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Saemann A, Schmid S, Licci M, Zelechowski M, Faludi B, Cattin PC, Soleman J, Guzman R. Enhancing educational experience through establishing a VR database in craniosynostosis: report from a single institute and systematic literature review. Front Surg 2024; 11:1440042. [PMID: 39296348 PMCID: PMC11408475 DOI: 10.3389/fsurg.2024.1440042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/16/2024] [Indexed: 09/21/2024] Open
Abstract
Background Craniosynostosis is a type of skull deformity caused by premature ossification of cranial sutures in children. Given its variability and anatomical complexity, three-dimensional visualization is crucial for effective teaching and understanding. We developed a VR database with 3D models to depict these deformities and evaluated its impact on teaching efficiency, motivation, and memorability. Methods We included all craniosynostosis cases with preoperative CT imaging treated at our institution from 2012 to 2022. Preoperative CT scans were imported into SpectoVR using a transfer function to visualize bony structures. Measurements, sub-segmentation, and anatomical teaching were performed in a fully immersive 3D VR experience using a headset. Teaching sessions were conducted in group settings where students and medical personnel explored and discussed the 3D models together, guided by a host. Participants' experiences were evaluated with a questionnaire assessing understanding, memorization, and motivation on a scale from 1 (poor) to 5 (outstanding). Results The questionnaire showed high satisfaction scores (mean 4.49 ± 0.25). Participants (n = 17) found the VR models comprehensible and navigable (mean 4.47 ± 0.62), with intuitive operation (mean 4.35 ± 0.79). Understanding pathology (mean 4.29 ± 0.77) and surgical procedures (mean 4.63 ± 0.5) was very satisfactory. The models improved anatomical visualization (mean 4.71 ± 0.47) and teaching effectiveness (mean 4.76 ± 0.56), with participants reporting enhanced comprehension and memorization, leading to an efficient learning process. Conclusion Establishing a 3D VR database for teaching craniosynostosis shows advantages in understanding and memorization and increases motivation for the study process, thereby allowing for more efficient learning. Future applications in patient consent and teaching in other medical areas should be explored.
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Affiliation(s)
- Attill Saemann
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
| | - Sina Schmid
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
| | - Maria Licci
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
| | - Marek Zelechowski
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Balazs Faludi
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Philippe C Cattin
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Jehuda Soleman
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Raphael Guzman
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
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Alam I, Garg K, Kumar AG, Raheja A, Shah H, Pandey K, Sharma R, Mishra S, Tandon V, Singh M, Ahmad FU, Suri A, Kale SS. Beyond Traditional Training: Exploring the Benefits of Virtual Reality Simulator in Lumbar Pedicle Screw Insertion - A Randomized Controlled Trial. World Neurosurg 2024; 189:e61-e68. [PMID: 38825310 DOI: 10.1016/j.wneu.2024.05.163] [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: 03/22/2024] [Revised: 05/26/2024] [Accepted: 05/26/2024] [Indexed: 06/04/2024]
Abstract
INTRODUCTION This study compares the effectiveness of virtual reality simulators (VRS) and a saw bone model for learning lumbar pedicle screw insertion (LPSI) in neurosurgery. METHODS A single-center, cross-sectional, randomized controlled laboratory investigation was conducted involving residents and fellows from a tertiary care referral hospital. Participants were divided into two groups (A and B). Group A performed 3 LPSI tasks: the first on a saw bone model, the second on VRS, and the third on another saw bone model. Group B completed 2 LPSI tasks: the first on a saw bone model and the second on another saw bone model. The accuracy of LPSI was evaluated through noncontrast computed tomography scans for the saw bone models, while the in-built application of VRS was utilized to check for accuracy of screw placement using the simulator. RESULTS The study included 38 participants (19 in each group). Group A participants showed reduced mean entry point error (0.11 mm, P 0.024), increased mean purchase length (4.66 cm, P 0.007), and no cortical breaches (P 0.031) when placing the second saw bone model screw. Similar improvements were observed among group A participants in PGY 1-3 while placing the second saw bone model screws. CONCLUSIONS Virtual reality simulators (VRS) prove to be an invaluable tool for teaching complex neurosurgical skills, such as LPSI, to trainees. This technology investment can enhance the learning curve while maintaining patient safety.
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Affiliation(s)
- Intekhab Alam
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Akshay Ganesh Kumar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Het Shah
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kushagra Pandey
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ravi Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shashwat Mishra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Tandon
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Manmohan Singh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Faiz U Ahmad
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shashank Sharad Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Pongeluppi RI, Coelho G, Ballestero MFM, Aragon DC, Colli BO, Santos de Oliveira R. Development and Evaluation of a Mixed Reality Model for Training the Retrosigmoid Approach. World Neurosurg 2024; 189:e459-e466. [PMID: 38906470 DOI: 10.1016/j.wneu.2024.06.085] [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: 06/11/2024] [Accepted: 06/15/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND The use of simulation has the potential to accelerate the learning curves and increase the efficiency of surgeons. However, there is currently a scarcity in models dedicated to skull base surgical approaches. Thus, the objective of this study was to develop a cost-effective mixed reality system consisting of an ultrarealistic physical model and augmented reality and evaluate its use in training surgeons on the retrosigmoid approach. METHODS The virtual models were developed from images of patients with vestibular schwannoma. The tumor was mirrored to allow bilateral approaches and the model has drawers for repositioning structures, allowing reuse of the material and cost reduction. Pre and posttest assessments were applied to 10 residents and young neurosurgeons, divided into control and test groups. Only the control group was exposed to the model. The difference in scores obtained by participants before and after exposure to the models was considered for analysis and participants in the control group answered self-satisfaction questionnaires. RESULTS The mean differences were 4.80 in the control group (95% credibility intervals=1.08-9.79) and 5.43 in the test group (95% credibility intervals=1.67-8.20). The average score of the self-satisfaction questionnaires was 24.0 (23-25). CONCLUSIONS The ultrarealistic model efficiently allowed retromastoid access to the cerebellopontine angle. A tendency toward greater gains in performance in the group exposed to the model was verified. Scores from the self-satisfaction questionnaires demonstrated that participants considered the model relevant for neurosurgical training and increased confidence among surgeons.
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Affiliation(s)
- Rodrigo Inacio Pongeluppi
- Division of Neurosurgery, University Hospital, Medical School of Ribeirão Preto, University of Sao Paulo, Sao Paulo, Brazil.
| | - Giselle Coelho
- Department of Surgery, Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil
| | | | - Davi Casale Aragon
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Sao Paulo, Brazil
| | - Benedicto Oscar Colli
- Division of Neurosurgery, University Hospital, Medical School of Ribeirão Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Ricardo Santos de Oliveira
- Division of Neurosurgery, University Hospital, Medical School of Ribeirão Preto, University of Sao Paulo, Sao Paulo, Brazil
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Qi Z, Corr F, Grimm D, Nimsky C, Bopp MHA. Extended Reality-Based Head-Mounted Displays for Surgical Education: A Ten-Year Systematic Review. Bioengineering (Basel) 2024; 11:741. [PMID: 39199699 PMCID: PMC11351461 DOI: 10.3390/bioengineering11080741] [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: 07/01/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 09/01/2024] Open
Abstract
Surgical education demands extensive knowledge and skill acquisition within limited time frames, often limited by reduced training opportunities and high-pressure environments. This review evaluates the effectiveness of extended reality-based head-mounted display (ExR-HMD) technology in surgical education, examining its impact on educational outcomes and exploring its strengths and limitations. Data from PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, ACM Digital Library, IEEE Xplore, WorldCat, and Google Scholar (Year: 2014-2024) were synthesized. After screening, 32 studies comparing ExR-HMD and traditional surgical training methods for medical students or residents were identified. Quality and bias were assessed using the Medical Education Research Study Quality Instrument, Newcastle-Ottawa Scale-Education, and Cochrane Risk of Bias Tools. Results indicate that ExR-HMD offers benefits such as increased immersion, spatial awareness, and interaction and supports motor skill acquisition theory and constructivist educational theories. However, challenges such as system fidelity, operational inconvenience, and physical discomfort were noted. Nearly half the studies reported outcomes comparable or superior to traditional methods, emphasizing the importance of social interaction. Limitations include study heterogeneity and English-only publications. ExR-HMD shows promise but needs educational theory integration and social interaction. Future research should address technical and economic barriers to global accessibility.
