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Finos K, Datta S, Sedrakyan A, Milsom JW, Pua BB. Mixed reality in interventional radiology: a focus on first clinical use of XR90 augmented reality-based visualization and navigation platform. Expert Rev Med Devices 2024; 21:679-688. [PMID: 39054630 DOI: 10.1080/17434440.2024.2379925] [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: 03/31/2024] [Accepted: 06/28/2024] [Indexed: 07/27/2024]
Abstract
INTRODUCTION Augmented reality (AR) and virtual reality (VR) are emerging tools in interventional radiology (IR), enhancing IR education, preprocedural planning, and intraprocedural guidance. AREAS COVERED This review identifies current applications of AR/VR in IR, with a focus on studies that assess the clinical impact of AR/VR. We outline the relevant technology and assess current limitations and future directions in this space. We found that the use of AR in IR lags other surgical fields, and the majority of the data exists in case series or small-scale studies. Educational use of AR/VR improves learning anatomy, procedure steps, and procedural learning curves. Preprocedural use of AR/VR decreases procedure times, especially in complex procedures. Intraprocedural AR for live tracking is accurate within 5 mm live patients and has up to 0.75 mm in phantoms, offering decreased procedure time and radiation exposure. Challenges include cost, ergonomics, rapid segmentation, and organ motion. EXPERT OPINION The use of AR/VR in interventional radiology may lead to safer and more efficient procedures. However, more data from larger studies is needed to better understand where AR/VR is confers the most benefit in interventional radiology clinical practice.
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Affiliation(s)
- Kyle Finos
- Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, USA
| | - Sanjit Datta
- Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, USA
| | - Art Sedrakyan
- Population Health Science, New York Presbyterian Hospital/Weill Cornell Medicine, New York, USA
| | - Jeffrey W Milsom
- Division of Colorectal Surgery, New York Presbyterian Hospital/Weill Cornell Medicine, New York, USA
| | - Bradley B Pua
- Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, USA
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Paccini M, Paschina G, De Beni S, Stefanov A, Kolev V, Patanè G. US & MR/CT Image Fusion with Markerless Skin Registration: A Proof of Concept. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024:10.1007/s10278-024-01176-w. [PMID: 39020154 DOI: 10.1007/s10278-024-01176-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/18/2024] [Accepted: 05/31/2024] [Indexed: 07/19/2024]
Abstract
This paper presents an innovative automatic fusion imaging system that combines 3D CT/MR images with real-time ultrasound acquisition. The system eliminates the need for external physical markers and complex training, making image fusion feasible for physicians with different experience levels. The integrated system involves a portable 3D camera for patient-specific surface acquisition, an electromagnetic tracking system, and US components. The fusion algorithm comprises two main parts: skin segmentation and rigid co-registration, both integrated into the US machine. The co-registration aligns the surface extracted from CT/MR images with the 3D surface acquired by the camera, facilitating rapid and effective fusion. Experimental tests in different settings, validate the system's accuracy, computational efficiency, noise robustness, and operator independence.
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Affiliation(s)
| | | | | | | | - Velizar Kolev
- MedCom GmbH, Dolivostr., 11, Darmstadt, 64293, Germany
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Albano D, Cintioli R, Messina C, Serpi F, Gitto S, Mascitti L, Vignati G, Glielmo P, Vitali P, Zagra L, Snoj Ž, Sconfienza LM. US-Guided Interventional Procedures for Total Hip Arthroplasty. J Clin Med 2024; 13:3976. [PMID: 38999539 PMCID: PMC11242179 DOI: 10.3390/jcm13133976] [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: 04/30/2024] [Revised: 06/23/2024] [Accepted: 07/04/2024] [Indexed: 07/14/2024] Open
Abstract
In patients with total hip arthroplasty (THA) with recurrent pain, symptoms may be caused by several conditions involving not just the joint, but also the surrounding soft tissues including tendons, muscles, bursae, and peripheral nerves. US and US-guided interventional procedures are important tools in the diagnostic work-up of patients with painful THA given that it is possible to reach a prompt diagnosis both directly identifying the pathological changes of periprosthetic structures and indirectly evaluating the response and pain relief to local injection of anesthetics under US monitoring. Then, US guidance can be used for the aspiration of fluid from the joint or periarticular collections, or alternatively to follow the biopsy needle to collect samples for culture analysis in the suspicion of prosthetic joint infection. Furthermore, US-guided percutaneous interventions may be used to treat several conditions with well-established minimally invasive procedures that involve injections of corticosteroid, local anesthetics, and platelet-rich plasma or other autologous products. In this review, we will discuss the clinical and technical applications of US-guided percutaneous interventional procedures in painful THA that can be used in routine daily practice for diagnostic and therapeutic purposes.
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Affiliation(s)
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, 20122 Milan, Italy
| | - Roberto Cintioli
- Postgraduate School of Diagnostic and Interventional Radiology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Francesca Serpi
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Salvatore Gitto
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Laura Mascitti
- Postgraduate School of Diagnostic and Interventional Radiology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Giacomo Vignati
- Postgraduate School of Diagnostic and Interventional Radiology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Pierluigi Glielmo
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Paolo Vitali
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Luigi Zagra
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | - Žiga Snoj
- Clinical Radiology Institute, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Department of Radiology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
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Díez-Montiel A, Pose-Díez-de-la-Lastra A, González-Álvarez A, Salmerón JI, Pascau J, Ochandiano S. Tablet-based Augmented reality and 3D printed templates in fully guided Microtia Reconstruction: a clinical workflow. 3D Print Med 2024; 10:17. [PMID: 38819536 PMCID: PMC11140883 DOI: 10.1186/s41205-024-00213-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/04/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Microtia is a congenital malformation of the auricle that affects approximately 4 of every 10,000 live newborns. Radiographic film paper is traditionally employed to bidimensionally trace the structures of the contralateral healthy ear in a quasi-artistic manner. Anatomical points provide linear and angular measurements. However, this technique proves time-consuming, subjectivity-rich, and greatly dependent on surgeon expertise. Hence, it's susceptible to shape errors and misplacement. METHODS We present an innovative clinical workflow that combines 3D printing and augmented reality (AR) to increase objectivity and reproducibility of these procedures. Specifically, we introduce patient-specific 3D cutting templates and remodeling molds to carve and construct the cartilaginous framework that will conform the new ear. Moreover, we developed an in-house AR application compatible with any commercial Android tablet. It precisely guides the positioning of the new ear during surgery, ensuring symmetrical alignment with the healthy one and avoiding time-consuming intraoperative linear or angular measurements. Our solution was evaluated in one case, first with controlled experiments in a simulation scenario and finally during surgery. RESULTS Overall, the ears placed in the simulation scenario had a mean absolute deviation of 2.2 ± 1.7 mm with respect to the reference plan. During the surgical intervention, the reconstructed ear was 3.1 mm longer and 1.3 mm wider with respect to the ideal plan and had a positioning error of 2.7 ± 2.4 mm relative to the contralateral side. Note that in this case, additional morphometric variations were induced from inflammation and other issues intended to be addressed in a subsequent stage of surgery, which are independent of our proposed solution. CONCLUSIONS In this work we propose an innovative workflow that combines 3D printing and AR to improve ear reconstruction and positioning in microtia correction procedures. Our implementation in the surgical workflow showed good accuracy, empowering surgeons to attain consistent and objective outcomes.
