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Kreiser K, Sollmann N, Renz M. Importance and potential of simulation training in interventional radiology. ROFO-FORTSCHR RONTG 2023; 195:883-889. [PMID: 37137320 DOI: 10.1055/a-2066-8009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Simulation training is a common method in many medical disciplines and is used to teach content knowledge, manual skills, and team skills without potential patient danger. METHODS Simulation models and methods in interventional radiology are explained. Strengths and weaknesses of both simulators for non-vascular and vascular radiological interventions are highlighted and necessary future developments are addressed. RESULTS Both custom-made and commercially available phantoms are available for non-vascular interventions. Interventions are performed under ultrasound guidance, with computed tomography assistance, or using mixed-reality methods. The wear and tear of physical phantoms can be countered with in-house production of 3D-printed models. Vascular interventions can be trained on silicone models or hightech simulators. Increasingly, patient-specific anatomies are replicated and simulated pre-intervention. The level of evidence of all procedures is low. CONCLUSION Numerous simulation methods are available in interventional radiology. Training on silicone models and hightech simulators for vascular interventions has the potential to reduce procedural time. This is associated with reduced radiation dose for both patient and physician, which can also contribute to improved patient outcome, at least in endovascular stroke treatment. Although a higher level of evidence should be achieved, simulation training should already be integrated into the guidelines of the professional societies and accordingly into the curricula of the radiology departments. KEY POINTS · There are numerous simulation methods for nonvascular and vascular radiologic interventions.. · Puncture models can be purchased commercially or made using 3D printing.. · Silicone models and hightech simulators allow patient-specific training.. · Simulation training reduces intervention time, benefiting both the patient and the physician.. · A higher level of evidence is possible via proof of reduced procedural times.. CITATION FORMAT · Kreiser K, Sollmann N, Renz M. Importance and potential of simulation training in interventional radiology. Fortschr Röntgenstr 2023; 195: 883 - 889.
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Affiliation(s)
- Kornelia Kreiser
- RKU, Department of Neuroradiology, University Hospital Ulm, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
| | - Martin Renz
- Departement of Diagnostic and Interventional Neuroradiology, Technical University of Munich Hospital Rechts der Isar, Munchen, Germany
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Wu J, Gao L, Shi Q, Qin C, Xu K, Jiang Z, Zhang X, Li M, Qiu J, Gu W. Accuracy Evaluation Trial of Mixed Reality-Guided Spinal Puncture Technology. Ther Clin Risk Manag 2023; 19:599-609. [PMID: 37484696 PMCID: PMC10361284 DOI: 10.2147/tcrm.s416918] [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: 04/12/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose To evaluate the accuracy of mixed reality (MR)-guided visualization technology for spinal puncture (MRsp). Methods MRsp involved the following three steps: 1. Lumbar spine computed tomography (CT) data were obtained to reconstruct virtual 3D images, which were imported into a HoloLens (2nd gen). 2. The patented MR system quickly recognized the spatial orientation and superimposed the virtual image over the real spine in the HoloLens. 3. The operator performed the spinal puncture with structural information provided by the virtual image. A posture fixation cushion was used to keep the subjects' lateral decubitus position consistent. 12 subjects were recruited to verify the setup error and the registration error. The setup error was calculated using the first two CT scans and measuring the displacement of two location markers. The projection points of the upper edge of the L3 spinous process (L3↑), the lower edge of the L3 spinous process (L3↓), and the lower edge of the L4 spinous process (L4↓) in the virtual image were positioned and marked on the skin as the registration markers. A third CT scan was performed to determine the registration error by measuring the displacement between the three registration markers and the corresponding real spinous process edges. Results The setup errors in the position of the cranial location marker between CT scans along the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) axes of the CT bed measured 0.09 ± 0.06 cm, 0.30 ± 0.28 cm, and 0.22 ± 0.12 cm, respectively, while those of the position of the caudal location marker measured 0.08 ± 0.06 cm, 0.29 ± 0.18 cm, and 0.18 ± 0.10 cm, respectively. The registration errors between the three registration markers and the subject's real L3↑, L3↓, and L4↓ were 0.11 ± 0.09 cm, 0.15 ± 0.13 cm, and 0.13 ± 0.10 cm, respectively, in the SI direction. Conclusion This MR-guided visualization technology for spinal puncture can accurately and quickly superimpose the reconstructed 3D CT images over a real human spine.
