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Queisner M, Eisenträger K. Surgical planning in virtual reality: a systematic review. J Med Imaging (Bellingham) 2024; 11:062603. [PMID: 38680654 PMCID: PMC11043584 DOI: 10.1117/1.jmi.11.6.062603] [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: 08/31/2023] [Revised: 03/05/2024] [Accepted: 03/18/2024] [Indexed: 05/01/2024] Open
Abstract
Purpose Virtual reality (VR) technology has emerged as a promising tool for physicians, offering the ability to assess anatomical data in 3D with visuospatial interaction qualities. The last decade has witnessed a remarkable increase in the number of studies focusing on the application of VR to assess patient-specific image data. This systematic review aims to provide an up-to-date overview of the latest research on VR in the field of surgical planning. Approach A comprehensive literature search was conducted based on the preferred reporting items for systematic reviews and meta-analyses covering the period from April 1, 2021 to May 10, 2023. It includes research articles reporting on preoperative surgical planning using patient-specific medical images in virtual reality using head-mounted displays. The review summarizes the current state of research in this field, identifying key findings, technologies, study designs, methods, and potential directions for future research. Results The selected studies show a positive impact on surgical decision-making and anatomy understanding compared to other visualization modalities. A substantial number of studies are reporting anecdotal evidence and case-specific outcomes. Notably, surgical planning using VR led to more frequent changes in surgical plans compared to planning with other visualization methods when surgeons reassessed their initial plans. VR demonstrated benefits in reducing planning time and improving spatial localization of pathologies. Conclusions Results show that the application of VR for surgical planning is still in an experimental stage but is gradually advancing toward clinical use. The diverse study designs, methodologies, and varying reporting hinder a comprehensive analysis. Some findings lack statistical evidence and rely on subjective assumptions. To strengthen evaluation, future research should focus on refining study designs, improving technical reporting, defining visual and technical proficiency requirements, and enhancing VR software usability and design. Addressing these areas could pave the way for an effective implementation of VR in clinical settings.
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Affiliation(s)
- Moritz Queisner
- Charité – Universitätsmedizin Berlin, Department of Surgery, Experimental Surgery, Berlin, Germany
- Humboldt Universität zu Berlin, Cluster of Excellence Matters of Activity, Berlin, Germany
| | - Karl Eisenträger
- Charité – Universitätsmedizin Berlin, Department of Surgery, Experimental Surgery, Berlin, Germany
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Keramati H, Lu X, Cabanag M, Wu L, Kushwaha V, Beier S. Applications and Advances of Immersive Technology in Cardiology. Curr Probl Cardiol 2024:102762. [PMID: 39067719 DOI: 10.1016/j.cpcardiol.2024.102762] [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: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024]
Abstract
Different forms of immersive technology, such as Virtual Reality (VR) and Augmented Reality (AR), are getting increasingly invested in medicine. Advances in head-mounted display technology, processing, and rendering power have demonstrated the increasing utility of immersive technology in medicine and the healthcare environment. There are a growing number of publications on using immersive technology in cardiology. We reviewed the articles published within the last decade that reported case studies or research that uses or investigates the application of immersive technology in the broad field of cardiology - from education to preoperative planning and intraoperative guidance. We summarize the advantages and disadvantages of using AR and VR for various application categories. Our review highlights the need for a robust assessment of the effectiveness of the methods and discusses the technical limitations that hinder the complete integration of AR and VR in cardiology, including cost-effectiveness and regulatory compliance. Despite the limitations and gaps that have inhibited us from benefiting from immersive technologies' full potential in cardiology settings to date, its promising impactful future for standard cardiovascular care is undoubtedly.
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Affiliation(s)
- Hamed Keramati
- School of Mechanical and Manufacturing Engineering, Faculty of Engineering, The University of New South Wales, Sydney, NSW 2052, Australia.
| | - Xueqing Lu
- Learning and Digital Environments, Deputy Vice-Chancellor Education and Student Experience, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Matt Cabanag
- School of Art and Design, Faculty of Arts, Design and Architecture, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Liao Wu
- School of Mechanical and Manufacturing Engineering, Faculty of Engineering, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Virag Kushwaha
- Eastern Heart Clinic, Prince of Wales Hospital, Barker Street Randwick, NSW 2031, Australia; Faculty of Medicine, The University of New South Wales, Kensington, Sydney, NSW 2033, Australia
| | - Susann Beier
- School of Mechanical and Manufacturing Engineering, Faculty of Engineering, The University of New South Wales, Sydney, NSW 2052, Australia
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Minga I, Al-Ani MA, Moharem-Elgamal S, Md AVH, Md ASA, Masoomi M, Mangi S. Use of Virtual Reality and 3D Models in Contemporary Practice of Cardiology. Curr Cardiol Rep 2024; 26:643-650. [PMID: 38683474 DOI: 10.1007/s11886-024-02061-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE OF REVIEW To provide an overview of the impact of virtual and augmented reality in contemporary cardiovascular medical practice. RECENT FINDINGS The utilization of virtual and augmented reality has emerged as an innovative technique in various cardiovascular subspecialties, including interventional adult, pediatric, and adult congenital as well as structural heart disease and heart failure. In particular, electrophysiology has proven valuable for both diagnostic and therapeutic procedures. The incorporation of 3D reconstruction modeling has significantly enhanced our understanding of patient anatomy and morphology, thereby improving diagnostic accuracy and patient outcomes. The interactive modeling of cardiac structure and function within the virtual realm plays a pivotal role in comprehending complex congenital, structural, and coronary pathology. This, in turn, contributes to safer interventions and surgical procedures. Noteworthy applications include septal defect device closure, transcatheter valvular interventions, and left atrial occlusion device implantation. The implementation of virtual reality has been shown to yield cost savings in healthcare, reduce procedure time, minimize radiation exposure, lower intravenous contrast usage, and decrease the extent of anesthesia required. These benefits collectively result in a more efficient and effective approach to patient care.