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Affiliation(s)
- Alberto Díez-Montiel
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
| | - Alicia Pose-Díez-de-la-Lastra
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain.
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, Leganés, 28911, Spain.
| | - Alba González-Álvarez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, Leganés, 28911, Spain
| | - José I Salmerón
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
| | - Javier Pascau
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, Leganés, 28911, Spain
| | - Santiago Ochandiano
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
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Borde T, Saccenti L, Li M, Varble NA, Hazen LA, Kassin MT, Ukeh IN, Horton KM, Delgado JF, Martin C, Xu S, Pritchard WF, Karanian JW, Wood BJ. Smart goggles augmented reality CT-US fusion compared to conventional fusion navigation for percutaneous needle insertion. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03148-5. [PMID: 38814530 DOI: 10.1007/s11548-024-03148-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/10/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE Targeting accuracy determines outcomes for percutaneous needle interventions. Augmented reality (AR) in IR may improve procedural guidance and facilitate access to complex locations. This study aimed to evaluate percutaneous needle placement accuracy using a goggle-based AR system compared to an ultrasound (US)-based fusion navigation system. METHODS Six interventional radiologists performed 24 independent needle placements in an anthropomorphic phantom (CIRS 057A) in four needle guidance cohorts (n = 6 each): (1) US-based fusion, (2) goggle-based AR with stereoscopically projected anatomy (AR-overlay), (3) goggle AR without the projection (AR-plain), and (4) CT-guided freehand. US-based fusion included US/CT registration with electromagnetic (EM) needle, transducer, and patient tracking. For AR-overlay, US, EM-tracked needle, stereoscopic anatomical structures and targets were superimposed over the phantom. Needle placement accuracy (distance from needle tip to target center), placement time (from skin puncture to final position), and procedure time (time to completion) were measured. RESULTS Mean needle placement accuracy using US-based fusion, AR-overlay, AR-plain, and freehand was 4.5 ± 1.7 mm, 7.0 ± 4.7 mm, 4.7 ± 1.7 mm, and 9.2 ± 5.8 mm, respectively. AR-plain demonstrated comparable accuracy to US-based fusion (p = 0.7) and AR-overlay (p = 0.06). Excluding two outliers, AR-overlay accuracy became 5.9 ± 2.6 mm. US-based fusion had the highest mean placement time (44.3 ± 27.7 s) compared to all navigation cohorts (p < 0.001). Longest procedure times were recorded with AR-overlay (34 ± 10.2 min) compared to AR-plain (22.7 ± 8.6 min, p = 0.09), US-based fusion (19.5 ± 5.6 min, p = 0.02), and freehand (14.8 ± 1.6 min, p = 0.002). CONCLUSION Goggle-based AR showed no difference in needle placement accuracy compared to the commercially available US-based fusion navigation platform. Differences in accuracy and procedure times were apparent with different display modes (with/without stereoscopic projections). The AR-based projection of the US and needle trajectory over the body may be a helpful tool to enhance visuospatial orientation. Thus, this study refines the potential role of AR for needle placements, which may serve as a catalyst for informed implementation of AR techniques in IR.
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Affiliation(s)
- Tabea Borde
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA.
| | - Laetitia Saccenti
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA
- Henri Mondor Biomedical Research Institute, Inserm U955, Team N°18, Créteil, France
| | - Ming Li
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA
| | - Nicole A Varble
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA
- Philips Healthcare, Cambridge, MA, 02141, USA
| | - Lindsey A Hazen
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA
| | - Michael T Kassin
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA
| | - Ifechi N Ukeh
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA
| | - Keith M Horton
- Department of Radiology, Georgetown Medical School, Medstar Washington Hospital Center, Washington, DC, 20007, USA
| | - Jose F Delgado
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA
| | - Charles Martin
- Department of Interventional Radiology, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Sheng Xu
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA
| | - William F Pritchard
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA
| | - John W Karanian
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA
| | - Bradford J Wood
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA.
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA.
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Lee KH, Li M, Varble N, Negussie AH, Kassin MT, Arrichiello A, Carrafiello G, Hazen LA, Wakim PG, Li X, Xu S, Wood BJ. Smartphone Augmented Reality Outperforms Conventional CT Guidance for Composite Ablation Margins in Phantom Models. J Vasc Interv Radiol 2024; 35:452-461.e3. [PMID: 37852601 DOI: 10.1016/j.jvir.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 09/23/2023] [Accepted: 10/08/2023] [Indexed: 10/20/2023] Open
Abstract
PURPOSE To develop and evaluate a smartphone augmented reality (AR) system for a large 50-mm liver tumor ablation with treatment planning for composite overlapping ablation zones. MATERIALS AND METHODS A smartphone AR application was developed to display tumor, probe, projected probe paths, ablated zones, and real-time percentage of the ablated target tumor volume. Fiducial markers were attached to phantoms and an ablation probe hub for tracking. The system was evaluated with tissue-mimicking thermochromic phantoms and gel phantoms. Four interventional radiologists performed 2 trials each of 3 probe insertions per trial using AR guidance versus computed tomography (CT) guidance approaches in 2 gel phantoms. Insertion points and optimal probe paths were predetermined. On Gel Phantom 2, serial ablated zones were saved and continuously displayed after each probe placement/adjustment, enabling feedback and iterative planning. The percentages of tumor ablated for AR guidance versus CT guidance, and with versus without display of recorded ablated zones, were compared among interventional radiologists with pairwise t-tests. RESULTS The means of percentages of tumor ablated for CT freehand and AR guidance were 36% ± 7 and 47% ± 4 (P = .004), respectively. The mean composite percentages of tumor ablated for AR guidance were 43% ± 1 (without) and 50% ± 2 (with display of ablation zone) (P = .033). There was no strong correlation between AR-guided percentage of ablation and years of experience (r < 0.5), whereas there was a strong correlation between CT-guided percentage of ablation and years of experience (r > 0.9). CONCLUSIONS A smartphone AR guidance system for dynamic iterative large liver tumor ablation was accurate, performed better than conventional CT guidance, especially for less experienced interventional radiologists, and enhanced more standardized performance across experience levels for ablation of a 50-mm tumor.
