1
|
Saccenti L, Bessy H, Ben Jedidia B, Longere B, Tortolano L, Derbel H, Luciani A, Kobeiter H, Grandpierre T, Tacher V. Performance Comparison of Augmented Reality Versus Ultrasound Guidance for Puncture: A Phantom Study. Cardiovasc Intervent Radiol 2024:10.1007/s00270-024-03727-8. [PMID: 38710797 DOI: 10.1007/s00270-024-03727-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/02/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE Augmented reality (AR) is an innovative approach that could assist percutaneous procedures; by directly seeing "through" a phantom, targeting a lesion might be more intuitive than using ultrasound (US). The objective of this study was to compare the performance of experienced interventional radiologists and operators untrained in soft tissue lesion puncture using AR guidance and standard US guidance. MATERIAL AND METHODS Three trained interventional radiologists with 5-10 years of experience and three untrained operators performed punctures of five targets in an abdominal phantom, with US guidance and AR guidance. Correct targeting, accuracy (defined as the Euclidean distance between the tip and the center of the target), planning time, and puncture time were documented. RESULTS Accuracy was higher for the trained group than the untrained group using US guidance (1 mm versus 4 mm, p = 0.001), but not when using AR guidance (4 mm vs. 4 mm, p = 0.76). All operators combined, no significant difference was found concerning accuracy between US and AR guidance (2 mm vs. 4 mm, p = 0.09), but planning time and puncture time were significantly shorter using AR (respectively, 15.1 s vs. 74 s, p < 0.001; 16.1 s vs. 59 s; p < 0.001). CONCLUSION Untrained and trained operators obtained comparable accuracy in percutaneous punctures when using AR guidance whereas US performance was better in the experienced group. All operators together, accuracy was similar between US and AR guidance, but shorter planning time, puncture time were found for AR guidance.
Collapse
Affiliation(s)
- Laetitia Saccenti
- Imagerie Medicale, Hopital Henri Mondor, Creteil, France.
- Henri Mondor's Institute of Biomedical Research, Inserm, U955 Team N°18, Creteil, France.
| | - Hugo Bessy
- Imagerie Medicale, Hopital Henri Mondor, Creteil, France
| | | | - Benjamin Longere
- Department of Cardiovascular Radiology, CHU Lille, 59000, Lille, France
| | | | - Haytham Derbel
- Imagerie Medicale, Hopital Henri Mondor, Creteil, France
- Henri Mondor's Institute of Biomedical Research, Inserm, U955 Team N°18, Creteil, France
| | - Alain Luciani
- Imagerie Medicale, Hopital Henri Mondor, Creteil, France
- Henri Mondor's Institute of Biomedical Research, Inserm, U955 Team N°18, Creteil, France
| | - Hicham Kobeiter
- Imagerie Medicale, Hopital Henri Mondor, Creteil, France
- Henri Mondor's Institute of Biomedical Research, Inserm, U955 Team N°18, Creteil, France
| | - Thierry Grandpierre
- Ecole superieure d'ingenieurs en electrotechnique et electronique, ESIEE Paris, Noisy Le Grand, France
| | - Vania Tacher
- Imagerie Medicale, Hopital Henri Mondor, Creteil, France
- Henri Mondor's Institute of Biomedical Research, Inserm, U955 Team N°18, Creteil, France
| |
Collapse
|
2
|
Fijačko N. Rethinking realities: A call for accurate terminology in eXtended Reality studies. Resusc Plus 2024; 17:100558. [PMID: 38586864 PMCID: PMC10995636 DOI: 10.1016/j.resplu.2024.100558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/09/2024] [Indexed: 04/09/2024] Open
Affiliation(s)
- Nino Fijačko
- Corresponding author at: Žitna ulica 15, University of Maribor, Faculty of Health Sciences, 2000 Maribor, Slovenia. @NinoFijacko
| |
Collapse
|
3
|
Theivendrampillai S, Yang B, Little M, Blick C. Targeted augmented reality-guided transperineal prostate biopsies study: initial experience. Ther Adv Urol 2024; 16:17562872241232582. [PMID: 38464882 PMCID: PMC10924555 DOI: 10.1177/17562872241232582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/24/2024] [Indexed: 03/12/2024] Open