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Affiliation(s)
- Ziyu Qi
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (F.C.); (D.G.); (C.N.)
- Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Felix Corr
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (F.C.); (D.G.); (C.N.)
| | - Dustin Grimm
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (F.C.); (D.G.); (C.N.)
| | - Christopher Nimsky
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (F.C.); (D.G.); (C.N.)
- Center for Mind, Brain and Behavior (CMBB), 35043 Marburg, Germany
| | - Miriam H. A. Bopp
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (F.C.); (D.G.); (C.N.)
- Center for Mind, Brain and Behavior (CMBB), 35043 Marburg, Germany
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Isikay I, Cekic E, Baylarov B, Tunc O, Hanalioglu S. Narrative review of patient-specific 3D visualization and reality technologies in skull base neurosurgery: enhancements in surgical training, planning, and navigation. Front Surg 2024; 11:1427844. [PMID: 39081485 PMCID: PMC11287220 DOI: 10.3389/fsurg.2024.1427844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/02/2024] [Indexed: 08/02/2024] Open
Abstract
Recent advances in medical imaging, computer vision, 3-dimensional (3D) modeling, and artificial intelligence (AI) integrated technologies paved the way for generating patient-specific, realistic 3D visualization of pathological anatomy in neurosurgical conditions. Immersive surgical simulations through augmented reality (AR), virtual reality (VR), mixed reality (MxR), extended reality (XR), and 3D printing applications further increased their utilization in current surgical practice and training. This narrative review investigates state-of-the-art studies, the limitations of these technologies, and future directions for them in the field of skull base surgery. We begin with a methodology summary to create accurate 3D models customized for each patient by combining several imaging modalities. Then, we explore how these models are employed in surgical planning simulations and real-time navigation systems in surgical procedures involving the anterior, middle, and posterior cranial skull bases, including endoscopic and open microsurgical operations. We also evaluate their influence on surgical decision-making, performance, and education. Accumulating evidence demonstrates that these technologies can enhance the visibility of the neuroanatomical structures situated at the cranial base and assist surgeons in preoperative planning and intraoperative navigation, thus showing great potential to improve surgical results and reduce complications. Maximum effectiveness can be achieved in approach selection, patient positioning, craniotomy placement, anti-target avoidance, and comprehension of spatial interrelationships of neurovascular structures. Finally, we present the obstacles and possible future paths for the broader implementation of these groundbreaking methods in neurosurgery, highlighting the importance of ongoing technological advancements and interdisciplinary collaboration to improve the accuracy and usefulness of 3D visualization and reality technologies in skull base surgeries.
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Affiliation(s)
- Ilkay Isikay
- Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Efecan Cekic
- Neurosurgery Clinic, Polatli Duatepe State Hospital, Ankara, Türkiye
| | - Baylar Baylarov
- Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Osman Tunc
- Btech Innovation, METU Technopark, Ankara, Türkiye
| | - Sahin Hanalioglu
- Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
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Sumunar DSEW, Stathakarou N, Davoody N. User acceptance of neuroanatomy virtual reality course: Contrasting views between undergraduate and postgraduate students. Health Informatics J 2024; 30:14604582241260601. [PMID: 38838637 DOI: 10.1177/14604582241260601] [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] [Indexed: 06/07/2024]
Abstract
Virtual Reality (VR) offers cost-efficient and effective tools for spatial 3-dimensional neuroanatomy learning. Enhancing users-system relationship is necessary for successful adoption of the system. The current study aimed to evaluate students' acceptance of VR for neuroanatomy. An exploratory qualitative case study based on Unified Theory of Acceptance and Use of Technology (UTAUT) framework carried out at [details omitted for double-anonymized peer review]. Participants in this study were students participating in a VR session, followed by a semi-structured interview. Deductive framework analysis employed to retrieve students' perspective and experience. A total of six undergraduate and 13 postgraduate students participated in this study. The following UTAUT constructs validated to be significant: Performance Expectancy, Effort Expectancy and Facilitating Conditions. System usability, depth of lesson and hardware optimizations are among concern for further improvements. In conclusion, students are accepting VR as a neuroanatomy learning resource. The findings of this research highlight the importance of system performance and user-centred approach in technology development for educational purposes.
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Affiliation(s)
- Dimas Septian Eko Wahyu Sumunar
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden
- Department of Health Policy and Management, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Natalia Stathakarou
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden
| | - Nadia Davoody
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden
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González-López P, Kuptsov A, Gómez-Revuelta C, Fernández-Villa J, Abarca-Olivas J, Daniel RT, Meling TR, Nieto-Navarro J. The Integration of 3D Virtual Reality and 3D Printing Technology as Innovative Approaches to Preoperative Planning in Neuro-Oncology. J Pers Med 2024; 14:187. [PMID: 38392620 PMCID: PMC10890029 DOI: 10.3390/jpm14020187] [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: 12/16/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Our study explores the integration of three-dimensional (3D) virtual reality (VR) and 3D printing in neurosurgical preoperative planning. Traditionally, surgeons relied on two-dimensional (2D) imaging for complex neuroanatomy analyses, requiring significant mental visualization. Fortunately, nowadays advanced technology enables the creation of detailed 3D models from patient scans, utilizing different software. Afterwards, these models can be experienced through VR systems, offering comprehensive preoperative rehearsal opportunities. Additionally, 3D models can be 3D printed for hands-on training, therefore enhancing surgical preparedness. This technological integration transforms the paradigm of neurosurgical planning, ensuring safer procedures.
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Affiliation(s)
- Pablo González-López
- Department of Neurosurgery, Hospital General Universitario, 03010 Alicante, Spain
| | - Artem Kuptsov
- Department of Neurosurgery, Hospital General Universitario, 03010 Alicante, Spain
| | | | | | - Javier Abarca-Olivas
- Department of Neurosurgery, Hospital General Universitario, 03010 Alicante, Spain
| | - Roy T Daniel
- Centre Hospitalier Universitaire Vaudois, 1005 Lausanne, Switzerland
| | - Torstein R Meling
- Department of Neurosurgery, Rigshospitalet, 92100 Copenhagen, Denmark
| | - Juan Nieto-Navarro
- Department of Neurosurgery, Hospital General Universitario, 03010 Alicante, Spain
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Ruparelia J, Manjunath N, Nachiappan DS, Raheja A, Suri A. Virtual Reality in Preoperative Planning of Complex Cranial Surgery. World Neurosurg 2023; 180:e11-e18. [PMID: 37307986 DOI: 10.1016/j.wneu.2023.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Changing paradigms of neurosurgical training and limited operative exposure during the residency period have made it necessary to evaluate newer technologies for training. Virtual reality (VR) technology provides three-dimensional reconstruction of routine imaging, along with the ability to see as well as interact. The application of VR technology in operative planning, which is an important part of neurosurgical training, has been incompletely studied so far. METHODS Sixteen final-year residents, post-M.Ch. (magister chirurgiae) residents, and fellows were included as study participants. They were divided into 2 groups based on their seniority for further analysis. Five complex cranial cases were selected and a multiple-choice question-based test was prepared by the authors, with 5 questions for each of the cases. The pretest score was determined based on performance on the test after participants accessed routine preoperative imaging. The posttest score was calculated after use of the VR system (ImmersiveTouch VR System, ImmersiveTouch Inc.). Analysis was performed by the investigators, who were blinded to the identity of the participant. Subanalysis based on the type of case and type of question was performed. Feedback was obtained from each participant regarding VR use. RESULTS There was an overall improvement in scores from pretest to posttest, which was also noted in the analysis based on the participants' seniority. This improvement was noted to be more for the vascular cases (15.89%) compared with the tumor cases (7.84%). Participants also fared better in questions related to surgical anatomy and surgical approach, compared with questions based on the diagnosis. There was overall positive feedback from participants regarding VR use, and most participants wanted VR to become a routine part of operative planning. CONCLUSIONS Our study shows that there is improvement in understanding of surgical aspects after use of this VR system.