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Affiliation(s)
- Jiajun Wu
- Department of Anesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People’s Republic of China
| | - Lei Gao
- Department of Anesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People’s Republic of China
| | - Qiao Shi
- Department of Anesthesiology, International Peace Maternity and Child Health Hospital of China, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, People’s Republic of China
| | - Chunhui Qin
- Department of Pain Management, Yueyang Integrated Traditional Chinese Medicine and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People’s Republic of China
| | - Kai Xu
- Department of Anesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People’s Republic of China
| | - Zhaoshun Jiang
- Department of Anesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People’s Republic of China
| | - Xixue Zhang
- Department of Anesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People’s Republic of China
| | - Ming Li
- Department of Radiology, Huadong Hospital affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
| | - Jianjian Qiu
- Department of Radiation Oncology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
| | - Weidong Gu
- Department of Anesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People’s Republic of China
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Halpern SA, Brace EJ, Hall AJ, Morrison RG, Patel DV, Yuh JY, Brolis NV. 3-D modeling applications in ultrasound education: a systematic review. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:188-197. [PMID: 34711434 DOI: 10.1016/j.ultrasmedbio.2021.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/13/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
Ultrasound offers a real-time 2-D view of structures within the human body. While many medical education programs have already dedicated a portion of their curriculum to ultrasound, others are concerned about cost, accessibility and limits to student practice. Student benefit may be affected by cognitive errors, which are in part owing to the mental heuristics required to visualize a 3-D structure by interpreting a 2-D image. A possible solution to eliminating subjectivity in ultrasound interpretation is the use of 3-D models to augment the traditional 2-D ultrasound experience. PubMed, Embase and Web of Science were searched for primary literature exploring relationships between 3-D modeling applications and their use in ultrasound education. The search and review process was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. Overall, 14 of the included 16 studies indicated a significant improvement in medical education of ultrasound with the intervention of 3-D modeling applications. This systematic review confirms that 3-D modeling applications benefit student learning in ultrasound education while illuminating the need for more research in this field.
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Affiliation(s)
- Sophie A Halpern
- Department of Family Medicine, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA.
| | - Eamonn J Brace
- Department of Family Medicine, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Arielle J Hall
- Department of Family Medicine, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Ryan G Morrison
- Department of Family Medicine, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Dip V Patel
- Department of Family Medicine, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Jonathan Y Yuh
- Department of Family Medicine, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Nils V Brolis
- Department of Family Medicine, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
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Sarmadi H, Muñoz-Salinas R, Álvaro Berbís M, Luna A, Medina-Carnicer R. Joint scene and object tracking for cost-Effective augmented reality guided patient positioning in radiation therapy. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 209:106296. [PMID: 34380076 DOI: 10.1016/j.cmpb.2021.106296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 07/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE The research is done in the field of Augmented Reality (AR) for patient positioning in radiation therapy is scarce. We propose an efficient and cost-effective algorithm for tracking the scene and the patient to interactively assist the patient's positioning process by providing visual feedback to the operator. Up to our knowledge, this is the first framework that can be employed for mobile interactive AR to guide patient positioning. METHODS We propose a pointcloud processing method that, combined with a fiducial marker-mapper algorithm and the generalized ICP algorithm, tracks the patient and the camera precisely and efficiently only using the CPU unit. The 3D reference model and body marker map alignment is calculated employing an efficient body reconstruction algorithm. RESULTS Our quantitative evaluation shows that the proposed method achieves a translational and rotational error of 4.17 mm/0.82∘ at 9 fps. Furthermore, the qualitative results demonstrate the usefulness of our algorithm in patient positioning on different human subjects. CONCLUSION Since our algorithm achieves a relatively high frame rate and accuracy employing a regular laptop (without a dedicated GPU), it is a very cost-effective AR-based patient positioning method. It also opens the way for other researchers by introducing a framework that could be improved upon for better mobile interactive AR patient positioning solutions in the future.
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Affiliation(s)
- Hamid Sarmadi
- Instituto Maimónides de Investigación en Biomedicina (IMIBIC). Avenida Menéndez Pidal s/n, Córdoba, 14004, Spain.
| | - Rafael Muñoz-Salinas
- Computing and Numerical Analysis Department, Edificio Einstein. Campus de Rabanales, Córdoba University, Córdoba, 14071, Spain; Instituto Maimónides de Investigación en Biomedicina (IMIBIC). Avenida Menéndez Pidal s/n, Córdoba, 14004, Spain.
| | - M Álvaro Berbís
- HT Médica, Hospital San Juan de Dios. Avda Brillante 106, Córdoba, 14012, Spain.
| | - Antonio Luna
- HT Médica, Clínica las Nieves, Carmelo Torres 2, Jaén, 23007, Spain.
| | - R Medina-Carnicer
- Computing and Numerical Analysis Department, Edificio Einstein. Campus de Rabanales, Córdoba University, Córdoba, 14071, Spain; Instituto Maimónides de Investigación en Biomedicina (IMIBIC). Avenida Menéndez Pidal s/n, Córdoba, 14004, Spain.