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Affiliation(s)
- Katerina H Lee
- McGovern Medical School at UTHealth, Houston, Texas; Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland
| | - Ming Li
- Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland
| | - Nicole Varble
- Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland; Philips Research North America, Cambridge, Massachusetts
| | - Ayele H Negussie
- Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland
| | - Michael T Kassin
- Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland
| | - Antonio Arrichiello
- Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland
| | - Gianpaolo Carrafiello
- Department of Radiology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Lindsey A Hazen
- Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland
| | - Paul G Wakim
- Biostatistics and Clinical Epidemiology Service, National Institutes of Health, Bethesda, Maryland
| | - Xiaobai Li
- Biostatistics and Clinical Epidemiology Service, National Institutes of Health, Bethesda, Maryland
| | - Sheng Xu
- Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland
| | - Bradford J Wood
- Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland.
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Li Y, Yang J, Zhao R, Zhao Y, Tian C, Li X, Li Y, Li J, Wang Y, Huang L. Ultracompact polarization multiplexing meta-combiner for augmented reality display. OPTICS EXPRESS 2024; 32:6266-6276. [PMID: 38439334 DOI: 10.1364/oe.515375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/26/2024] [Indexed: 03/06/2024]
Abstract
Augmented reality (AR) display, as a next-generation innovative technology, is revolutionizing the ways of perceiving and communicating by overlaying virtual images onto real-world scenes. However, the current AR devices are often bulky and cumbersome, posing challenges for long-term wearability. Metasurfaces have flexible capabilities of manipulating light waves at subwavelength scales, making them as ideal candidates for replacing traditional optical elements in AR display devices. In this work, we propose and fabricate what we believe is a novel reflective polarization multiplexing gradient metasurface based on propagation phase principle to replace the optical combiner element in traditional AR display devices. Our designed metasurface exhibits different polarization modulations for reflected and transmitted light, enabling efficient deflection of reflected light while minimizing the impact on transmitted light. This work reveals the significant potential of metasurfaces in next-generation optical display systems and provides a reliable theoretical foundation for future integrated waveguide schemes, driving the development of next-generation optical display products towards lightweight and comfortable.
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Charalampopoulos G, Bale R, Filippiadis D, Odisio BC, Wood B, Solbiati L. Navigation and Robotics in Interventional Oncology: Current Status and Future Roadmap. Diagnostics (Basel) 2023; 14:98. [PMID: 38201407 PMCID: PMC10795729 DOI: 10.3390/diagnostics14010098] [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: 08/27/2023] [Revised: 12/26/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
Interventional oncology (IO) is the field of Interventional Radiology that provides minimally invasive procedures under imaging guidance for the diagnosis and treatment of malignant tumors. Sophisticated devices can be utilized to increase standardization, accuracy, outcomes, and "repeatability" in performing percutaneous Interventional Oncology techniques. These technologies can reduce variability, reduce human error, and outperform human hand-to-eye coordination and spatial relations, thus potentially normalizing an otherwise broad diversity of IO techniques, impacting simulation, training, navigation, outcomes, and performance, as well as verification of desired minimum ablation margin or other measures of successful procedures. Stereotactic navigation and robotic systems may yield specific advantages, such as the potential to reduce procedure duration and ionizing radiation exposure during the procedure and, at the same time, increase accuracy. Enhanced accuracy, in turn, is linked to improved outcomes in many clinical scenarios. The present review focuses on the current role of percutaneous navigation systems and robotics in diagnostic and therapeutic Interventional Oncology procedures. The currently available alternatives are presented, including their potential impact on clinical practice as reflected in the peer-reviewed medical literature. A review of such data may inform wiser investment of time and resources toward the most impactful IR/IO applications of robotics and navigation to both standardize and address unmet clinical needs.
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Affiliation(s)
- Georgios Charalampopoulos
- 2nd Department of Radiology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str, 12462 Athens, Greece;
| | - Reto Bale
- Interventional Oncology/Stereotaxy and Robotics, Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Dimitrios Filippiadis
- 2nd Department of Radiology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str, 12462 Athens, Greece;
| | - Bruno C. Odisio
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Bradford Wood
- Interventional Radiology and Center for Interventional Oncology, NIH Clinical Center and National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Luigi Solbiati
- Department of Radiology, IRCCS Humanitas Research Hospital, Rozzano (Milano), Italy and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milano), 20072 Milano, Italy;
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Elsakka A, Park BJ, Marinelli B, Swinburne NC, Schefflein J. Virtual and Augmented Reality in Interventional Radiology: Current Applications, Challenges, and Future Directions. Tech Vasc Interv Radiol 2023; 26:100919. [PMID: 38071031 PMCID: PMC11152052 DOI: 10.1016/j.tvir.2023.100919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Virtual reality (VR) and augmented Reality (AR) are emerging technologies with the potential to revolutionize Interventional radiology (IR). These innovations offer advantages in patient care, interventional planning, and educational training by improving the visualization and navigation of medical images. Despite progress, several challenges hinder their widespread adoption, including limitations in navigation systems, cost, clinical acceptance, and technical constraints of AR/VR equipment. However, ongoing research holds promise with recent advancements such as shape-sensing needles and improved organ deformation modeling. The development of deep learning techniques, particularly for medical imaging segmentation, presents a promising avenue to address existing accuracy and precision issues. Future applications of AR/VR in IR include simulation-based training, preprocedural planning, intraprocedural guidance, and increased patient engagement. As these technologies advance, they are expected to facilitate telemedicine, enhance operational efficiency, and improve patient outcomes, marking a new frontier in interventional radiology.
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Affiliation(s)
- Ahmed Elsakka
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brian J Park
- Oregon Health & Science University, Portland, OR
| | - Brett Marinelli
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nathaniel C Swinburne
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Javin Schefflein
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY.
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Albano D, Messina C, Gitto S, Chianca V, Sconfienza LM. Bone biopsies guided by augmented reality: a pilot study. Eur Radiol Exp 2023; 7:40. [PMID: 37468652 PMCID: PMC10356701 DOI: 10.1186/s41747-023-00353-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE To test the technical feasibility of an augmented reality (AR) navigation system to guide bone biopsies. METHODS We enrolled patients subjected to percutaneous computed tomography (CT)-guided bone biopsy using a novel AR navigation system. Data from prospectively enrolled patients (AR group) were compared with data obtained retrospectively from previous standard CT-guided bone biopsies (control group). We evaluated the following: procedure duration, number of CT passes, patient's radiation dose (dose-length product), complications, and specimen adequacy. Technical success was defined as the ability to complete the procedure as planned, reaching the target center. Technical efficacy was assessed evaluating specimen adequacy. RESULTS Eight patients (4 males) aged 58 ± 24 years (mean ± standard deviation) were enrolled in the AR group and compared with 8 controls (4 males) aged 60 ± 15 years. No complications were observed. Procedure duration, number of CT passes, and radiation dose were 22 ± 5 min, 4 (median) [4, 6 interquartile range] and 1,034 ± 672 mGy*cm for the AR group and 23 ± 5 min, 9 [7.75, 11.25], and 1,954 ± 993 mGy*cm for controls, respectively. No significant differences were observed for procedure duration (p = 0.878). Conversely, number of CT passes and radiation doses were significantly lower for the AR group (p < 0.001 and p = 0.021, respectively). Technical success and technical efficacy were 100% for both groups. CONCLUSIONS This AR navigation system is safe, feasible, and effective; it can decrease radiation exposure and number of CT passes during bone biopsies without increasing duration time. RELEVANCE STATEMENT This augmented reality (AR) navigation system is a safe and feasible guidance for bone biopsies; it may ensure a decrease in the number of CT passes and patient's radiation dose. KEY POINTS • This AR navigation system is a safe guidance for bone biopsies. • It ensures decrease of number of CT passes and patient's radiation exposure. • Procedure duration was similar to that of standard CT-guided biopsy. • Technical success was 100% as in all patients the target was reached. • Technical efficacy was 100% as the specimen was adequate in all patients.