Abstract
Background Transperineal biopsy of magnetic resonance imaging (MRI)-detected prostate lesions is now the established technique used in prostate cancer (CaP) diagnostics. Virtual Surgery Intelligence (VSI) Holomedicine by Apoqlar (Hamburg, Germany) is a mixed reality (MR)/augmented reality (AR) software platform that runs on the HoloLens II system (Microsoft, Redford, USA). Multiparametric prostate MRI images were converted into 3D holograms and added into a MR space, enabling visualization of a 3D hologram and image-assisted prostate biopsy. Objective The Targeted Augmented Reality-GuidEd Transperineal (TARGET) study investigated the feasibility of performing AR-guided prostate biopsies in a MR framework, using the VSI platform in patients with MRI-detected prostate lesions. Methods Ten patients with a clinical suspicion of CaP on MRI (Prostate Imaging-Reporting and Data System, PI-RADS 4/5) were uploaded to the VSI HoloLens system. Two MR/AR-guided prostate biopsies were then acquired using the PrecisionPoint Freehand transperineal biopsy system. Cognitive fusion biopsies were performed as standard of care following the MR/AR-guided prostate biopsies. Results All 10 patients successfully underwent MR/AR-guided prostate biopsy after 3D MR images were overlaid on the patient's body. Prostatic tissue was obtained in all MR/AR-guided specimens. Seven patients (70%) had matching histology in both the standard and MR/AR-guided biopsies. The remaining three had ISUP (International Society of Urological Pathology) Grade 2 CaP. There were no immediate complications. Conclusion We believe this is a world first. The initial feasibility data from the TARGET study demonstrated that an MR/AR-guided prostate biopsy utilizing the VSI Holomedicine system is a viable option in CaP diagnostics. The next stage in development is to combine AR images with real-time needle insertion and to provide further data to formally appraise the sensitivity and specificity of the technique.
Collapse
Affiliation(s)
| | - Bob Yang
- Royal Berkshire Hospital, Reading, Berkshire, UK
| | - Mark Little
- Royal Berkshire Hospital, Reading, Berkshire, UK
| | - Christopher Blick
- Department of Urology, Royal Berkshire Hospital, Craven Road, Reading, Berkshire RG1 5AN, UK
| |
Collapse
|
4
|
Dominique G, Kunitsky K, Natchagande G, Jalloh M, Gebreamlak AL, Lawal I, Agounkpe MM, Hodonou FD, Yevi DMI, Avakoudjo JDG, McCammon K, Watson G, Scotland KB. Evaluation of augmented reality technology in global urologic surgery. Am J Surg 2023; 226:471-476. [PMID: 37286453 PMCID: PMC10192066 DOI: 10.1016/j.amjsurg.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND The COVID-19 pandemic drastically reduced opportunities for surgical skill sharing between high-income and low to middle-income countries. Augmented reality (AR) technology allows mentors in one country to virtually train a mentee in another country during surgical cases without international travel. We hypothesize that AR technology is an effective live surgical training and mentorship modality. METHODS Three senior urologic surgeons in the US and UK worked with four urologic surgeon trainees across the continent of Africa using AR systems. Trainers and trainees individually completed post-operative questionnaires evaluating their experience. RESULTS Trainees rated the quality of virtual training as equivalent to in-person training in 83% of cases (N = 5 of 6 responses). Trainers reported the technology's visual quality as "acceptable" in 67% of cases (N = 12 of 18 responses). The audiovisual capabilities of the technology had a "high" impact in the majority of the cases. CONCLUSION AR technology can effectively facilitate surgical training when in-person training is limited or unavailable.
