HoloInjection: augmented reality support for CT‐guided spinal needle injections

Abstract

The correct placement of needles is decisive for the success of many minimally-invasive interventions and therapies. These needle insertions are usually only guided by radiological imaging and can benefit from additional navigation support. Augmented reality (AR) is a promising tool to conveniently provide needed information and may thus overcome the limitations of existing approaches. To this end, a prototypical AR application was developed to guide the insertion of needles to spinal targets using the mixed reality glasses Microsoft HoloLens. The system's registration accuracy was attempted to measure and three guidance visualisation concepts were evaluated concerning achievable in-plane and out-of-plane needle orientation errors in a comparison study. Results suggested high registration accuracy and showed that the AR prototype is suitable for reducing out-of-plane orientation errors. Limitations, like comparatively high in-plane orientation errors, effects of the viewing position and missing image slices indicate potential for improvement that needs to be addressed before transferring the application to clinical trials.

Comparison of Augmented Reality Display Techniques to Support Medical Needle Insertion

“…Future work should, thus, investigate effects of different OST HMDs on guided needle insertion. Moreover, focal problems of the OST-HMD in use were reported in related work [20]. The issue is inherent to the HoloLens being designed for virtual content to be placed at 2 m distance.…”

“…Related work also implemented different techniques, which may have resulted in varying outcomes. For example, threedimensional access paths have been displayed, on which the needles needed to be aligned [15,20]. Especially devices with stereoscopic displaying capabilities (e.g.…”

“…without navigation system) and reported favorable results for the AR solution. Most of related work investigating OST AR navigation systems used HMDs to visualize guidance information within the view of the user [1,15,20]. These systems were positively assessed by measuring accuracy data of guided needle insertion tasks.…”

Application of Mixed Reality in Medical Training and Surgical Planning Focused on Minimally Invasive Surgery

“…This technology facilitates the spatial localisation of anatomical structures and improves mental alignment, which simplifies preoperative planning (Lee et al, 2017). This technology has already been evaluated as an assistance tool during endoscopic procedures (Al Janabi et al, 2020), spine surgery (Liu et al, 2020), interventional radiology procedures (Deib et al, 2018;Heinrich et al, 2019), and orthopaedic surgery (Gregory et al, 2018). In the latter, this technology was tested using the Holoportal MR application (TeraRecon; Durham, NC), as a proof of concept, in a real surgical environment during the implantation of a shoulder prosthesis (Gregory et al, 2018).…”

Development and Accuracy Evaluation of Augmented Reality-based Patient Positioning System in Radiotherapy: A Phantom Study

“…Augmented reality (AR), a variant of virtual reality (VR), enhances real-world imaging by virtually superimposing computer-generated images (11)(12)(13)(14). If AR is applied to the patient position at the time of radiotherapy, then it might become possible to skip line drawing on the patient's body.…”