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Affiliation(s)
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milan, 20161, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, 20122, Italy
| | - Salvatore Gitto
- IRCCS Istituto Ortopedico Galeazzi, Milan, 20161, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, 20122, Italy
| | - Vito Chianca
- Clinica Di Radiologia EOC IIMSI, Lugano, Switzerland
- Ospedale Evangelico Betania, Via Argine 604, Naples, 80147, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, 20161, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, 20122, Italy
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11
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von Ende E, Ryan S, Crain MA, Makary MS. Artificial Intelligence, Augmented Reality, and Virtual Reality Advances and Applications in Interventional Radiology. Diagnostics (Basel) 2023; 13:diagnostics13050892. [PMID: 36900036 PMCID: PMC10000832 DOI: 10.3390/diagnostics13050892] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/12/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
Artificial intelligence (AI) uses computer algorithms to process and interpret data as well as perform tasks, while continuously redefining itself. Machine learning, a subset of AI, is based on reverse training in which evaluation and extraction of data occur from exposure to labeled examples. AI is capable of using neural networks to extract more complex, high-level data, even from unlabeled data sets, and better emulate, or even exceed, the human brain. Advances in AI have and will continue to revolutionize medicine, especially the field of radiology. Compared to the field of interventional radiology, AI innovations in the field of diagnostic radiology are more widely understood and used, although still with significant potential and growth on the horizon. Additionally, AI is closely related and often incorporated into the technology and programming of augmented reality, virtual reality, and radiogenomic innovations which have the potential to enhance the efficiency and accuracy of radiological diagnoses and treatment planning. There are many barriers that limit the applications of artificial intelligence applications into the clinical practice and dynamic procedures of interventional radiology. Despite these barriers to implementation, artificial intelligence in IR continues to advance and the continued development of machine learning and deep learning places interventional radiology in a unique position for exponential growth. This review describes the current and possible future applications of artificial intelligence, radiogenomics, and augmented and virtual reality in interventional radiology while also describing the challenges and limitations that must be addressed before these applications can be fully implemented into common clinical practice.
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12
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Pose-Díez-de-la-Lastra A, Moreta-Martinez R, García-Sevilla M, García-Mato D, Calvo-Haro JA, Mediavilla-Santos L, Pérez-Mañanes R, von Haxthausen F, Pascau J. HoloLens 1 vs. HoloLens 2: Improvements in the New Model for Orthopedic Oncological Interventions. SENSORS 2022; 22:s22134915. [PMID: 35808407 PMCID: PMC9269857 DOI: 10.3390/s22134915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022]
Abstract
This work analyzed the use of Microsoft HoloLens 2 in orthopedic oncological surgeries and compares it to its predecessor (Microsoft HoloLens 1). Specifically, we developed two equivalent applications, one for each device, and evaluated the augmented reality (AR) projection accuracy in an experimental scenario using phantoms based on two patients. We achieved automatic registration between virtual and real worlds using patient-specific surgical guides on each phantom. They contained a small adaptor for a 3D-printed AR marker, the characteristic patterns of which were easily recognized using both Microsoft HoloLens devices. The newest model improved the AR projection accuracy by almost 25%, and both of them yielded an RMSE below 3 mm. After ascertaining the enhancement of the second model in this aspect, we went a step further with Microsoft HoloLens 2 and tested it during the surgical intervention of one of the patients. During this experience, we collected the surgeons’ feedback in terms of comfortability, usability, and ergonomics. Our goal was to estimate whether the improved technical features of the newest model facilitate its implementation in actual surgical scenarios. All of the results point to Microsoft HoloLens 2 being better in all the aspects affecting surgical interventions and support its use in future experiences.
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Affiliation(s)
- Alicia Pose-Díez-de-la-Lastra
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain; (A.P.-D.-d.-l.-L.); (R.M.-M.); (M.G.-S.); (D.G.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain; (J.A.C.-H.); (L.M.-S.); (R.P.-M.)
| | - Rafael Moreta-Martinez
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain; (A.P.-D.-d.-l.-L.); (R.M.-M.); (M.G.-S.); (D.G.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain; (J.A.C.-H.); (L.M.-S.); (R.P.-M.)
| | - Mónica García-Sevilla
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain; (A.P.-D.-d.-l.-L.); (R.M.-M.); (M.G.-S.); (D.G.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain; (J.A.C.-H.); (L.M.-S.); (R.P.-M.)
| | - David García-Mato
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain; (A.P.-D.-d.-l.-L.); (R.M.-M.); (M.G.-S.); (D.G.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain; (J.A.C.-H.); (L.M.-S.); (R.P.-M.)
| | - José Antonio Calvo-Haro
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain; (J.A.C.-H.); (L.M.-S.); (R.P.-M.)
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Lydia Mediavilla-Santos
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain; (J.A.C.-H.); (L.M.-S.); (R.P.-M.)
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Rubén Pérez-Mañanes
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain; (J.A.C.-H.); (L.M.-S.); (R.P.-M.)
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Felix von Haxthausen
- Institute for Robotics and Cognitive Systems, University of Lübeck, 23562 Lübeck, Germany;
| | - Javier Pascau
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain; (A.P.-D.-d.-l.-L.); (R.M.-M.); (M.G.-S.); (D.G.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain; (J.A.C.-H.); (L.M.-S.); (R.P.-M.)