Collapse
Affiliation(s)
- Georgina Dominique
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA; David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Kevin Kunitsky
- Kansas City University of Medicine and Bioscience, Kansas City, MO, USA
| | - Gilles Natchagande
- Universitaire Centre National Hospitalier Universitaire Hubert K. Maga de Cotonou, Benin
| | | | | | | | | | - Fred D Hodonou
- Universitaire Centre National Hospitalier Universitaire Hubert K. Maga de Cotonou, Benin
| | | | - Josué D G Avakoudjo
- Universitaire Centre National Hospitalier Universitaire Hubert K. Maga de Cotonou, Benin
| | | | - Graham Watson
- East Sussex Healthcare NHS Trust, East Sussex, United Kingdom
| | - Kymora B Scotland
- David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
| |
Collapse
|
5
|
Ong K, Bald P, Dryhurst D, Ahmed S, Yusuf GT, Lunawat R, Sriprasad S, Thapa G, Tirnoveanu A, Webb R, Rahman E. The design and validation of a low-cost trans perineal (TP) prostate biopsy simulator for training: improving trainees' confidence and cognitive targeting skills. World J Urol 2023:10.1007/s00345-023-04387-y. [PMID: 37129680 PMCID: PMC10153043 DOI: 10.1007/s00345-023-04387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/27/2023] [Indexed: 05/03/2023] Open
Abstract
PURPOSE The aim of this research was to create a novel and low-cost TP prostate biopsy simulator that has face, content and construct validity with high educational value. METHODS This research developed a trans perineal prostate (TP) biopsy simulator using 3D-printed moulds and tissue-mimicking materials. Important regions (anterior, mid, and posterior zones) were coded with different colours. Ultrasound visible abnormal lesions were embedded in the prostate phantom. Expert and novice participants in TP biopsies were recruited. Essential skills were identified through the consensus of six experts. These skills were assessed through tasks performed by participants. This included the accuracy and timing of systematic and target biopsies. Immediate feedback was determined by the colour of the biopsy cores taken. A survey was distributed to evaluate its realism and educational value. RESULTS The material cost of one simulator was £7.50. This simulator was proven to have face, content, and construct validity. There was a significant difference (p = 0.02) in the accuracy of systematic biopsies between both experts and novices. Significant difference was also observed (p = 0.01), in accurately identifying target lesion on ultrasound between both groups. Participants rated the overall realism of the simulator 4.57/5 (range 3-5). 100% of the experts agreed that introducing this simulator to training will be beneficial. 85.7% of the participants strongly agree that the simulator improved their confidence in TP biopsies. CONCLUSION There is value in integrating this proof-of-concept TP prostate biopsy simulator into training. It has highly rated educational value and has face, content, and construct validity.
Collapse
Affiliation(s)
- Kelly Ong
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
- Princess Royal University Hospital, Farnborough Common, Bromley, Kent, BR6 8ND, UK
| | - Philip Bald
- Institute of Mechanical Engineers (IMechE), London, UK
| | - David Dryhurst
- Princess Royal University Hospital, Farnborough Common, Bromley, Kent, BR6 8ND, UK
| | - Saif Ahmed
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
| | - Gibran Tim Yusuf
- Princess Royal University Hospital, Farnborough Common, Bromley, Kent, BR6 8ND, UK
| | - Rahul Lunawat
- Princess Royal University Hospital, Farnborough Common, Bromley, Kent, BR6 8ND, UK
| | - Seshadri Sriprasad
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
| | - Gauri Thapa
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
| | - Alice Tirnoveanu
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
| | - Richard Webb
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
| | - Eqram Rahman
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK.
