A. et al. An augmented reality-guided biopsy system using a high-speed motion tracking and real-time registration platform. Proc SPIE Int Soc Opt Eng 2024; 12928: 129281G
- 19 Lin MA, Siu AF, Bae JH. et al. HoloNeedle: Augmented Reality Guidance System for Needle Placement Investigating the Advantages of Three-Dimensional Needle Shape Reconstruction. IEEE Robotics and Automation Letters 2018; 3: 4156-4162
- 20 Nicolau SA, Pennec X, Soler L. et al. An augmented reality system for liver thermal ablation: Design and evaluation on clinical cases. Medical Image Analysis 2009; 13: 494-506