- Correspondence: ; Tel.: +34-91-624-8196
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Luerken L, Haimerl M, Doppler M, Uller W, Beyer LP, Stroszczynski C, Einspieler I. Update on Percutaneous Local Ablative Procedures for the Treatment of Hepatocellular Carcinoma. ROFO-FORTSCHR RONTG 2022; 194:1075-1086. [PMID: 35545102 DOI: 10.1055/a-1768-0954] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide. Because many hepatocellular carcinomas are already unresectable at the time of initial diagnosis, percutaneous tumor ablation has become established in recent decades as a curative therapeutic approach for very early (BCLC 0) and early (BCLC A) HCC. The aim of this paper is to provide a concise overview of the percutaneous local ablative procedures currently in use, based on their technical characteristics as well as clinical relevance, taking into account the current body of studies. MATERIALS AND METHODS The literature search included all original papers, reviews, and meta-analyses available via MEDLINE and Pubmed on the respective percutaneous ablation procedures; the primary focus was on randomized controlled trials and publications from the last 10 years. RESULTS AND CONCLUSIONS Radiofrequency ablation (RFA) and microwave ablation (MWA) are well-established procedures that are considered equal to surgical resection in the treatment of stage BCLC 0 and A HCC with a diameter up to 3 cm due to their strong evidence in international and national guidelines. For tumors with a diameter between 3 and 5 cm, the current S3 guidelines recommend a combination of transarterial chemoembolization (TACE) and thermal ablation using RFA or MWA as combination therapy is superior to thermal ablation alone in tumors of this size and shows comparable results to surgical resection in terms of overall survival. Alternative, less frequently employed thermal procedures include cryotherapy (CT) and laser ablation (LA). Non-thermal procedures include irreversible electroporation (IRE), interstitial brachytherapy (IBT), and most recently, electrochemotherapy (ECT). Due to insufficient evidence, these have only been used in individual cases and within the framework of studies. However, the nonthermal methods are a reasonable alternative for ablation of tumors adjacent to large blood vessels and bile ducts because they cause significantly less damage to these structures than thermal ablation methods. With advances in the technology of the respective procedures, increasingly good evidence, and advancements in supportive techniques such as navigation devices and fusion imaging, percutaneous ablation procedures may expand their indications for the treatment of larger and more advanced tumors in the coming years. KEY POINTS · RFA and MWA are considered equal to surgical resection as a first-line therapy for the curative treatment of stage BCLC 0 and A HCCs with a diameter of up to 3 cm.. · For HCCs with a diameter between 3 and 5 cm, a combination of TACE and RFA or MWA is recommended. This combination therapy yields results comparable to those of surgical resection in terms of overall survival.. · Due to insufficient evidence, alternative ablation methods have only been used in individual cases and within the framework of studies. However, nonthermal methods, such as IRE, IBT, and, most recently, ECT, are a reasonable alternative for ablation of HCCs adjacent to large blood vessels and bile ducts because they cause significantly less damage to these structures than thermal ablation methods.. CITATION FORMAT · Luerken L, Haimerl M, Doppler M et al. Update on Percutaneous Local Ablative Procedures for the Treatment of Hepatocellular Carcinoma. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1768-0954.
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Affiliation(s)
- Lukas Luerken
- Department of Radiology, University Hospital Regensburg, Germany
| | - Michael Haimerl
- Institut für Röntgendiagnostik, University Hospital Regensburg, Germany
| | - Michael Doppler
- Department of Radiology, University Hospital Freiburg Department of Radiology, Freiburg, Germany
| | - Wibke Uller
- Department of Radiology, University Hospital Freiburg Department of Radiology, Freiburg, Germany
| | - Lukas Philipp Beyer
- Institut für Röntgendiagnostik, University Hospital Regensburg, Germany.,Diagnostische und Interventionelle Radiologie, Klinikum Ernst von Bergmann gGmbH, Potsdam, Germany
| | | | - Ingo Einspieler
- Department of Radiology, University Hospital Regensburg, Germany
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14
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Thermal Ablation of Liver Tumors Guided by Augmented Reality: An Initial Clinical Experience. Cancers (Basel) 2022; 14:cancers14051312. [PMID: 35267620 PMCID: PMC8909771 DOI: 10.3390/cancers14051312] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/25/2022] [Accepted: 02/27/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Over the last two decades, augmented reality (AR) has been used as a visualization tool in many medical fields in order to increase precision, limit the radiation dose, and decrease the variability among operators. Here, we report the first in vivo study of a novel AR system for the guidance of percutaneous interventional oncology procedures. Methods: Eight patients with 15 liver tumors (0.7−3.0 cm, mean 1.56 + 0.55) underwent percutaneous thermal ablations using AR guidance (i.e., the Endosight system). Prior to the intervention, the patients were evaluated with US and CT. The targeted nodules were segmented and three-dimensionally (3D) reconstructed from CT images, and the probe trajectory to the target was defined. The procedures were guided solely by AR, with the position of the probe tip was subsequently confirmed by conventional imaging. The primary endpoints were the targeting accuracy, the system setup time, and targeting time (i.e., from the target visualization to the correct needle insertion). The technical success was also evaluated and validated by co-registration software. Upon completion, the operators were assessed for cybersickness or other symptoms related to the use of AR. Results: Rapid system setup and procedural targeting times were noted (mean 14.3 min; 12.0−17.2 min; 4.3 min, 3.2−5.7 min, mean, respectively). The high targeting accuracy (3.4 mm; 2.6−4.2 mm, mean) was accompanied by technical success in all 15 lesions (i.e., the complete ablation of the tumor and 13/15 lesions with a >90% 5-mm periablational margin). No intra/periprocedural complications or operator cybersickness were observed. Conclusions: AR guidance is highly accurate, and allows for the confident performance of percutaneous thermal ablations.
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15
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Huber TC, Bochnakova T, Koethe Y, Park B, Farsad K. Percutaneous Therapies for Hepatocellular Carcinoma: Evolution of Liver Directed Therapies. J Hepatocell Carcinoma 2021; 8:1181-1193. [PMID: 34589446 PMCID: PMC8476177 DOI: 10.2147/jhc.s268300] [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: 06/15/2021] [Accepted: 08/31/2021] [Indexed: 12/13/2022] Open
Abstract
Percutaneous ablation is a mainstay of treatment for early stage, unresectable hepatocellular carcinoma (HCC). Recent advances in technology have created multiple ablative modalities for treatment of this common malignancy. The purpose of this review is to familiarize readers with the technical and clinical aspects of both existing and emerging percutaneous treatment options for HCC.
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Affiliation(s)
- Timothy C Huber
- Dotter Department of Interventional Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Teodora Bochnakova
- Dotter Department of Interventional Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Yilun Koethe
- Dotter Department of Interventional Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Brian Park
- Dotter Department of Interventional Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Khashayar Farsad
- Dotter Department of Interventional Radiology, Oregon Health and Science University, Portland, OR, USA
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16
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Zhao Z, Poyhonen J, Chen Cai X, Sophie Woodley Hooper F, Ma Y, Hu Y, Ren H, Song W, Tsz Ho Tse Z. Augmented reality technology in image-guided therapy: State-of-the-art review. Proc Inst Mech Eng H 2021; 235:1386-1398. [PMID: 34304631 PMCID: PMC8573682 DOI: 10.1177/09544119211034357] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Image-guided therapies have been on the rise in recent years as they can achieve higher accuracy and are less invasive than traditional methods. By combining augmented reality technology with image-guided therapy, more organs, and tissues can be observed by surgeons to improve surgical accuracy. In this review, 233 publications (dated from 2015 to 2020) on the design and application of augmented reality-based systems for image-guided therapy, including both research prototypes and commercial products, were considered for review. Based on their functions and applications. Sixteen studies were selected. The engineering specifications and applications were analyzed and summarized for each study. Finally, future directions and existing challenges in the field were summarized and discussed.
