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D'Aiello AF, Bognoni L, Bevilacqua F, Negura DG, Ferrero P, Micheletti A, Giamberti A, Militaru S, Militaru C, Chessa M. Holographic Techniques as a Novel Method for Intervention Planning: A Tertiary Centres Experience. CURRENT HEALTH SCIENCES JOURNAL 2023; 49:584-593. [PMID: 38559839 PMCID: PMC10976210 DOI: 10.12865/chsj.49.04.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 10/07/2023] [Indexed: 04/04/2024]
Abstract
Advanced holographic visualization techniques are becoming increasingly important in clinical practice, not only for diagnostic purposes but also in the planning of interventional or surgical procedures. The traditional approach for visualizing anatomic structures is based on standard imaging modalities such as echocardiography, cardiac magnetic resonance (CMR) and cardiac CT scan (CCT) which, however, can only provide two-dimensional (2D) images thus limiting 3D perception. Many recent studies have shown that the use of 3D imaging modalities such as augmented reality, virtual reality, mixed reality and holography improve the short and long-term outcome of percutaneous or surgical procedures. In this article, we report our experience on the use of the hologram in different clinical scenarios and in the field of university education.
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Affiliation(s)
- Angelo Fabio D'Aiello
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
| | - Ludovica Bognoni
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
| | - Francesca Bevilacqua
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
| | - Diana Gabriela Negura
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
| | - Paolo Ferrero
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
| | - Angelo Micheletti
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
| | - Alessandro Giamberti
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
| | - Sebastian Militaru
- Department of Cardiology, University of Medicine and Pharmacy of Craiova, Romania
| | - Constantin Militaru
- Department of Cardiology, University of Medicine and Pharmacy of Craiova, Romania
| | - Massimo Chessa
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
- Vita Salute San Raffaele University, Milan, Italy
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d'Aiello AF, Cabitza F, Natali C, Viganò S, Ferrero P, Bognoni L, Pasqualin G, Giamberti A, Chessa M. The Effect of Holographic Heart Models and Mixed Reality for Anatomy Learning in Congenital Heart Disease: An Exploratory Study. J Med Syst 2023; 47:64. [PMID: 37195484 PMCID: PMC10191923 DOI: 10.1007/s10916-023-01959-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/26/2023] [Indexed: 05/18/2023]
Abstract
In this paper, we present an exploratory study on the potential impact of holographic heart models and mixed reality technology on medical training, and in particular in teaching complex Congenital Heart Diseases (CHD) to medical students. Fifty-nine medical students were randomly allocated into three groups. Each participant in each group received a 30-minute lecture on a CHD condition interpretation and transcatheter treatment with different instructional tools. The participants of the first group attended a lecture in which traditional slides were projected onto a flat screen (group "regular slideware", RS). The second group was shown slides incorporating videos of holographic anatomical models (group "holographic videos", HV). Finally, those in the third group wore immersive, head-mounted devices (HMD) to interact directly with holographic anatomical models (group "mixed reality", MR). At the end of the lecture, the members of each group were asked to fill in a multiple-choice questionnaire aimed at evaluating their topic proficiency, as a proxy to evaluate the effectiveness of the training session (in terms of acquired notions); participants from group MR were also asked to fill in a questionnaire regarding the recommendability and usability of the MS Hololens HMDs, as a proxy of satisfaction regarding its use experience (UX). The findings show promising results for usability and user acceptance.
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Affiliation(s)
- Angelo Fabio d'Aiello
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
- European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart), Milan, Italy
| | - Federico Cabitza
- Department of Informatics, Systems and Communication, University of Milano-Bicocca, viale Sarca 336, Milano, 20126, Italy.
- IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso 173, Milano, 20157, Italy.
