Introduction
MRI‐guided targeted biopsy has become standard of care for diagnosis of prostate cancer, with establishment of several biopsy techniques and platforms. Augmented reality smart glasses have emerged as novel technology to support image‐guided interventions. We aimed to investigate its usage while prostate biopsy.
Methods
MRI with PIRADS‐lesions ≥3 was uploaded to smart glasses (Vuzix BladeR) and augmented reality smart glasses‐assisted targeted biopsy (SMART‐TB) of the prostate was performed using cognitive fusion technology at the point of care. Detection rates were compared to systematic biopsy. Feasibility for SMART‐TB was assessed (10 domains from bad [1] to excellent [10]).
Results
SMART‐TB was performed for four patients. Prostate cancer detection was more likely for SMART‐TB (46%; 13/28) than for systematic biopsy (27%; 13/48). Feasibility scores were high [8–10] for practicality, multitasking, execution speed, comfort and device weight and low [1–4] for handling, battery and image quality. Median execution time: 28 min; Investment cost smart glass: 1017 USD.
Conclusion
First description of SMART‐TB demonstrated convenient feasibility. This novel technology might enhance diagnosis of prostate cancer in future.
Zwar haben jeher technologische Weiterentwicklungen die medizinische Versorgung in deren stetigem Wandel optimiert, so waren diese jedoch immer noch für den Anwender weitestgehend fassbar. Getrieben durch immense finanzielle Anstrengungen sind innovative Produkte und technische Lösungen entstanden, die den medizinischen Alltag transformieren und diesen in Zukunft um eine Dimension erweitern werden: die Virtual und Augmented Reality. Dieser Übersichtsartikel fasst die aktuellen wissenschaftlichen Projekte und den zukünftigen Nutzen von Virtual und Augmented Reality im Fachgebiet der Urologie zusammen.
PurposeWhile several biopsy techniques and platforms for magnetic resonance imaging (MRI)-guided targeted biopsy of the prostate have been established, none of them has proven definite superiority. Augmented and virtual reality (mixed reality) smartglasses have emerged as an innovative technology to support image-guidance and optimize accuracy during medical interventions. We aimed to investigate the benefits of smartglasses for MRI-guided mixed reality-assisted cognitive targeted biopsy of the prostate.MethodsFor prospectively collected patients with suspect prostate PIRADS lesions, multiparametric MRI was uploaded to a smartglass (Microsoft® Hololens I), and smartglass-assisted targeted biopsy (SMART TB) of the prostate was executed by generation of a cognitive fusion technology at the point-of-care. Detection rates of prostate cancer (PCA) were compared between SMART TB and 12-core systematic biopsy. Assessment of SMART-TB was executed by the two performing surgeons based on 10 domains on a 10-point scale ranging from bad (1) to excellent (10).ResultsSMART TB and systematic biopsy of the prostate were performed for 10 patients with a total of 17 suspect PIRADS lesions (PIRADS 3, n = 6; PIRADS 4, n = 6; PIRADS 5, n = 5). PCA detection rate per core was significant (p < 0.05) higher for SMART TB (47%) than for systematic biopsy (19%). Likelihood for PCA according to each core of a PIRADS lesion (17%, PIRADS 3; 58%, PIRADS 4; 67%, PIRADS 5) demonstrated convenient accuracy. Feasibility scores for SMART TB were high for practicality (10), multitasking (10), execution speed (9), comfort (8), improvement of surgery (8) and image quality (8), medium for physical stress (6) and device handling (6) and low for device weight (5) and battery autonomy (4).ConclusionSMART TB has the potential to increase accuracy for PCA detection and might enhance cognitive MRI-guided targeted prostate biopsy in the future.
Introduction: Due to a lack of time and staff, informed consent (IC) in clinical practice often lacks clarity, comprehensibility and scope of information. Digital media offer great potential to enhance IC, but are still too rarely used. Aim of this study is to evaluate the effectiveness of multimedia-supported compared to traditional paper-based IC.
Methods: In the randomized, controlled, three-arm DICon (Digital Informed Consent for urological surgery) study 70 patients with an indication for prostate biopsy were randomized 1:1:1 to receive traditional paper-based IC vs. multimedia-supported information before IC vs. multimedia-supported information during IC. Patient satisfaction, anxiety and information gain were measured by validated questionnaires 2 weeks and directly before the procedure and time efficiency was recorded. Statistical analysis was performed using Kruskal-Wallis and Dunn's test (one-way ANOVA) and two-way ANOVA (with bonferroni post-test).
Results: Multimedia information prior to the consultation saved 32.9% time compared to paper-based (5.3 min. vs. 9.5 min; p<0.05) and 60.4% time compared to shared multimedia information (5.3 min. vs. 13.9 min.; p<0.001), with no difference in satisfaction (62.6 vs. 62.7 vs. 68.6 of max. 80; p=0.07), anxiety (8 vs. 8.1 vs. 7 of max. 16; p=0.35), or information gain (6.5 vs. 5.7 vs. 6.7 of max. 10; p=0.23). Results on satisfaction (56.6 vs. 62.6 vs. 66; p=0.06), anxiety (7.2 vs. 7.2 vs. 6.8; p=0.84), and information gain (7 vs. 6.4 vs. 5.9; p=0.43) remained stable over time.
Conclusions: Multimedia-supported IC provided improved time efficiency (33% gain) compared to traditional paper-based IC, with comparable satisfaction, anxiety and information gain. Multimedia-supported information materials should therefore be used more frequently in patient education.
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