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Affiliation(s)
- Zhuo Zhao
- School of Electrical and Computer Engineering, University of Georgia, Athens, GA, USA
| | - Jasmin Poyhonen
- Department of Electronic Engineering, University of York, York, UK
| | - Xin Chen Cai
- Department of Electronic Engineering, University of York, York, UK
| | | | - Yangmyung Ma
- Hull York Medical School, University of York, York, UK
| | - Yihua Hu
- Department of Electronic Engineering, University of York, York, UK
| | - Hongliang Ren
- Department of Electronic Engineering The Chinese University of Hong Kong (CUHK), Hong Kong, China
| | - Wenzhan Song
- School of Electrical and Computer Engineering, University of Georgia, Athens, GA, USA
| | - Zion Tsz Ho Tse
- Department of Electronic Engineering, University of York, York, UK
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17
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Solbiati LA. Augmented Reality: Thrilling Future for Interventional Oncology? Cardiovasc Intervent Radiol 2021; 44:782-783. [PMID: 33709274 DOI: 10.1007/s00270-021-02801-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Luigi A Solbiati
- Department of Radiology, Humanitas Clinical and Research Center, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy. .,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy. .,, Via Carlo Cattaneo, 5, Busto Arsizio, VA, Italy.
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18
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Long DJ, Li M, De Ruiter QMB, Hecht R, Li X, Varble N, Blain M, Kassin MT, Sharma KV, Sarin S, Krishnasamy VP, Pritchard WF, Karanian JW, Wood BJ, Xu S. Comparison of Smartphone Augmented Reality, Smartglasses Augmented Reality, and 3D CBCT-guided Fluoroscopy Navigation for Percutaneous Needle Insertion: A Phantom Study. Cardiovasc Intervent Radiol 2021; 44:774-781. [PMID: 33409547 DOI: 10.1007/s00270-020-02760-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/23/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare needle placement performance using an augmented reality (AR) navigation platform implemented on smartphone or smartglasses devices to that of CBCT-guided fluoroscopy in a phantom. MATERIALS AND METHODS An AR application was developed to display a planned percutaneous needle trajectory on the smartphone (iPhone7) and smartglasses (HoloLens1) devices in real time. Two AR-guided needle placement systems and CBCT-guided fluoroscopy with navigation software (XperGuide, Philips) were compared using an anthropomorphic phantom (CIRS, Norfolk, VA). Six interventional radiologists each performed 18 independent needle placements using smartphone (n = 6), smartglasses (n = 6), and XperGuide (n = 6) guidance. Placement error was defined as the distance from the needle tip to the target center. Placement time was recorded. For XperGuide, dose-area product (DAP, mGy*cm2) and fluoroscopy time (sec) were recorded. Statistical comparisons were made using a two-way repeated measures ANOVA. RESULTS The placement error using the smartphone, smartglasses, or XperGuide was similar (3.98 ± 1.68 mm, 5.18 ± 3.84 mm, 4.13 ± 2.38 mm, respectively, p = 0.11). Compared to CBCT-guided fluoroscopy, the smartphone and smartglasses reduced placement time by 38% (p = 0.02) and 55% (p = 0.001), respectively. The DAP for insertion using XperGuide was 3086 ± 2920 mGy*cm2, and no intra-procedural radiation was required for augmented reality. CONCLUSIONS Smartphone- and smartglasses-based augmented reality reduced needle placement time and radiation exposure while maintaining placement accuracy compared to a clinically validated needle navigation platform.
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Affiliation(s)
- Dilara J Long
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Ming Li
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA.
| | - Quirina M B De Ruiter
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Rachel Hecht
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Xiaobai Li
- Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Nicole Varble
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA.,Philips Research of North America, Cambridge, MA, 02141, USA
| | - Maxime Blain
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Michael T Kassin
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Karun V Sharma
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, USA
| | - Shawn Sarin
- Department of Interventional Radiology, George Washington University Hospital, Washington, DC, USA
| | - Venkatesh P Krishnasamy
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - William F Pritchard
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - John W Karanian
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Bradford J Wood
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Sheng Xu
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
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Park BJ, Hunt SJ, Nadolski GJ, Gade TP. Augmented reality improves procedural efficiency and reduces radiation dose for CT-guided lesion targeting: a phantom study using HoloLens 2. Sci Rep 2020; 10:18620. [PMID: 33122766 PMCID: PMC7596500 DOI: 10.1038/s41598-020-75676-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/19/2020] [Indexed: 12/14/2022] Open
Abstract
Out-of-plane lesions pose challenges for CT-guided interventions. Augmented reality (AR) headsets are capable to provide holographic 3D guidance to assist CT-guided targeting. A prospective trial was performed assessing CT-guided lesion targeting on an abdominal phantom with and without AR guidance using HoloLens 2. Eight operators performed a cumulative total of 86 needle passes. Total needle redirections, radiation dose, procedure time, and puncture rates of nontargeted lesions were compared with and without AR. Mean number of needle passes to reach the target reduced from 7.4 passes without AR to 3.4 passes with AR (p = 0.011). Mean CT dose index decreased from 28.7 mGy without AR to 16.9 mGy with AR (p = 0.009). Mean procedure time reduced from 8.93 min without AR to 4.42 min with AR (p = 0.027). Puncture rate of a nontargeted lesion decreased from 11.9% without AR (7/59 passes) to 0% with AR (0/27 passes). First needle passes were closer to the ideal target trajectory with AR versus without AR (4.6° vs 8.0° offset, respectively, p = 0.018). AR reduced variability and elevated the performance of all operators to the same level irrespective of prior clinical experience. AR guidance can provide significant improvements in procedural efficiency and radiation dose savings for targeting out-of-plane lesions.