| | - Chiara Natali
- Department of Informatics, Systems and Communication, University of Milano-Bicocca, viale Sarca 336, Milano, 20126, Italy
| | - Sophia Viganò
- Department of Informatics, Systems and Communication, University of Milano-Bicocca, viale Sarca 336, Milano, 20126, Italy
| | - Paolo Ferrero
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
- European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart), Milan, Italy
| | - Ludovica Bognoni
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
| | - Giulia Pasqualin
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
- European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart), Milan, Italy
| | - Alessandro Giamberti
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
- European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart), Milan, Italy
| | - Massimo Chessa
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Italy
- European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart), Milan, Italy
- School of Medicine and Surgery, Vita e Salute San Raffaele University, Via Olgettina 58, Milano, 20132, Italy
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Veer V, Phelps C, Moro C. Incorporating Mixed Reality for Knowledge Retention in Physiology, Anatomy, Pathology, and Pharmacology Interdisciplinary Education: A Randomized Controlled Trial. MEDICAL SCIENCE EDUCATOR 2022; 32:1579-1586. [PMID: 36532413 PMCID: PMC9755411 DOI: 10.1007/s40670-022-01635-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 06/17/2023]
Abstract
Disease education is a fundamental component in health science and medicine curricula, as it prepares students for their progression into health profession careers. However, this requires an ability to integrate concepts across multiple disciplines. Technology-enhanced interventions may bridge this gap, and this study assessed the effectiveness of a textbook-style or a three-dimensional mixed reality (MR, a hybrid of augmented and virtual reality) HoloLens resource for student learning and knowledge retention using asthma as a model of disease. Sixty-seven first-year undergraduate health science and medical students were randomized into two groups to complete a lesson on the physiology, anatomy, pathology, and pharmacology of asthma, delivered through either a textbook-style (n = 34) or MR (n = 33) resource. Participants took part in the study in small groups and completed the intervention and surveys in separate areas of a large laboratory space. A pre-test prior to the lesson included multiple-choice questions, with the post-test having additional multiple-choice questions to assess learning. A follow-up test to assess retention was performed two weeks later. Pre- and post-test scores revealed increased learning across both the textbook (p = 0.001) and MR (p = 0.05) interventions, although higher test results were obtained by those using the textbook-style resource (p < 0.05). There was no difference between groups in knowledge retention scores. Although the textbook-style resource was more effective for increasing test results, participants perceived MR as more favorable, highlighting the experience as enjoyable and useful. This study presents MR as an option for integration in cases where educators wish to enhance student enjoyment of the learning experience. However, the results suggest that traditional text-based resources persist as a fundamental delivery mode within a modern curriculum.
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Affiliation(s)
- Vineesha Veer
- Faculty of Health Sciences and Medicine, Bond, University, Gold Coast, Australia
| | - Charlotte Phelps
- Faculty of Health Sciences and Medicine, Bond, University, Gold Coast, Australia
| | - Christian Moro
- Faculty of Health Sciences and Medicine, Bond, University, Gold Coast, Australia
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Abstract
Augmented reality (AR) is an innovative system that enhances the real world by superimposing virtual objects on reality. The aim of this study was to analyze the application of AR in medicine and which of its technical solutions are the most used. We carried out a scoping review of the articles published between 2019 and February 2022. The initial search yielded a total of 2649 articles. After applying filters, removing duplicates and screening, we included 34 articles in our analysis. The analysis of the articles highlighted that AR has been traditionally and mainly used in orthopedics in addition to maxillofacial surgery and oncology. Regarding the display application in AR, the Microsoft HoloLens Optical Viewer is the most used method. Moreover, for the tracking and registration phases, the marker-based method with a rigid registration remains the most used system. Overall, the results of this study suggested that AR is an innovative technology with numerous advantages, finding applications in several new surgery domains. Considering the available data, it is not possible to clearly identify all the fields of application and the best technologies regarding AR.
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Kiraly L, Shah NC, Abdullah O, Al-Ketan O, Rowshan R. Three-Dimensional Virtual and Printed Prototypes in Complex Congenital and Pediatric Cardiac Surgery-A Multidisciplinary Team-Learning Experience. Biomolecules 2021; 11:1703. [PMID: 34827702 PMCID: PMC8615737 DOI: 10.3390/biom11111703] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 12/15/2022] Open
Abstract
Three-dimensional (3D) virtual modeling and printing advances individualized medicine and surgery. In congenital cardiac surgery, 3D virtual models and printed prototypes offer advantages of better understanding of complex anatomy, hands-on preoperative surgical planning and emulation, and improved communication within the multidisciplinary team and to patients. We report our single center team-learning experience about the realization and validation of possible clinical benefits of 3D-printed models in surgical planning of complex congenital cardiac surgery. CT-angiography raw data were segmented into 3D-virtual models of the heart-great vessels. Prototypes were 3D-printed as rigid "blood-volume" and flexible "hollow". The accuracy of the models was evaluated intraoperatively. Production steps were realized in the framework of a clinical/research partnership. We produced 3D prototypes of the heart-great vessels for 15 case scenarios (nine males, median age: 11 months) undergoing complex intracardiac repairs. Parity between 3D models and intraoperative structures was within 1 mm range. Models refined diagnostics in 13/15, provided new anatomic information in 9/15. As a team-learning experience, all complex staged redo-operations (13/15; Aristotle-score mean: 10.64 ± 1.95) were rehearsed on the 3D models preoperatively. 3D-printed prototypes significantly contributed to an improved/alternative operative plan on the surgical approach, modification of intracardiac repair in 13/15. No operative morbidity/mortality occurred. Our clinical/research partnership provided coverage for the extra time/labor and material/machinery not financed by insurance. 3D-printed models provided a team-learning experience and contributed to the safety of complex congenital cardiac surgeries. A clinical/research partnership may open avenues for bioprinting of patient-specific implants.