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Affiliation(s)
- Jigish Ruparelia
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Niveditha Manjunath
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | - Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
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Hou X, Xu R, Chen L, Yang D, Li D. 3D color multimodality fusion imaging as an augmented reality educational and surgical planning tool for extracerebral tumors. Neurosurg Rev 2023; 46:280. [PMID: 37875636 DOI: 10.1007/s10143-023-02184-0] [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: 08/02/2023] [Revised: 08/26/2023] [Accepted: 10/14/2023] [Indexed: 10/26/2023]
Abstract
Extracerebral tumors often occur on the surface of the brain or at the skull base. It is important to identify the peritumoral sulci, gyri, and nerve fibers. Preoperative visualization of three-dimensional (3D) multimodal fusion imaging (MFI) is crucial for surgery. However, the traditional 3D-MFI brain models are homochromatic and do not allow easy identification of anatomical functional areas. In this study, 33 patients with extracerebral tumors without peritumoral edema were retrospectively recruited. They underwent 3D T1-weighted MRI, diffusion tensor imaging (DTI), and CT angiography (CTA) sequence scans. 3DSlicer, Freesurfer, and BrainSuite were used to explore 3D-color-MFI and preoperative planning. To determine the effectiveness of 3D-color-MFI as an augmented reality (AR) teaching tool for neurosurgeons and as a patient education and communication tool, questionnaires were administered to 15 neurosurgery residents and all patients, respectively. For neurosurgical residents, 3D-color-MFI provided a better understanding of surgical anatomy and more efficient techniques for removing extracerebral tumors than traditional 3D-MFI (P < 0.001). For patients, the use of 3D-color MFI can significantly improve their understanding of the surgical approach and risks (P < 0.005). 3D-color-MFI is a promising AR tool for extracerebral tumors and is more useful for learning surgical anatomy, developing surgical strategies, and improving communication with patients.
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Affiliation(s)
- Xiaolin Hou
- Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 61173, China
| | - Ruxiang Xu
- Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 61173, China.
| | - Longyi Chen
- Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 61173, China.
| | - Dongdong Yang
- The Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Dingjun Li
- Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 61173, China
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Shao X, Qiang D, Yuan Q. A new neuroanatomical two-dimensional fitting three-dimensional imaging techniques in neuroanatomy education. BMC MEDICAL EDUCATION 2023; 23:333. [PMID: 37179320 PMCID: PMC10183128 DOI: 10.1186/s12909-023-04323-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Neuroanatomy is the most abstract and complex anatomy. Neurosurgeons have to spend plenty of time mastering the nuances of the autopsy. However, the laboratory that can meet the requirements of neurosurgery microanatomy is only owned by several large medical colleges because it is an expensive affair. Thus, laboratories worldwide are searching for substitutes,but the reality and local details might not meet the exact requirements of the anatomical structure. Herein, we compared the traditional teaching mode, the 3D image generated by the current advanced hand-held scanner and our self-developed 2D image fitting 3D imaging method in the comparative study of neuroanatomy education. METHODS To examine the efficacy of two-dimensional fitting three-dimensional imaging techniques in neuroanatomy education. 60 clinical students of grade 2020 in Wannan Medical College were randomly divided into traditional teaching group, hand held scanner 3D imaging group and 2D fitting 3D method group, with 20 students in each group.First, the modeling images of the hand held scanner 3D imaging group and the 2D fitting 3D method group are analyzed and compared, and then the teaching results of the three groups are evaluated by objective and subjective evaluation methods. The objective evaluation is in the form of examination papers, unified proposition and unified score; The subjective evaluation is conducted in the form of questionnaires to evaluate. RESULTS The modeling and image analysis of the current advanced hand-held 3D imaging scanner and our self-developed 2D fitting 3D imaging method were compared.The images (equivalent to 1, 10, and 40 × magnification) of the model points and polygons using the Cinema 4D R19 virtual camera of 50, 500, and 2000 mm showed 1,249,955 points and 2,500,122 polygons in the skull data obtained using the hand-held scanner. The 3D model data of the skull consisted of 499,914 points, while the number of polygons reached up to 60,000,000, which was about fourfold that of the hand-held 3D scanning. This model used 8 K mapping technology, and hand-held scanner 3D imaging 3D scanning modeling used a 0.13 K map based on the map data, thereby indicating that the 2D fitting 3D imaging method is delicate and real. Comparative analysis of general data of three groups of students.The comparison of test results, clinical practice assessment and teaching satisfaction of the three groups shows that the performance of hand held scanner 3D imaging group is better than that of traditional teaching group (P < 0.01), and that of 2D fitting 3D method group is significantly better than that of traditional teaching group (P < 0.01). CONCLUSIONS The method used in this study can achieve real reduction. Compared to hand-held scanning, this method is more cost-effective than the cost of the equipment and the results. Moreover, the post-processing is easy to master, and the autopsy can be performed easily after learning, negating the need to seek professional help. It has a wide application prospect in teaching.
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Affiliation(s)
- Xuefei Shao
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical Collgeg (Yijishan Hospital of Wannan Medical Collgeg), Wuhu, China
| | - Di Qiang
- Department of Dermatology and STD, The First Affiliated Hospital of Wannan Medical Collgeg (Yijishan Hospital of Wannan Medical Collgeg), Wuhu, China
| | - Quan Yuan
- Department of Imaging, The First Affiliated Hospital of Wannan Medical Collgeg (Yijishan Hospital of Wannan Medical Collgeg), No.22 Road, Wuhu city, 241002, Anhui Province, China.
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Gurses ME, Hanalioglu S, Mignucci-Jiménez G, Gökalp E, Gonzalez-Romo NI, Gungor A, Cohen-Gadol AA, Türe U, Lawton MT, Preul MC. Three-Dimensional Modeling and Extended Reality Simulations of the Cross-Sectional Anatomy of the Cerebrum, Cerebellum, and Brainstem. Oper Neurosurg (Hagerstown) 2023:01787389-990000000-00693. [PMID: 37083688 DOI: 10.1227/ons.0000000000000703] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/06/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Understanding the anatomy of the human cerebrum, cerebellum, and brainstem and their 3-dimensional (3D) relationships is critical for neurosurgery. Although 3D photogrammetric models of cadaver brains and 2-dimensional images of postmortem brain slices are available, neurosurgeons lack free access to 3D models of cross-sectional anatomy of the cerebrum, cerebellum, and brainstem that can be simulated in both augmented reality (AR) and virtual reality (VR). OBJECTIVE To create 3D models and AR/VR simulations from 2-dimensional images of cross-sectionally dissected cadaveric specimens of the cerebrum, cerebellum, and brainstem. METHODS The Klingler method was used to prepare 3 cadaveric specimens for dissection in the axial, sagittal, and coronal planes. A series of 3D models and AR/VR simulations were then created using 360° photogrammetry. RESULTS High-resolution 3D models of cross-sectional anatomy of the cerebrum, cerebellum, and brainstem were obtained and used in creating AR/VR simulations. Eleven axial, 9 sagittal, and 7 coronal 3D models were created. The sections were planned to show important deep anatomic structures. These models can be freely rotated, projected onto any surface, viewed from all angles, and examined at various magnifications. CONCLUSION To our knowledge, this detailed study is the first to combine up-to-date technologies (photogrammetry, AR, and VR) for high-resolution 3D visualization of the cross-sectional anatomy of the entire human cerebrum, cerebellum, and brainstem. The resulting 3D images are freely available for use by medical professionals and students for better comprehension of the 3D relationship of the deep and superficial brain anatomy.