| |
Collapse
|
6
|
Duan H, Iagaru A. The use of advanced imaging in guiding the further investigation and treatment of primary prostate cancer. Cancer Imaging 2022; 22:45. [PMID: 36057766 PMCID: PMC9441085 DOI: 10.1186/s40644-022-00481-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/05/2022] [Indexed: 11/10/2022] Open
Abstract
In the era of precision medicine, oncological imaging techniques are advancing at a rapid pace, particularly molecular imaging with promising new targets for prostate cancer (PC) such as gastrin releasing peptide receptors (GRPR) along the established and indispensable prostate specific membrane antigen (PSMA). As PC is characterized by heterogenous tumor biology ranging from indolent to aggressive disease, distinguishing clinically significant tumors from indolent disease is critical. Multiparametric MRI- and PET-targeted prostate biopsies mitigate the shortcomings and risks of standard systematic template biopsy by identifying more significant cancers.Focal treatment for localized disease is a minimally invasive approach that targets the index tumor - the lesion of the highest grade - while sparing the surrounding healthy tissue. Real-time MRI-guidance and thermal control with MR-thermometry, improves treatment accuracy and results in lower rates of functional side effects. PET imaging could be an useful tool to assess response to treatment compared to invasive prostate biopsies.In this comprehensive review, we focus on the image-guided detection and treatment of localized primary prostate cancer, its current status and future perspectives.
Collapse
Affiliation(s)
- Heying Duan
- Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford University, Stanford, CA, USA
| | - Andrei Iagaru
- Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford University, Stanford, CA, USA.
| |
Collapse
|
7
|
Sparwasser P, Haack M, Frey L, Boehm K, Boedecker C, Huber T, Stroh K, Brandt MP, Mager R, Höfner T, Tsaur I, Haferkamp A, Borgmann H. Assessment of a novel smartglass-based point-of-care fusion approach for mixed reality-assisted targeted prostate biopsy: A pilot proof-of-concept study. Front Surg 2022; 9:892170. [PMID: 35937598 PMCID: PMC9354482 DOI: 10.3389/fsurg.2022.892170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose While several biopsy techniques and platforms for magnetic resonance imaging (MRI)-guided targeted biopsy of the prostate have been established, none of them has proven definite superiority. Augmented and virtual reality (mixed reality) smartglasses have emerged as an innovative technology to support image-guidance and optimize accuracy during medical interventions. We aimed to investigate the benefits of smartglasses for MRI-guided mixed reality-assisted cognitive targeted biopsy of the prostate. Methods For prospectively collected patients with suspect prostate PIRADS lesions, multiparametric MRI was uploaded to a smartglass (Microsoft® Hololens I), and smartglass-assisted targeted biopsy (SMART TB) of the prostate was executed by generation of a cognitive fusion technology at the point-of-care. Detection rates of prostate cancer (PCA) were compared between SMART TB and 12-core systematic biopsy. Assessment of SMART-TB was executed by the two performing surgeons based on 10 domains on a 10-point scale ranging from bad (1) to excellent (10). Results SMART TB and systematic biopsy of the prostate were performed for 10 patients with a total of 17 suspect PIRADS lesions (PIRADS 3, n = 6; PIRADS 4, n = 6; PIRADS 5, n = 5). PCA detection rate per core was significant (p < 0.05) higher for SMART TB (47%) than for systematic biopsy (19%). Likelihood for PCA according to each core of a PIRADS lesion (17%, PIRADS 3; 58%, PIRADS 4; 67%, PIRADS 5) demonstrated convenient accuracy. Feasibility scores for SMART TB were high for practicality (10), multitasking (10), execution speed (9), comfort (8), improvement of surgery (8) and image quality (8), medium for physical stress (6) and device handling (6) and low for device weight (5) and battery autonomy (4). Conclusion SMART TB has the potential to increase accuracy for PCA detection and might enhance cognitive MRI-guided targeted prostate biopsy in the future.
Collapse
Affiliation(s)
- P. Sparwasser
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
- Correspondence: Peter Sparwasser
| | - M. Haack
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - L. Frey
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - K. Boehm
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - C. Boedecker
- Department of General, Visceral and Transplant Surgery, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - T. Huber
- Department of General, Visceral and Transplant Surgery, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - K. Stroh
- Department of Radiology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - M. P. Brandt
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - R. Mager
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - T. Höfner
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - I. Tsaur
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - A. Haferkamp
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - H. Borgmann
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
- Department of Urology, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| |
Collapse
|