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Tuladhar S, AlSallami N, Alsadoon A, Prasad PWC, Alsadoon OH, Haddad S, Alrubaie A. A recent review and a taxonomy for hard and soft tissue visualization-based mixed reality. Int J Med Robot 2020; 16:1-22. [PMID: 32388923 DOI: 10.1002/rcs.2120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Mixed reality (MR) visualization is gaining popularity in image-guided surgery (IGS) systems, especially for hard and soft tissue surgeries. However, a few MR systems are implemented in real time. Some factors are limiting MR technology and creating a difficulty in setting up and evaluating the MR system in real environments. Some of these factors include: the end users are not considered, the limitations in the operating room, and the medical images are not fully unified into the operating interventions. METHODOLOGY The purpose of this article is to use Data, Visualization processing, and View (DVV) taxonomy to evaluate the current MR systems. DVV includes all the components required to be considered and validated for the MR used in hard and soft tissue surgeries. This taxonomy helps the developers and end users like researchers and surgeons to enhance MR system for the surgical field. RESULTS We evaluated, validated, and verified the taxonomy based on system comparison, completeness, and acceptance criteria. Around 24 state-of-the-art solutions that are picked relate to MR visualization, which is then used to demonstrate and validate this taxonomy. The results showed that most of the findings are evaluated and others are validated. CONCLUSION The DVV taxonomy acts as a great resource for MR visualization in IGS. State-of-the-art solutions are classified, evaluated, validated, and verified to elaborate the process of MR visualization during surgery. The DVV taxonomy provides the benefits to the end users and future improvements in MR.
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Affiliation(s)
- Selina Tuladhar
- School of Computing and Mathematics, Charles Sturt University, Sydney, New South Wales, Australia
| | - Nada AlSallami
- Computer Science Department, Worcester State University, Worcester, Massachusetts, USA
| | - Abeer Alsadoon
- School of Computing and Mathematics, Charles Sturt University, Sydney, New South Wales, Australia.,Department of Information Technology, Study Group Australia, Sydney, New South Wales, Australia
| | - P W C Prasad
- School of Computing and Mathematics, Charles Sturt University, Sydney, New South Wales, Australia
| | - Omar H Alsadoon
- Department of Islamic Sciences, Al Iraqia University, Baghdad, Iraq
| | - Sami Haddad
- Department of Oral and Maxillofacial Services, Greater Western Sydney Area Health Services, Sydney, New South Wales, Australia.,Department of Oral and Maxillofacial Services, Central Coast Area Health, Gosford, New South Wales, Australia
| | - Ahmad Alrubaie
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Azimi E, Winkler A, Tucker E, Qian L, Doswell J, Navab N, Kazanzides P. Can Mixed-Reality Improve the Training of Medical Procedures? ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2018:4065-4068. [PMID: 30441249 DOI: 10.1109/embc.2018.8513387] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
One cause of preventable death is a lack of proper skills for providing critical care. The conventional course taught to non-medical individuals involves instructions of advanced emergency procedures routinely limited to a verbal block of instructions in a standardized presentation (for example, an instructional video).In the present study, we evaluate the benefits of using an OST-HMD for training of caregivers in an emergency medical environment. A rich user interface was implemented that provides 3D visual aids including images, text and tracked 3D overlays corresponding to each task that needs to be performed. A user study with 20 participants is conducted which involves training of two tasks where each subject performs one task with the HMD and the other with standard training. Two evaluations were performed, with the first immediately after the training followed by a second one three weeks later. Our results indicate that using a mixed reality HMD is more engaging, improves the time-on-task, and increases the confidence level of users in providing emergency and critical care.
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Venkata HS, Alsadoon A, Prasad PWC, Alsadoon OH, Haddad S, Deva A, Hsu J. A novel mixed reality in breast and constructive jaw surgical tele-presence. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2019; 177:253-268. [PMID: 31319954 DOI: 10.1016/j.cmpb.2019.05.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/25/2019] [Accepted: 05/28/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND AIM Surgical telepresence has been implemented using Mixed reality (MR) but, MR is theory based and only used for investigating research. The Aim of this paper is to propose and implement a new solution by merging augmented video (generating in local site) and virtual expertise surgeon hand (remote site). This system is to improve the visualization of surgical area, overlay accuracy in the merged video without having any discoloured patterns on hand, smudging artefacts on surgeon hand boundary and occluded areas of surgical area. METHODOLOGY The Proposed system consists of an Enhanced Multi-Layer Mean Value Cloning (EMLMV) algorithm that improves the overlay accuracy, visualization accuracy and the processing time. This proposed algorithm includes trimap and alpha matting as a pre-processing stage of merging process, which helps to remove the smudging and discoloured artefacts surrounded by remote surgeon hand. RESULTS Results showing that the proposed system improved the accuracy by reducing the overlay error of merging image from 1.3 mm (Millimeter) to 0.9 mm. Furthermore, it improves the visibility of surgeon hand in the final merged image from 98.4% (visibility of pixels) to 99.1% (visibility of pixels). Similarly, the processing time in our proposed solution is reduced, which is computed as 10 s to produce 50 frames, whilst, the state of art solution computes 11 s for the same number of frames. CONCLUSION The proposed system focuses on the merging of augmented reality video (local site), and the virtual reality video (remote site) with the accurate visualization. we consider discoloured areas, smudging artefacts and occlusion as the main aspects to improve the accuracy of merged video in terms of overlay error and visualization error. So, the proposed system would produce the merged video with the removal of artefacts around the expert surgeon hand.