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Affiliation(s)
- Muhammet Enes Gurses
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Sahin Hanalioglu
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Giancarlo Mignucci-Jiménez
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Elif Gökalp
- Department of Neurosurgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nicolas I Gonzalez-Romo
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Abuzer Gungor
- Department of Neurosurgery, Yeditepe University Faculty of Medicine, Istanbul, Turkey
| | - Aaron A Cohen-Gadol
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
- The Neurosurgical Atlas, Carmel, Indiana, USA
| | - Uğur Türe
- Department of Neurosurgery, Yeditepe University Faculty of Medicine, Istanbul, Turkey
| | - Michael T Lawton
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Mark C Preul
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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12
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Gsaxner C, Li J, Pepe A, Jin Y, Kleesiek J, Schmalstieg D, Egger J. The HoloLens in medicine: A systematic review and taxonomy. Med Image Anal 2023; 85:102757. [PMID: 36706637 DOI: 10.1016/j.media.2023.102757] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/05/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
The HoloLens (Microsoft Corp., Redmond, WA), a head-worn, optically see-through augmented reality (AR) display, is the main player in the recent boost in medical AR research. In this systematic review, we provide a comprehensive overview of the usage of the first-generation HoloLens within the medical domain, from its release in March 2016, until the year of 2021. We identified 217 relevant publications through a systematic search of the PubMed, Scopus, IEEE Xplore and SpringerLink databases. We propose a new taxonomy including use case, technical methodology for registration and tracking, data sources, visualization as well as validation and evaluation, and analyze the retrieved publications accordingly. We find that the bulk of research focuses on supporting physicians during interventions, where the HoloLens is promising for procedures usually performed without image guidance. However, the consensus is that accuracy and reliability are still too low to replace conventional guidance systems. Medical students are the second most common target group, where AR-enhanced medical simulators emerge as a promising technology. While concerns about human-computer interactions, usability and perception are frequently mentioned, hardly any concepts to overcome these issues have been proposed. Instead, registration and tracking lie at the core of most reviewed publications, nevertheless only few of them propose innovative concepts in this direction. Finally, we find that the validation of HoloLens applications suffers from a lack of standardized and rigorous evaluation protocols. We hope that this review can advance medical AR research by identifying gaps in the current literature, to pave the way for novel, innovative directions and translation into the medical routine.
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Affiliation(s)
- Christina Gsaxner
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria.
| | - Jianning Li
- Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
| | - Antonio Pepe
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria
| | - Yuan Jin
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; Research Center for Connected Healthcare Big Data, Zhejiang Lab, Hangzhou, 311121 Zhejiang, China
| | - Jens Kleesiek
- Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
| | - Dieter Schmalstieg
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria
| | - Jan Egger
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; BioTechMed, 8010 Graz, Austria; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
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13
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Fan J. Theory and method for evaluating the importance of college course teaching for future education: From virtual reality to metaverse. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2023. [DOI: 10.3233/jifs-220931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
As the latest and most popular concept in the world, metaverse as well as its application and technology integration has attracted the attention of all walks of life including information, economics, management, design and education, etc. However, the definition of metaverse as a technology or an intelligent scene still has no unified consensus in the academic and scientific fields. We believe that the metaverse should be a key concept and emerging theory in the future field of wisdom. This research focuses on the evaluation of the importance of college teaching courses for future education in the context of the metaverse, and discusses which courses may be greatly affected by the concept of the metaverse. First, on the basis of analyzing the scholars’ understanding of the concept of the metaverse and related application research literature, we give the specific framework of this paper and the definition of the edu-metaverse, and propose a future intelligent teaching environment construction model based on the metaverse. It should be noted that our research is under the framework of the metaverse intelligent teaching construction model, and mainly focuses on the in-depth analysis of the teaching evaluation problem in colleges, which is a multi-attribute decision-making problem in the field of systems science. We propose an improved Pythagorean fuzzy multi-attribute decision-making method based on cumulative prospect theory, including improved scoring function, improved distance measure method, improved combination weighting method, etc., and construct a cumulative prospect value function. The proposed theory and method were applied to teaching courses of 10 majors in Chinese colleges to construct an importance evaluation indicator system. The importance of the courses was ranked, verifying the applicability and scientificity of the proposed method. The research content of this paper can provide a reference for the decision-making of Chinese education authorities. More importantly, the method proposed in this research is also universal, and can also provide theoretical support and experience reference for multi disciplines and fields, such as financial investment, engineering construction evaluation, enterprise management decision-making, and emergency management, etc.
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Affiliation(s)
- Jiongjiong Fan
- Ma’anshan Xiushan Experimental School, Ma’anshan City, China
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14
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Ng PY, Bing EG, Cuevas A, Aggarwal A, Chi B, Sundar S, Mwanahamuntu M, Mutebi M, Sullivan R, Parham GP. Virtual reality and surgical oncology. Ecancermedicalscience 2023; 17:1525. [PMID: 37113716 PMCID: PMC10129400 DOI: 10.3332/ecancer.2023.1525] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Indexed: 04/29/2023] Open
Abstract
More than 80% of people diagnosed with cancer will require surgery. However, less than 5% have access to safe, affordable and timely surgery in low- and middle-income countries (LMICs) settings mostly due to the lack of trained workforce. Since its creation, virtual reality (VR) has been heralded as a viable adjunct to surgical training, but its adoption in surgical oncology to date is poorly understood. We undertook a systematic review to determine the application of VR across different surgical specialties, modalities and cancer pathway globally between January 2011 and 2021. We reviewed their characteristics and respective methods of validation of 24 articles. The results revealed gaps in application and accessibility of VR with a proclivity for high-income countries and high-risk, complex oncological surgeries. There is a lack of standardisation of clinical evaluation of VR, both in terms of clinical trials and implementation science. While all VR illustrated face and content validity, only around two-third exhibited construct validity and predictive validity was lacking overall. In conclusion, the asynchrony between VR development and actual global cancer surgery demand means the technology is not effectively, efficiently and equitably utilised to realise its surgical capacity-building potential. Future research should prioritise cost-effective VR technologies with predictive validity for high demand, open cancer surgeries required in LMICs.
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Affiliation(s)
- Peng Yun Ng
- King’s College London, London WC2R 2LS, UK
- Guy’s and St Thomas’ Trust, London SE1 9R, UK
| | - Eric G Bing
- Institute for Leadership Impact, Southern Methodist University, Dallas, TX 75205, USA
| | - Anthony Cuevas
- Department of Teaching and Learning, Technology-Enhanced Immersive Learning Cluster, Annette Simmons School of Education and Human Development, Southern Methodist University, Dallas, TX 75205, USA
| | - Ajay Aggarwal
- King’s College London, London WC2R 2LS, UK
- Guy’s and St Thomas’ Trust, London SE1 9R, UK
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Benjamin Chi
- Icahn School of Medicine, New York, NY 10029-6574, USA
| | - Sudha Sundar
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B152TT, UK
- Pan Birmingham Gynaecological Cancer Centre, City Hospital, Birmingham, B187QH, UK
| | | | - Miriam Mutebi
- Department of Surgery, Aga Khan University Hospital, Nairobi 30270-00100, Kenya
| | - Richard Sullivan
- Conflict & Health Research Group, King’s College London, London WC2R 2LS, UK
| | - Groesbeck P Parham
- Department of Surgery, Aga Khan University Hospital, Nairobi 30270-00100, Kenya
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15
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Letter to the Editor Regarding "Utility of a Pilot Neurosurgical Operative Skills Boot Camp in Medical Student Training". World Neurosurg 2022; 167:249-250. [PMID: 36793175 DOI: 10.1016/j.wneu.2022.08.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/20/2022]
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16
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Singh R, Singh R, Baby B, Suri A. Effect of the Segmentation Threshold on Computed Tomography-Based Reconstruction of Skull Bones with Reference Optical Three-Dimensional Scanning. World Neurosurg 2022; 166:e34-e43. [PMID: 35718274 DOI: 10.1016/j.wneu.2022.06.050] [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: 04/07/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND A variety of applications related to neurosurgical procedures, education, and training require accurate reconstruction of the involved structures from the medical images such as computed tomography (CT). This study evaluates the quality of CT-based reconstruction of dry skull bones for advanced neurosurgical applications. The accuracy and precision of these models were examined with reference optical scanning. METHODS Three consecutive CT and optical scans of different skull bones were acquired and used to develop three-dimensional models. The accuracy of three-dimensional models was examined by manual inspection of the defined anatomical landmarks of the skull. Reproducibility was examined by deviation analysis of the models developed from repeated CT and optical scans. RESULTS Precision was excellent in both the techniques with less than 0.1 mm deviation error. On the interscan evaluation of the CT versus optical scan model, deviations of more than 0.1 mm were observed in 16 out of 21 instances. CT reconstruction using standard segmentation algorithms results in missing bone portions while using the default bone segmentation threshold. The segmentation threshold was varied to construct missing bone regions, and its effect on the iso-surface generation was evaluated. The threshold variation led to increased mean deviations of surfaces up to 0.6 mm. CONCLUSIONS The study reveals that bone structure, complexity, and segmentation threshold lead to CT reconstruction variability. The trade-off between the desirable model and accepted mean deviation should be considered as per traits of the desired application.