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Affiliation(s)
- Laszlo Kiraly
- Division of Pediatric Cardiac Surgery, Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi P.O. Box 51900, United Arab Emirates
- Department of Public Health, Semmelweis University, H-1085 Budapest, Hungary
- Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital System, 1E Kent Ridge Road, NUHS Tower Block, Level 9, Singapore 119228, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 8, Singapore 119228, Singapore
| | - Nishant C. Shah
- Division of Pediatric Cardiology, Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi P.O. Box 51900, United Arab Emirates;
| | - Osama Abdullah
- Core Technology Platform Operations, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates; (O.A.); (O.A.-K.); (R.R.)
| | - Oraib Al-Ketan
- Core Technology Platform Operations, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates; (O.A.); (O.A.-K.); (R.R.)
| | - Reza Rowshan
- Core Technology Platform Operations, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates; (O.A.); (O.A.-K.); (R.R.)
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Rai AT, Deib G, Smith D, Boo S. Teleproctoring for Neurovascular Procedures: Demonstration of Concept Using Optical See-Through Head-Mounted Display, Interactive Mixed Reality, and Virtual Space Sharing-A Critical Need Highlighted by the COVID-19 Pandemic. AJNR Am J Neuroradiol 2021; 42:1109-1115. [PMID: 33707282 PMCID: PMC8191671 DOI: 10.3174/ajnr.a7066] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/11/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE Physician training and onsite proctoring are critical for safely introducing new biomedical devices, a process that has been disrupted by the pandemic. A teleproctoring concept using optical see-through head-mounted displays with a proctor's ability to see and, more important, virtually interact in the operator's visual field is presented. MATERIALS AND METHODS Test conditions were created for simulated proctoring using a bifurcation aneurysm flow model for WEB device deployment. The operator in the angiography suite wore a Magic Leap-1 optical see-through head-mounted display to livestream his or her FOV to a proctor's computer in an adjacent building. A Web-based application (Spatial) was used for the proctor to virtually interact in the operator's visual space. Tested elements included the quality of the livestream, communication, and the proctor's ability to interact in the operator's environment using mixed reality. A hotspot and a Wi-Fi-based network were tested. RESULTS The operator successfully livestreamed the angiography room environment and his FOV of the monitor to the remotely located proctor. The proctor communicated and guided the operator through the procedure over the optical see-through head-mounted displays, a process that was repeated several times. The proctor used mixed reality and virtual space sharing to successfully project images, annotations, and data in the operator's FOV for highlighting any device or procedural aspects. The livestream latency was 0.71 (SD, 0.03) seconds for Wi-Fi and 0.86 (SD, 0.3) seconds for the hotspot (P = .02). The livestream quality was subjectively better over the Wi-Fi. CONCLUSIONS New technologies using head-mounted displays and virtual space sharing could offer solutions applicable to remote proctoring in the neurointerventional space.
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Affiliation(s)
- A T Rai
- From the Department of Interventional Neuroradiology (A.T.R., G.D., S.B.), Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, West Virginia
| | - G Deib
- From the Department of Interventional Neuroradiology (A.T.R., G.D., S.B.), Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, West Virginia
| | - D Smith
- West Virginia University Reed College of Media (D.S.), Morgantown, West Virginia
| | - S Boo
- From the Department of Interventional Neuroradiology (A.T.R., G.D., S.B.), Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, West Virginia
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