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Affiliation(s)
- Brian J Park
- Oregon Health and Science, University School of Medicine, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
| | - Stephen J Hunt
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Gregory J Nadolski
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Terence P Gade
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
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20
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Helmberger T. The evolution of interventional oncology in the 21st century. Br J Radiol 2020; 93:20200112. [PMID: 32706978 PMCID: PMC7465871 DOI: 10.1259/bjr.20200112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 12/15/2022] Open
Abstract
Interventional oncology (IO) has proven to be highly efficient in the local therapy of numerous malignant tumors in addition to surgery, chemotherapy, and radiotherapy. Due to the advent of immune-oncology with the possibility of tumor control at the molecular and cellular levels, a system change is currently emerging. This will significantly rule oncology in the coming decades. Therefore, one cannot think about IO in the 21st century without considering immunology. For IO, this means paying much more attention to the immunomodulatory effects of the interventional techniques, which have so far been neglected, and to explore the synergistic possibilities with immuno-oncology. It can be expected that the combined use of IO and immuno-oncology will help to overcome the limitations of the latter, such as limited local effects and a high rate of side-effects. To do this, however, sectoral boundaries must be removed and interdisciplinary research efforts must be strengthened. In case of success, IO will face an exciting future.
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Affiliation(s)
- Thomas Helmberger
- Department of Radiology, Neuroradiology, and minimal-invasive Therapy, Munich Klinik Bogenhausen Englschalkingerstr. 77 81925, Munich, Germany
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21
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Elsayed M, Kadom N, Ghobadi C, Strauss B, Al Dandan O, Aggarwal A, Anzai Y, Griffith B, Lazarow F, Straus CM, Safdar NM. Virtual and augmented reality: potential applications in radiology. Acta Radiol 2020; 61:1258-1265. [PMID: 31928346 DOI: 10.1177/0284185119897362] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The modern-day radiologist must be adept at image interpretation, and the one who most successfully leverages new technologies may provide the highest value to patients, clinicians, and trainees. Applications of virtual reality (VR) and augmented reality (AR) have the potential to revolutionize how imaging information is applied in clinical practice and how radiologists practice. This review provides an overview of VR and AR, highlights current applications, future developments, and limitations hindering adoption.
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Affiliation(s)
- Mohammad Elsayed
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Comeron Ghobadi
- Department of Radiology, The University of Chicago Pritzker School of Medicine, IL, USA
| | - Benjamin Strauss
- Department of Radiology, The University of Chicago Pritzker School of Medicine, IL, USA
| | - Omran Al Dandan
- Department of Radiology, Imam Abdulrahman Bin Faisal University College of Medicine, Dammam, Eastern Province, Saudi Arabia
| | - Abhimanyu Aggarwal
- Department of Radiology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Yoshimi Anzai
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Brent Griffith
- Department of Radiology, Henry Ford Health System, Detroit, MI, USA
| | - Frances Lazarow
- Department of Radiology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Christopher M Straus
- Department of Radiology, The University of Chicago Pritzker School of Medicine, IL, USA
| | - Nabile M Safdar
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
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22
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Li M, Seifabadi R, Long D, De Ruiter Q, Varble N, Hecht R, Negussie AH, Krishnasamy V, Xu S, Wood BJ. Smartphone- versus smartglasses-based augmented reality (AR) for percutaneous needle interventions: system accuracy and feasibility study. Int J Comput Assist Radiol Surg 2020; 15:1921-1930. [PMID: 32734314 DOI: 10.1007/s11548-020-02235-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/14/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the system accuracy and needle placement performance of smartphone- and smartglasses-based augmented reality (AR) for percutaneous needle interventions. METHODS An AR platform was developed to enable the superimposition of annotated anatomy and a planned needle trajectory onto a patient in real time. The system accuracy of the AR display on smartphone (iPhone7) and smartglasses (HoloLens1) devices was evaluated on a 3D-printed phantom. The target overlay error was measured as the distance between actual and virtual targets (n = 336) on the AR display, derived from preprocedural CT. The needle overlay angle was measured as the angular difference between actual and virtual needles (n = 12) on the AR display. Three operators each used the iPhone (n = 8), HoloLens (n = 8) and CT-guided freehand (n = 8) to guide needles into targets in a phantom. Needle placement error was measured with post-placement CT. Needle placement time was recorded from needle puncture to navigation completion. RESULTS The target overlay error of the iPhone was comparable to the HoloLens (1.75 ± 0.59 mm, 1.74 ± 0.86 mm, respectively, p = 0.9). The needle overlay angle of the iPhone and HoloLens was similar (0.28 ± 0.32°, 0.41 ± 0.23°, respectively, p = 0.26). The iPhone-guided needle placements showed reduced error compared to the HoloLens (2.58 ± 1.04 mm, 3.61 ± 2.25 mm, respectively, p = 0.05) and increased time (87 ± 17 s, 71 ± 27 s, respectively, p = 0.02). Both AR devices reduced placement error compared to CT-guided freehand (15.92 ± 8.06 mm, both p < 0.001). CONCLUSION An augmented reality platform employed on smartphone and smartglasses devices may provide accurate display and navigation guidance for percutaneous needle-based interventions.
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Affiliation(s)
- Ming Li
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA.
| | - Reza Seifabadi
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Dilara Long
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Quirina De Ruiter
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Nicole Varble
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
- Philips Research of North America, Cambridge, MA, USA
| | - Rachel Hecht
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Ayele H Negussie
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Venkatesh Krishnasamy
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Sheng Xu
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Bradford J Wood
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
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23
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Solbiati L, Gennaro N, Muglia R. Augmented Reality: From Video Games to Medical Clinical Practice. Cardiovasc Intervent Radiol 2020; 43:1427-1429. [PMID: 32632853 DOI: 10.1007/s00270-020-02575-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/22/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Luigi Solbiati
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. .,Department of Radiology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
| | - Nicolo' Gennaro
- Training School in Radiology, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Riccardo Muglia
- Training School in Radiology, Humanitas University, Pieve Emanuele, Milan, Italy
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24
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Park BJ, Hunt SJ, Martin C, Nadolski GJ, Wood BJ, Gade TP. Augmented and Mixed Reality: Technologies for Enhancing the Future of IR. J Vasc Interv Radiol 2020; 31:1074-1082. [PMID: 32061520 DOI: 10.1016/j.jvir.2019.09.020] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/01/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022] Open
Abstract
Augmented and mixed reality are emerging interactive and display technologies. These technologies are able to merge virtual objects, in either 2 or 3 dimensions, with the real world. Image guidance is the cornerstone of interventional radiology. With augmented or mixed reality, medical imaging can be more readily accessible or displayed in actual 3-dimensional space during procedures to enhance guidance, at times when this information is most needed. In this review, the current state of these technologies is addressed followed by a fundamental overview of their inner workings and challenges with 3-dimensional visualization. Finally, current and potential future applications in interventional radiology are highlighted.