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Affiliation(s)
- Ramandeep Singh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Rajdeep Singh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Britty Baby
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India; Amar Nath and Shashi Khosla School of Information Technology, Indian Institute of Technology Delhi, New Delhi, India
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
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17
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Liu Y, Ma T, Huang X, Li T. Fuzzy theory and method for evaluating the importance of college course teaching for future education. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2022. [DOI: 10.3233/jifs-221671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As the latest and most popular concept in the world, metaverse as well as its application and technology integration has attracted the attention of all walks of life including information, economics, management, design and education, etc. However, the definition of metaverse as a technology or an intelligent scene still has no unified consensus in the academic and scientific fields. We believe that the metaverse should be a key concept and emerging theory in the future field of wisdom. This research focuses on the evaluation of the importance of college teaching courses for future education in the context of the metaverse, and discusses which courses may be greatly affected by the concept of the metaverse. First, on the basis of analyzing the scholars’ understanding of the concept of the metaverse and related application research literature, we give the specific framework of this paper and the definition of the edu-metaverse, and propose a future intelligent teaching environment construction model based on the metaverse. It should be noted that our research is under the framework of the metaverse intelligent teaching construction model, and mainly focuses on the in-depth analysis of the teaching evaluation problem in colleges, which is a multi-attribute decision-making problem in the field of systems science. We propose an improved Pythagorean fuzzy multi-attribute decision-making method based on cumulative prospect theory, including improved scoring function, improved distance measure method, improved combination weighting method, etc., and construct a cumulative prospect value function. The proposed theory and method were applied to teaching courses of 10 majors in Chinese colleges to construct an importance evaluation indicator system. The importance of the courses was ranked, verifying the applicability and scientificity of the proposed method. The research content of this paper can provide a reference for the decision-making of Chinese education authorities. More importantly, the method proposed in this research is also universal, and can also provide theoretical support and experience reference for multi disciplines and fields, such as financial investment, engineering construction evaluation, enterprise management decision-making, and emergency management, etc.
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Affiliation(s)
- Yuyang Liu
- School of Humanities, Jiangxi University of Finance and Economics, Nanchang, Jiangxi, China
- Jiangxi Brain Control Technology Co., Ltd., Nanchang, Jiangxi, China
| | - Tinghuai Ma
- College of Computer and Software, Nanjing University of Information Science & Technology, Nanjing, China
| | - Xuejian Huang
- College of Computer and Software, Nanjing University of Information Science & Technology, Nanjing, China
- VR Modern Industry College, Jiangxi University of Finance and Economics, Nanchang, China
| | - Ting Li
- School of Mathematical Sciences, Nanjing Normal University, Nanjing, China
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18
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Application Effect of Motion Capture Technology in Basketball Resistance Training and Shooting Hit Rate in Immersive Virtual Reality Environment. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:4584980. [PMID: 35785072 PMCID: PMC9249460 DOI: 10.1155/2022/4584980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/19/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022]
Abstract
With the progress of society, sports have become the mainstream of social development. Strengthening the athletic ability of basketball players can effectively improve their shooting percentage. Firstly, virtual reality (VR) technology and motion capture technology are summarized. Secondly, the resistance training and shooting training of basketball players are analyzed and explained. Finally, the algorithm of motion capture technology is designed to capture and optimize the movements of athletes. In addition, a comprehensive evaluation of the shooting percentage of basketball players is carried out. The results show that the motion capture technology proposed here effectively captures the shooting action of basketball players, and the shooting percentage of players is promoted through resistance training. Among all athletes, the highest shooting percentage improvement is around 14% and the lowest is around 4%. In all groups, athletes of different heights have the largest difference in the improvement of shooting percentage. Therefore, this work plays an important role in improving the shooting rate of basketball players through VR technology. It provides technical support for improving the shooting percentage of basketball players and contributes to the progress of athletes' comprehensive athletic ability.
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19
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Kaliaperumal C. Predicting the Position of the Internal Landmarks of Middle Cranial Fossa Using the Zygomatic Root: An Attempt to Simplify Its Complexity. INDIAN JOURNAL OF NEUROSURGERY 2022. [DOI: 10.1055/s-0042-1750297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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20
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Steiert C, Behringer SP, Kraus LM, Bissolo M, Demerath T, Beck J, Grauvogel J, Reinacher PC. Augmented reality-assisted craniofacial reconstruction in skull base lesions - an innovative technique for single-step resection and cranioplasty in neurosurgery. Neurosurg Rev 2022; 45:2745-2755. [PMID: 35441994 PMCID: PMC9349131 DOI: 10.1007/s10143-022-01784-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/19/2022] [Accepted: 03/30/2022] [Indexed: 10/31/2022]
Abstract
Defects of the cranial vault often require cosmetic reconstruction with patient-specific implants, particularly in cases of craniofacial involvement. However, fabrication takes time and is expensive; therefore, efforts must be made to develop more rapidly available and more cost-effective alternatives. The current study investigated the feasibility of an augmented reality (AR)-assisted single-step procedure for repairing bony defects involving the facial skeleton and the skull base. In an experimental setting, nine neurosurgeons fabricated AR-assisted and conventionally shaped ("freehand") implants from polymethylmethacrylate (PMMA) on a skull model with a craniofacial bony defect. Deviations of the surface profile in comparison with the original model were quantified by means of volumetry, and the cosmetic results were evaluated using a multicomponent scoring system, each by two blinded neurosurgeons. Handling the AR equipment proved to be quite comfortable. The median volume deviating from the surface profile of the original model was low in the AR-assisted implants (6.40 cm3) and significantly reduced in comparison with the conventionally shaped implants (13.48 cm3). The cosmetic appearance of the AR-assisted implants was rated as very good (median 25.00 out of 30 points) and significantly improved in comparison with the conventionally shaped implants (median 14.75 out of 30 points). Our experiments showed outstanding results regarding the possibilities of AR-assisted procedures for single-step reconstruction of craniofacial defects. Although patient-specific implants still represent the gold standard in esthetic aspects, AR-assisted procedures hold high potential for an immediately and widely available, cost-effective alternative providing excellent cosmetic outcomes.
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Affiliation(s)
- Christine Steiert
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Simon Phillipp Behringer
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Luisa Mona Kraus
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marco Bissolo
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Theo Demerath
- Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Juergen Beck
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Juergen Grauvogel
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Peter Christoph Reinacher
- Department of Stereotactic and Functional Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Fraunhofer Institute for Laser Technology, Aachen, Germany
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21
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Scott H, Griffin C, Coggins W, Elberson B, Abdeldayem M, Virmani T, Larson-Prior LJ, Petersen E. Virtual Reality in the Neurosciences: Current Practice and Future Directions. Front Surg 2022; 8:807195. [PMID: 35252318 PMCID: PMC8894248 DOI: 10.3389/fsurg.2021.807195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/30/2021] [Indexed: 01/05/2023] Open
Abstract
Virtual reality has made numerous advancements in recent years and is used with increasing frequency for education, diversion, and distraction. Beginning several years ago as a device that produced an image with only a few pixels, virtual reality is now able to generate detailed, three-dimensional, and interactive images. Furthermore, these images can be used to provide quantitative data when acting as a simulator or a rehabilitation device. In this article, we aim to draw attention to these areas, as well as highlight the current settings in which virtual reality (VR) is being actively studied and implemented within the field of neurosurgery and the neurosciences. Additionally, we discuss the current limitations of the applications of virtual reality within various settings. This article includes areas in which virtual reality has been used in applications both inside and outside of the operating room, such as pain control, patient education and counseling, and rehabilitation. Virtual reality's utility in neurosurgery and the neurosciences is widely growing, and its use is quickly becoming an integral part of patient care, surgical training, operative planning, navigation, and rehabilitation.