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Affiliation(s)
- Iva Minga
- University of Chicago Medical Center, Chicago, IL, USA
| | | | | | | | | | | | - Saima Mangi
- Liaquat National Hospital, Karachi, Pakistan.
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Dual SA, Cowger J, Roche E, Nayak A. The Future of Durable Mechanical Circulatory Support: Emerging Technological Innovations and Considerations to Enable Evolution of the Field. J Card Fail 2024; 30:596-609. [PMID: 38431185 DOI: 10.1016/j.cardfail.2024.01.011] [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: 12/22/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 03/05/2024]
Abstract
The field of durable mechanical circulatory support (MCS) has undergone an incredible evolution over the past few decades, resulting in significant improvements in longevity and quality of life for patients with advanced heart failure. Despite these successes, substantial opportunities for further improvements remain, including in pump design and ancillary technology, perioperative and postoperative management, and the overall patient experience. Ideally, durable MCS devices would be fully implantable, automatically controlled, and minimize the need for anticoagulation. Reliable and long-term total artificial hearts for biventricular support would be available; and surgical, perioperative, and postoperative management would be informed by the individual patient phenotype along with computational simulations. In this review, we summarize emerging technological innovations in these areas, focusing primarily on innovations in late preclinical or early clinical phases of study. We highlight important considerations that the MCS community of clinicians, engineers, industry partners, and venture capital investors should consider to sustain the evolution of the field.
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Affiliation(s)
- Seraina A Dual
- KTH Royal Institute of Technology, Department of Biomedical Engineering and Health Systems, Stockholm, Sweden
| | | | - Ellen Roche
- Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Aditi Nayak
- Baylor University Medical Center, Dallas, Texas.
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Kulshrestha K, Morales DLS. Myocardial support of the failing heart in adult congenital heart disease. Curr Probl Pediatr Adolesc Health Care 2023:101396. [PMID: 37391343 DOI: 10.1016/j.cppeds.2023.101396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Affiliation(s)
- Kevin Kulshrestha
- The Heart Institute, Department of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, United States
| | - David L S Morales
- The Heart Institute, Department of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, United States.
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Vegulla RV, Tandon A, Rathinaswamy J, Cherian KM, Hussain T, Murala JS. Advanced imaging and digitization of preserved heart specimens using virtual reality - A primer. Ann Pediatr Cardiol 2022; 15:351-357. [PMID: 36935839 PMCID: PMC10015399 DOI: 10.4103/apc.apc_176_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 05/12/2022] [Accepted: 06/11/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Preserved congenital heart specimens are an important component of training professionals working with children and adults with congenital heart disease. They are curated in few institutions worldwide and not freely accessible. This was a proof-of-concept project to explore the use of advanced cardiac imaging modalities (computed tomography [CT] and magnetic resonance imaging [MRI]) and virtual reality (VR) simulation to assess the feasibility and identify the best method of imaging curated cardiac pathology specimens. Methods Seven specimens in glass jars with formalin, with varied anatomic lesions, from a curated collection were imaged using MRI and high-dose CT to compare the fidelity of models created via each modality. Three-dimensional (3D) models were created and loaded into a VR headset and viewed in virtual space. Two independent physicians performed a "virtual dissection" and scored the resultant models. Results The highest fidelity and tissue characterization of more delicate structures was achieved with T2 spoiled gradient-echo sequences on MRI (median score of 4 out of 5). CT (median score of 3), while excellent for external anatomy, lost some fidelity with delicate internal anatomy, even at high-radiation doses. No specimens were damaged. Conclusions We believe that in vitro heart specimens can be easily scanned with high fidelity at a relatively low cost, without causing damage, using high-dose CT and MRI. The ability to "walk through" different chambers of the heart makes the understanding of anatomy easy and intuitive. VR and 3D printing are technologies that could be easily adapted to digitize preserved heart specimens, making it globally accessible for teaching and training purposes.
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Affiliation(s)
- Ravi V. Vegulla
- Department of Pediatric Cardiology, University of Texas Southwestern, Dallas, Texas, USA
| | - Animesh Tandon
- Department of Pediatric Cardiology, University of Texas Southwestern, Dallas, Texas, USA
| | - Jebaraj Rathinaswamy
- Department of Pediatric Cardiology, Sri Ramachandra Medical Centre, Chennai, Tamil Nadu, India
| | - Kotturathu Mammen Cherian
- Department of Cardiovascular and Thoracic Surgery, Frontier Lifeline Hospital, Chennai, Tamil Nadu, India
| | - Tarique Hussain
- Department of Pediatric Cardiology, University of Texas Southwestern, Dallas, Texas, USA
| | - John S. Murala
- Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern, Dallas, Texas, USA
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Ramakrishnan S. Pediatric cardiology: Is India self-reliant? Ann Pediatr Cardiol 2021; 14:253-259. [PMID: 34667394 PMCID: PMC8457276 DOI: 10.4103/apc.apc_153_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 11/07/2022] Open
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