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Affiliation(s)
- Brian J Park
- Department of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.
| | - Stephen J Hunt
- Department of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
| | - Charles Martin
- Department of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio
| | - Gregory J Nadolski
- Department of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
| | - Bradford J Wood
- Interventional Radiology, National Institutes of Health, Bethesda, Maryland
| | - Terence P Gade
- Department of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
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25
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Farshad-Amacker NA, Bay T, Rosskopf AB, Spirig JM, Wanivenhaus F, Pfirrmann CWA, Farshad M. Ultrasound-guided interventions with augmented reality in situ visualisation: a proof-of-mechanism phantom study. Eur Radiol Exp 2020; 4:7. [PMID: 32020366 PMCID: PMC7000569 DOI: 10.1186/s41747-019-0129-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/29/2019] [Indexed: 02/07/2023] Open
Abstract
Background Ultrasound (US) images are currently displayed on monitors, and their understanding needs good orientation skills. Direct overlay of US images onto the according anatomy is possible with augmented reality (AR) technologies. Our purpose was to explore the performance of US-guided needle placement with and without AR in situ US viewing. Methods Three untrained operators and two experienced radiologists performed 200 US-guided punctures: 100 with and 100 without AR in situ US. The punctures were performed in two different phantoms, a leg phantom with soft tissue lesions and a vessel phantom. Time to puncture and number of needle passes were recorded for each puncture. Data are reported as median [range] according to their non-normal distribution. Results AR in situ US resulted in reduced time (median [range], 13 s [3–101] versus 14 s [3–220]) and number of needle passes (median [range], 1 [1–4] versus 1 [1–8]) compared to the conventional technique. The initial gap in performance of untrained versus experienced operators with the conventional US (time, 21.5 s [3–220] versus 10.5 s [3–94] and needle passes 1 [1–8] versus 1 [1, 2]) was reduced to 12.5 s [3–101] versus 13 s [3–100] and 1 [1–4] versus 1 [1–4] when using AR in situ US, respectively. Conclusion AR in situ US could be a potential breakthrough in US applications by simplifying operator’s spatial orientation and reducing experience-based differences in performance of US-guided interventions. Further studies are needed to confirm these preliminary phantom results.
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Affiliation(s)
| | - Till Bay
- Incremed AG, Lenghalde 5, 8008, Zurich, Switzerland
| | - Andrea B Rosskopf
- Radiology, Balgrist University Hospital, Forchstrasse, 340, 8008, Zurich, Switzerland
| | - José M Spirig
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Florian Wanivenhaus
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | | | - Mazda Farshad
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
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26
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Gerup J, Soerensen CB, Dieckmann P. Augmented reality and mixed reality for healthcare education beyond surgery: an integrative review. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:1-18. [PMID: 31955150 PMCID: PMC7246121 DOI: 10.5116/ijme.5e01.eb1a] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 12/24/2019] [Indexed: 05/07/2023]
Abstract
OBJECTIVES This study aimed to review and synthesize the current research and state of augmented reality (AR), mixed reality (MR) and the applications developed for healthcare education beyond surgery. METHODS An integrative review was conducted on all relevant material, drawing on different data sources, including the databases of PubMed, PsycINFO, and ERIC from January 2013 till September 2018. Inductive content analysis and qualitative synthesis were performed. Additionally, the quality of the studies was assessed with different structured tools. RESULTS Twenty-six studies were included. Studies based on both AR and MR involved established applications in 27% of all cases (n=6), the rest being prototypes. The most frequently studied subjects were related to anatomy and anesthesia (n=13). All studies showed several healthcare educational benefits of AR and MR, significantly outperforming traditional learning approaches in 11 studies examining various outcomes. Studies had a low-to-medium quality overall with a MERSQI mean of 12.26 (SD=2.63), while the single qualitative study had high quality. CONCLUSIONS This review suggests the progress of learning approaches based on AR and MR for various medical subjects while moving the research base away from feasibility studies on prototypes. Yet, lacking validity of study conclusions, heterogeneity of research designs and widely varied reporting challenges transferability of the findings in the studies included in the review. Future studies should examine suitable research designs and instructional objectives achievable by AR and MR-based applications to strengthen the evidence base, making it relevant for medical educators and institutions to apply the technologies.
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Affiliation(s)
- Jaris Gerup
- School of Medical Sciences, University of Copenhagen, Denmark
| | | | - Peter Dieckmann
- Copenhagen Academy of Medical Education and Simulation (CAMES), Center for Human Resources, Herlev and Gentofte Hospital, Denmark
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27
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Smartphone Augmented Reality CT-Based Platform for Needle Insertion Guidance: A Phantom Study. Cardiovasc Intervent Radiol 2020; 43:756-764. [DOI: 10.1007/s00270-019-02403-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/21/2019] [Indexed: 01/06/2023]
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28
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Artificial Intelligence in Interventional Radiology: A Literature Review and Future Perspectives. JOURNAL OF ONCOLOGY 2019; 2019:6153041. [PMID: 31781215 PMCID: PMC6874978 DOI: 10.1155/2019/6153041] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 09/22/2019] [Accepted: 10/01/2019] [Indexed: 01/17/2023]
Abstract
The term “artificial intelligence” (AI) includes computational algorithms that can perform tasks considered typical of human intelligence, with partial to complete autonomy, to produce new beneficial outputs from specific inputs. The development of AI is largely based on the introduction of artificial neural networks (ANN) that allowed the introduction of the concepts of “computational learning models,” machine learning (ML) and deep learning (DL). AI applications appear promising for radiology scenarios potentially improving lesion detection, segmentation, and interpretation with a recent application also for interventional radiology (IR) practice, including the ability of AI to offer prognostic information to both patients and physicians about interventional oncology procedures. This article integrates evidence-reported literature and experience-based perceptions to assist not only residents and fellows who are training in interventional radiology but also practicing colleagues who are approaching to locoregional mini-invasive treatments.
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29
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Real-time control of respiratory motion: Beyond radiation therapy. Phys Med 2019; 66:104-112. [PMID: 31586767 DOI: 10.1016/j.ejmp.2019.09.241] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/23/2019] [Accepted: 09/26/2019] [Indexed: 12/16/2022] Open
Abstract
Motion management in radiation oncology is an important aspect of modern treatment planning and delivery. Special attention has been paid to control respiratory motion in recent years. However, other medical procedures related to both diagnosis and treatment are likely to benefit from the explicit control of breathing motion. Quantitative imaging - including increasingly important tools in radiology and nuclear medicine - is among the fields where a rapid development of motion control is most likely, due to the need for quantification accuracy. Emerging treatment modalities like focussed-ultrasound tumor ablation are also likely to benefit from a significant evolution of motion control in the near future. In the present article an overview of available respiratory motion systems along with ongoing research in this area is provided. Furthermore, an attempt is made to envision some of the most expected developments in this field in the near future.
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Auloge P, Cazzato RL, Ramamurthy N, de Marini P, Rousseau C, Garnon J, Charles YP, Steib JP, Gangi A. Augmented reality and artificial intelligence-based navigation during percutaneous vertebroplasty: a pilot randomised clinical trial. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 29:1580-1589. [DOI: 10.1007/s00586-019-06054-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 05/29/2019] [Accepted: 06/26/2019] [Indexed: 12/24/2022]
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