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Affiliation(s)
- Hayden Scott
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- *Correspondence: Hayden Scott
| | - Connor Griffin
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - William Coggins
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Brooke Elberson
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Mohamed Abdeldayem
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Tuhin Virmani
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Linda J. Larson-Prior
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Erika Petersen
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
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22
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Guérinot C, Marcon V, Godard C, Blanc T, Verdier H, Planchon G, Raimondi F, Boddaert N, Alonso M, Sailor K, Lledo PM, Hajj B, El Beheiry M, Masson JB. New Approach to Accelerated Image Annotation by Leveraging Virtual Reality and Cloud Computing. FRONTIERS IN BIOINFORMATICS 2022; 1:777101. [PMID: 36303792 PMCID: PMC9580868 DOI: 10.3389/fbinf.2021.777101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/15/2021] [Indexed: 01/02/2023] Open
Abstract
Three-dimensional imaging is at the core of medical imaging and is becoming a standard in biological research. As a result, there is an increasing need to visualize, analyze and interact with data in a natural three-dimensional context. By combining stereoscopy and motion tracking, commercial virtual reality (VR) headsets provide a solution to this critical visualization challenge by allowing users to view volumetric image stacks in a highly intuitive fashion. While optimizing the visualization and interaction process in VR remains an active topic, one of the most pressing issue is how to utilize VR for annotation and analysis of data. Annotating data is often a required step for training machine learning algorithms. For example, enhancing the ability to annotate complex three-dimensional data in biological research as newly acquired data may come in limited quantities. Similarly, medical data annotation is often time-consuming and requires expert knowledge to identify structures of interest correctly. Moreover, simultaneous data analysis and visualization in VR is computationally demanding. Here, we introduce a new procedure to visualize, interact, annotate and analyze data by combining VR with cloud computing. VR is leveraged to provide natural interactions with volumetric representations of experimental imaging data. In parallel, cloud computing performs costly computations to accelerate the data annotation with minimal input required from the user. We demonstrate multiple proof-of-concept applications of our approach on volumetric fluorescent microscopy images of mouse neurons and tumor or organ annotations in medical images.
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Affiliation(s)
- Corentin Guérinot
- Decision and Bayesian Computation, USR 3756 (C3BI/DBC) & Neuroscience Department CNRS UMR 3751, Université de Paris, Institut Pasteur, Paris, France
- Perception and Memory Unit, CNRS UMR3571, Institut Pasteur, Paris, France
- Sorbonne Université, Collège Doctoral, Paris, France
| | - Valentin Marcon
- Decision and Bayesian Computation, USR 3756 (C3BI/DBC) & Neuroscience Department CNRS UMR 3751, Université de Paris, Institut Pasteur, Paris, France
| | - Charlotte Godard
- Decision and Bayesian Computation, USR 3756 (C3BI/DBC) & Neuroscience Department CNRS UMR 3751, Université de Paris, Institut Pasteur, Paris, France
- École Doctorale Physique en Île-de-France, PSL University, Paris, France
| | - Thomas Blanc
- Sorbonne Université, Collège Doctoral, Paris, France
- Laboratoire Physico-Chimie, Institut Curie, PSL Research University, CNRS UMR168, Paris, France
| | - Hippolyte Verdier
- Decision and Bayesian Computation, USR 3756 (C3BI/DBC) & Neuroscience Department CNRS UMR 3751, Université de Paris, Institut Pasteur, Paris, France
- Histopathology and Bio-Imaging Group, Sanofi R&D, Vitry-Sur-Seine, France
- Université de Paris, UFR de Physique, Paris, France
| | - Guillaume Planchon
- Decision and Bayesian Computation, USR 3756 (C3BI/DBC) & Neuroscience Department CNRS UMR 3751, Université de Paris, Institut Pasteur, Paris, France
| | - Francesca Raimondi
- Decision and Bayesian Computation, USR 3756 (C3BI/DBC) & Neuroscience Department CNRS UMR 3751, Université de Paris, Institut Pasteur, Paris, France
- Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Malformations Cardiaques Congénitales Complexes M3C, Hôpital Universitaire Necker-Enfants Malades, Université de Paris, Paris, France
- Pediatric Radiology Unit, Hôpital Universitaire Necker-Enfants Malades, Université de Paris, Paris, France
- UMR-1163 Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Nathalie Boddaert
- Pediatric Radiology Unit, Hôpital Universitaire Necker-Enfants Malades, Université de Paris, Paris, France
- UMR-1163 Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Mariana Alonso
- Perception and Memory Unit, CNRS UMR3571, Institut Pasteur, Paris, France
| | - Kurt Sailor
- Perception and Memory Unit, CNRS UMR3571, Institut Pasteur, Paris, France
| | - Pierre-Marie Lledo
- Perception and Memory Unit, CNRS UMR3571, Institut Pasteur, Paris, France
| | - Bassam Hajj
- Sorbonne Université, Collège Doctoral, Paris, France
- École Doctorale Physique en Île-de-France, PSL University, Paris, France
| | - Mohamed El Beheiry
- Decision and Bayesian Computation, USR 3756 (C3BI/DBC) & Neuroscience Department CNRS UMR 3751, Université de Paris, Institut Pasteur, Paris, France
| | - Jean-Baptiste Masson
- Decision and Bayesian Computation, USR 3756 (C3BI/DBC) & Neuroscience Department CNRS UMR 3751, Université de Paris, Institut Pasteur, Paris, France
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Nassar AK, Al-Manaseer F, Knowlton LM, Tuma F. Virtual reality (VR) as a simulation modality for technical skills acquisition. Ann Med Surg (Lond) 2021; 71:102945. [PMID: 34840738 PMCID: PMC8606692 DOI: 10.1016/j.amsu.2021.102945] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 12/25/2022] Open
Abstract
Efforts continue to facilitate surgical skills training and provide accessible and safe training opportunities. Educational technology has played an essential role in minimizing the challenges facing traditional surgical training and providing feasible training opportunities. Simulation and virtual reality (VR) offer an important innovative training approach to enhance and supplement both technical and non-technical skills acquisition and overcome the many training challenges facing surgical training programs. To maximize the effectiveness of simulation modalities, an in-depth understanding of the cognitive learning theory is necessary. Knowing the stages and mental processes of skills acquisition when integrated with simulation applications can help trainees achieve maximal learning outcomes. This article aims to review important literature related to VR effectiveness and discuss the leading theories of technical skills acquisition related to VR simulation technologies. VR simulation offers an innovative training approach to supplement both technical and non-technical skills acquisition. VR simulation with haptic feedback is a promising modality for safe, repetitive, and learner-oriented operative training. VR simulation facilitates deliberate practice with built-in auto feedback to address limited staff resources. To maximize the effectiveness of simulation, an in-depth understanding of the cognitive learning theory is necessary.
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Affiliation(s)
| | | | | | - Faiz Tuma
- Central Michigan University College of Medicine, Saginaw, USA
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24
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Skandalakis GP, Noussios G, Paraskevas G, Salmas M, Katsourakis A, Chytas D. Letter to the Editor Regarding "Online Neuroanatomy Education and Its Role During the Coronavirus Disease 2019 (COVID-19) Lockdown". World Neurosurg 2021; 152:238. [PMID: 34340285 DOI: 10.1016/j.wneu.2021.04.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Georgios P Skandalakis
- First Department of Neurosurgery, "Evangelismos" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Noussios
- Department of Physical Education and Sports Sciences of Serres, Aristotle University of Thessaloniki, Greece
| | - Georgios Paraskevas
- Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Marios Salmas
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Dimitrios Chytas
- Department of Anatomy, School of Physiotherapy, University of Peloponnese, Sparta, Greece.