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Affiliation(s)
| | - Abeer Alsadoon
- School of Computing and Mathematics, Charles Sturt University, Sydney, Australia.
| | - P W C Prasad
- School of Computing and Mathematics, Charles Sturt University, Sydney, Australia
| | | | - Sami Haddad
- Department of Oral and Maxillofacial Services, Greater Western Sydney Area Health Services, Sydney, Australia; Department of Oral and Maxillofacial Services, Central Coast Area Health, Australia
| | - Anand Deva
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Jeremy Hsu
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
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Park EJ, Yoon YT, Hong CK, Ha YR, Ahn JH. Randomized, noninferiority study between video versus hand ultrasound with wet foam dressing materials to simulate B-lines in lung ultrasound: A CONSORT-compliant article. Medicine (Baltimore) 2017; 96:e7642. [PMID: 28746228 PMCID: PMC5627854 DOI: 10.1097/md.0000000000007642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND This study evaluated the efficacy of a teaching method using simulated B-lines of hand ultrasound with a wet foam dressing material. METHODS This prospective, randomized, noninferiority study was conducted on emergency medical technician students without any relevant training in ultrasound. Following a lecture including simulated (SG) or real video clips (RG) of B-lines, a posttest was conducted and a retention test was performed after 2 months. The test consisted of questions about B-lines in 40 randomly mixed video clips (20 simulated and 20 real videos) with 4 answer scores (R-1 [the correct answer score for the real video clips] vs S-1 [the correct answer score for the simulated video clips] in the posttest, R-2 [the correct answer score for the real video clips] vs S-2 [the correct answer score for the simulated video clips] in the retention test). RESULTS A total of 77 and 73 volunteers participated in the posttest (RG, 38; SG, 39) and retention test (RG, 36; SG, 37), respectively. There was no significant (P > .05) difference in scores of R-1, S-1, R-2, or S-2 between RG and SG. The mean score differences between RG and SG were -0.6 (95% confidence interval [CI]: -1.49 to 0.11) in R-1, -0.1 (95% CI: -1.04 to 0.86) in S-1, 0 (95% CI: -1.57 to 1.50) in R-2, and -0.2 (95% CI: -1.52 to 0.25) in S-2. The mean differences and 95% CIs for all parameters fell within the noninferiority margin of 2 points (10%). CONCLUSION Simulated B-lines of hand ultrasound with a wet foam dressing material were not inferior to real B-lines. They were effective for teaching and simulations. TRIAL REGISTRATION The study was registered with the Clinical Trial Registry of Korea: https://cris.nih.go.kr/cris/index.jsp (KCT0002144).
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Affiliation(s)
- Eun Jung Park
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon
| | - Young Tak Yoon
- Department of Emergency Medicine, Bundang Jesaeng General Hospital, Sungnam-si, Republic of Korea
| | - Chong Kun Hong
- Department of Emergency Medicine, Bundang Jesaeng General Hospital, Sungnam-si, Republic of Korea
| | - Young Rock Ha
- Department of Emergency Medicine, Bundang Jesaeng General Hospital, Sungnam-si, Republic of Korea
| | - Jung Hwan Ahn
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon
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Mura M, Parrini S, Ciuti G, Ferrari V, Freschi C, Ferrari M, Dario P, Menciassi A. A computer-assisted robotic platform for vascular procedures exploiting 3D US-based tracking. Comput Assist Surg (Abingdon) 2016; 21:63-79. [DOI: 10.1080/24699322.2016.1185467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Marco Mura
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
| | | | - Gastone Ciuti
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
| | | | | | | | - Paolo Dario
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
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Patient-specific ultrasound liver phantom: materials and fabrication method. Int J Comput Assist Radiol Surg 2014; 10:1065-75. [DOI: 10.1007/s11548-014-1120-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 09/15/2014] [Indexed: 10/24/2022]
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