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25
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Qi F, Gan Y, Wang S, Tie Y, Chen J, Li C. Efficacy of a virtual reality-based basic and clinical fused curriculum for clinical education on the lumbar intervertebral disc. Neurosurg Focus 2021; 51:E17. [PMID: 34333480 DOI: 10.3171/2021.5.focus20756] [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: 08/24/2020] [Accepted: 05/18/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Today, minimally invasive procedures have become mainstream surgical procedures. Percutaneous endoscopic transforaminal discectomy for lumbar disc herniation (LDH) requires profound knowledge of the laparoscopic lumbar anatomy. Immersive virtual reality (VR) provides three-dimensional patient-specific models to help in the process of preclinical surgical preparation. In this study, the authors investigated the efficacy of VR application in LDH for training orthopedic residents and postgraduates. METHODS VR images of the lumbar anatomy were created with immersive VR and mAnatomy software. The study was conducted among 60 residents and postgraduates. A questionnaire was developed to assess the effect of and satisfaction with this VR-based basic and clinical fused curriculum. The teaching effect was also evaluated through a postlecture test, and the results of the prelecture surgical examination were taken as baselines. RESULTS All participants in the VR group agreed that VR-based education is practical, attractive, and easy to operate, compared to traditional teaching, and promotes better understanding of the anatomical structures involved in LDH. Learners in the VR group achieved higher scores on an anatomical and clinical fusion test than learners in the traditional group (84.67 ± 14.56 vs 76.00 ± 16.10, p < 0.05). CONCLUSIONS An immersive VR-based basic and clinical fused curriculum can increase residents' and postgraduates' interest and support them in mastering the structural changes and complicated symptoms of LDH. However, a simplified operational process and more realistic haptics of the VR system are necessary for further surgical preparation and application.
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Affiliation(s)
- Fangfang Qi
- 1Teaching and Research Bureau of Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University.,2Department of Anatomy and Neurobiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou.,3Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou
| | - Yixiang Gan
- 4School of Medicine, Sun Yat-sen University, Shenzhen
| | - Shengwen Wang
- 5Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou.,6Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou
| | - Yizhe Tie
- 7Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou; and
| | - Jiewen Chen
- 8Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chunhai Li
- 1Teaching and Research Bureau of Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University.,8Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
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26
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Intra-operative 3D hologram support with mixed reality technique based on CT-MRI fusion images: operation guidance for brain brachytherapy. J Contemp Brachytherapy 2021; 13:205-210. [PMID: 33897795 PMCID: PMC8060965 DOI: 10.5114/jcb.2021.105289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 02/15/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose The study investigated whether intra-operative 3D hologram, a computer graphics model of the brain, with mixed reality (MR) technique based on computed tomography-magnetic resonance imaging (CT-MRI) fusion images could be helpful during brachytherapy for brain metastasis. Material and methods A patient with relapsed brain metastasis was reported. Pre-operative CT and MRI image fusion was performed, with software developed by our center and the Chinese University of Hong Kong. 3D polygon data segmented from pre-operative CT-MRI fusion images were registered into HoloLens (Microsoft Corporation, Redmond, WA, USA). 125I seed implantation was performed under MR guidance. Results Interventional surgeons could share the same hologram and move the hologram from their respective angles, while wearing the HoloLens without any monitors. The intra-operative hologram offered good visualization of the skull, tumor location, and main vessels around the tumor during brain brachytherapy of a patient with brain metastasis. The interventional surgeons could easily compare the patient’s actual anatomy with the hologram before and during the brain brachytherapy procedure. D90 and V100 of post-operative plan and pre-operative plan were 131.8 Gy vs. 132.0 Gy and 94.8% vs. 94.0%, respectively. The patient’s imaging findings together with clinical symptoms were greatly improved at 3 and 6 months after the implantation. Conclusions This initial experience suggests that the use of the intra-operative hologram with MR technique based on CT-MRI fusion images helped in brachytherapy guidance. Further research is needed to explore the potential of this approach in neuro-navigation.
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Cerebral Anatomy Detection and Surgical Planning in Patients with Anterior Skull Base Meningiomas Using a Virtual Reality Technique. J Clin Med 2021; 10:jcm10040681. [PMID: 33578799 PMCID: PMC7916569 DOI: 10.3390/jcm10040681] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/20/2021] [Accepted: 02/07/2021] [Indexed: 12/02/2022] Open
Abstract
Anterior skull base meningiomas represent a wide cohort of tumors with different locations, extensions, configurations, and anatomical relationships. Diagnosis of these tumors and review of their therapies are inseparably connected with cranial imaging. We analyzed the influence of three-dimensional-virtual reality (3D-VR) reconstructions versus conventional computed tomography (CT) and magnetic resonance imaging (MRI) images (two-dimensional (2D) and screen 3D) on the identification of anatomical structures and on the surgical planning in patients with anterior skull base meningiomas. Medical files were retrospectively analyzed regarding patient- and disease-related data. Preoperative 2D-CT and 2D-MRI scans were retrospectively reconstructed to 3D-VR images and visualized via VR software to detect the characteristics of tumors. A questionnaire of experienced neurosurgeons evaluated the influence of the VR visualization technique on identification of tumor morphology and relevant anatomy and on surgical strategy. Thirty patients were included and 600 answer sheets were evaluated. The 3D-VR modality significantly influenced the detection of tumor-related anatomical structures (p = 0.002), recommended head positioning (p = 0.005), and surgical approach (p = 0.03). Therefore, the reconstruction of conventional preoperative 2D scans into 3D images and the spatial and anatomical presentation in VR models enabled greater understanding of anatomy and pathology, and thus influenced operation planning and strategy.
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28
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Chen S, Zhu J, Cheng C, Pan Z, Liu L, Du J, Shen X, Shen Z, Zhu H, Liu J, Yang H, Ma C, Pan H. Can virtual reality improve traditional anatomy education programmes? A mixed-methods study on the use of a 3D skull model. BMC MEDICAL EDUCATION 2020; 20:395. [PMID: 33129310 PMCID: PMC7603711 DOI: 10.1186/s12909-020-02255-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 09/24/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Realistic, portable, and scalable lectures, cadaveric models, 2D atlases and computer simulations are being combined more frequently for teaching anatomy, which result in major increases in user satisfaction. However, although digital simulations may be more portable, interesting, or motivating than traditional teaching tools, whether they are superior in terms of student learning remain unclear. This paper presents a study in which the educational effectiveness of a virtual reality (VR) skull model is compared with that of cadaveric skulls and atlases. The aim of this study was to compare the results of teaching with VR to results of teaching with traditional teaching methods by administering objective questionnaires and perception surveys. METHODS A mixed-methods study with 73 medical students was conducted with three different groups, namely, the VR group (N = 25), cadaver group (N = 25) and atlas group (N = 23). Anatomical structures were taught through an introductory lecture and model-based learning. All students completed the pre- and post-intervention tests, which comprised a theory test and an identification test. The theory test consisted of 18 multiple-choice questions, and the identification test consisted of 25 fill-in-the-blank questions. RESULTS The participants in all three groups had significantly higher total scores on the post-intervention test than on the pre-intervention test; the post-intervention test score in the VR group was not statistically significantly higher than the post-intervention test score of the other groups (VR: 30 [IQR: 22-33.5], cadaver: 26 [IQR: 20-31.5], atlas: 28[IQR: 20-33]; p > 0.05). The participants in the VR and cadaver groups provided more positive feedback on their learning models than the atlas group (VR: 26 [IQR: 19-30], cadaver: 25 [IQR: 19.5-29.5], atlas: 12 [IQR: 9-20]; p < 0.001). CONCLUSIONS The skull virtual learning resource (VLR) was equally efficient as the cadaver skull and atlas in teaching anatomy structures. Such a model can aid individuals in understanding complex anatomical structures with a higher level of motivation and tolerable adverse effects.
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Affiliation(s)
- Shi Chen
- Department of Endocrinology, Endocrine Key Laboratory of Ministry of Health, Peking Union Medical College Hospital (PUMCH), Chinese Academe of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100730, China
- National Virtual Simulation Laboratory Education Center of Medical Sciences, PUMCH, CAMS & PUMC, Beijing, 100730, China
| | - Jiawei Zhu
- Eight-year Program of Clinical Medicine, PUMCH, CAMS & PUMC, Beijing, 100730, China
| | - Cheng Cheng
- Eight-year Program of Clinical Medicine, PUMCH, CAMS & PUMC, Beijing, 100730, China
| | - Zhouxian Pan
- Eight-year Program of Clinical Medicine, PUMCH, CAMS & PUMC, Beijing, 100730, China
| | - Lingshan Liu
- Eight-year Program of Clinical Medicine, PUMCH, CAMS & PUMC, Beijing, 100730, China
| | - Jianhua Du
- Eight-year Program of Clinical Medicine, PUMCH, CAMS & PUMC, Beijing, 100730, China
| | - Xinhua Shen
- Department of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Zhen Shen
- The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Automation, Chinese Academy of Sciences (CASIA), Beijing, 100190, China
| | - Huijuan Zhu
- Department of Endocrinology, Endocrine Key Laboratory of Ministry of Health, Peking Union Medical College Hospital (PUMCH), Chinese Academe of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100730, China
| | - Jihai Liu
- National Virtual Simulation Laboratory Education Center of Medical Sciences, PUMCH, CAMS & PUMC, Beijing, 100730, China
- Department of Emergency, PUMCH, CAMS & PUMC, Beijing, 100730, China
| | - Hua Yang
- National Virtual Simulation Laboratory Education Center of Medical Sciences, PUMCH, CAMS & PUMC, Beijing, 100730, China
- Department of Otolaryngology-Head and Neck Surgery, PUMCH, CAMS & PUMC, Beijing, 100730, China
| | - Chao Ma
- Department of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Hui Pan
- Department of Endocrinology, Endocrine Key Laboratory of Ministry of Health, Peking Union Medical College Hospital (PUMCH), Chinese Academe of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100730, China.
- Medical Department, PUMCH, CAMS & PUMC, Beijing, 100730, China.
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Chase T, Shah DK, Parry JP, Bhagavath B, Lindheim SR, Petrozza JC, Pfeifer S, Stetter C, Kunselman A, Estes SJ. Surgical simulation supplements reproductive endocrinology and infertility fellowship training. F S Rep 2020; 1:154-161. [PMID: 34223232 PMCID: PMC8244323 DOI: 10.1016/j.xfre.2020.06.002] [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: 05/12/2020] [Revised: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 10/26/2022] Open
Abstract
Objective To assess if a surgical boot camp improves laparoscopic skill among reproduction endocrinology and infertility (REI) fellows and increases fellow desire to incorporate surgical skills into practice and to examine whether fellowship in vitro fertilization (IVF) volume correlates with surgical efficiency. Design Prospective evaluation. Setting Simulation Center. Patients Forty REI fellows. Interventions Fellows were timed before and after training in laparoscopic suturing and knot tying and while using virtual simulators. Fellows were surveyed before boot camp on prior experience with IVF and reproductive surgery, and immediately and 1 month after boot camp on their desire to incorporate surgical skills into practice. Main Outcome Measures Efficiency of laparoscopic suturing and knot tying before and after boot camp; likelihood and persistence of incorporating surgical skills into practice immediately and 1 month after boot camp; and correlation between fellowship IVF volume and fellow surgical efficiency. Results Fellows experienced significant improvement in laparoscopic suturing (44 sec), intracorporeal knot tying (82 sec), and extracorporeal knot tying (71 sec). Fellows reported being more likely to incorporate operative hysteroscopy (89%), operative laparoscopy (87%), and laparoscopic suturing (84%) into practice immediately following boot camp with no difference 1 month later. Fifty-four percent of fellows reported being more likely to perform robotic surgery after the boot camp, increasing to 70% 1 month later. There were weak correlations between IVF case volume and efficiency in laparoscopic suturing or hysteroscopic polypectomy (Spearman correlation coefficients, -0.14 and -0.03). Conclusions An intensive surgical boot camp enhances surgical skill among REI fellows.
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Affiliation(s)
- Tess Chase
- Department of Obstetrics and Gynecology, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Divya K Shah
- Division of Reproductive Endocrinology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Bala Bhagavath
- Division of Reproductive Endocrinology and Infertility, University of Wisconsin, Madison, Wisconsin
| | - Steven R Lindheim
- Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.,Division of Reproductive Endocrinology and Infertility, Wright State University, Dayton, Ohio
| | - John C Petrozza
- Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital, Boston, Massachusetts
| | - Samantha Pfeifer
- Division of Reproductive Endocrinology and Infertility, Weill Cornell Medical Center, New York, New York
| | - Christina Stetter
- Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
| | - Allen Kunselman
- Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
| | - Stephanie J Estes
- Department of Obstetrics and Gynecology, Penn State Hershey Medical Center, Hershey, Pennsylvania
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Lin M, Fredrickson VL, Catapano JS, Attenello FJ. Commentary: Mini Fronto-Orbital pproach: "Window Opening" Towards the Superomedial Orbit-A Virtual Reality-Planned Anatomic Study. Oper Neurosurg (Hagerstown) 2020; 19:E285-E287. [PMID: 32412632 DOI: 10.1093/ons/opaa122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 03/17/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Michelle Lin
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Vance L Fredrickson
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Joshua S Catapano
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Frank J Attenello
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
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31
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Strickland BA, Brunswick A, Zada G. Commentary: Expanded Endoscopic Endonasal Transtuberculum Approach for Tuberculum Sellae Meningioma: Operative Video With 360-Degree Fly-Through and Surgical Rehearsal in Virtual Reality: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2020; 19:E181-E182. [PMID: 32243544 DOI: 10.1093/ons/opaa064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 02/02/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ben A Strickland
- Department of Neurosurgery, The Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Andrew Brunswick
- Department of Neurosurgery, The Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Gabriel Zada
- Department of Neurosurgery, The Keck School of Medicine of the University of Southern California, Los Angeles, California
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32
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Dean S, Halpern J, McAllister M, Lazenby M. Nursing education, virtual reality and empathy? Nurs Open 2020; 7:2056-2059. [PMID: 33072391 PMCID: PMC7544867 DOI: 10.1002/nop2.551] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 11/12/2022] Open
Abstract
An empathic approach to patient‐centred care is a core of nursing practice. One of the methods to develop empathy, which is gaining currency is the use of virtual reality simulations in education. This paper posits some questions, does it simply reinforce a ‘type’ of patient, neglecting caring for the patient as unique, is empathy what results or is it pity, does it result in a greater distance being created between the patient and the health care provider? Can we ever really know what it is like to walk in a patient's shoes when what we experience through virtual reality provides a small snapshot of the vicissitudes of living with an illness or disability. We suggest that what matters most in simulations using virtual reality is how the student exits the experience and if they leave knowing just what patients ‘like that’ feel, or whether they leave with humility and curiosity.
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Affiliation(s)
- Sue Dean
- Faculty of Health University of Technology Sydney Sydney NSW Australia
| | - Jodi Halpern
- Bioethics and Medical Humanities School of Public Health and Joint Medical Program University of California Berkeley CA USA
| | - Margaret McAllister
- Nursing, Midwifery and Social Sciences/Higher Education CQ University Noosaville Qld Australia
| | - Mark Lazenby
- Nursing and Philosophy UConn School of Nursing Stoors CT USA
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Dawoud RA, Philbrick B, McMahon JT, Douglas JM, Bhatia N, Faraj R, Greven A, Buster B, Rindler RS, Laxpati NG, Gary MF. Letter to the Editor "Virtual Neurosurgery Clerkship for Medical Students". World Neurosurg 2020; 139:456-459. [PMID: 32426074 PMCID: PMC7233241 DOI: 10.1016/j.wneu.2020.05.085] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/09/2020] [Indexed: 11/23/2022]
Affiliation(s)
- Reem A Dawoud
- Emory University School of Medicine, Atlanta, Georgia.
| | | | | | | | - Neil Bhatia
- Emory University School of Medicine, Atlanta, Georgia
| | - Razan Faraj
- Emory University School of Medicine, Atlanta, Georgia
| | - Alex Greven
- Emory University School of Medicine, Atlanta, Georgia
| | - Bryan Buster
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Rima S Rindler
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Nealen G Laxpati
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Matthew F Gary
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
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