Immersive 3D Visualisation (3D Printing, Virtual Reality) enhances spatial understanding of complex congenital heart defects

Abstract

Background: Diagnosing, managing complex CHD demands excellent morphological understanding. Individual differences in visuospatial skills, training and experience can impact spatial interpretation of volumetric cardiac imaging. Immersive 3D visualisation may help overcome these challenges, but evidence of clinical benefit is lacking. This study explores variability in visuospatial abilities and interpretation of conventionally viewed volumetric cardiac imaging data among members of a pediatric cardiac unit, and impact of using immersive 3D formats (3D-prints, Virtual Reality) on spatial understanding of complex CHD morphology. Methods: Prospective cohort study involving 9 heterogenous members of an advanced pediatric cardiac program [3 consultant cardiologists, 2 cardiothoracic surgeons, 1 cardiac radiologist, 3 cardiology trainees]. Participants visuospatial abilities were quantified using a validated test (Revised PSVT:R). Understanding of spatial relationships was assessed using structured questionnaires for 17 unique anonymised volumetric cardiac scans (15 CT, 2 MRI) of complex CHD visualised in three formats 1). conventional DICOM (CDICOM); 2). 3D prints (3DP); 3). Virtual Reality (VR). Accuracy, time taken, perceived level of difficulty, and confidence in interpretation were assessed and compared. Results : Spatial abilities varied widely (median 8, IQR 6-30), independent of expertise/experience. Limitations in conventional reading were significantly overcome with immersive 3D. Mean accuracy score of 60.48% +/- 17.13% with CDICOM increased to 83.93% +/- 7.84% with 3DP, and 90.81% +/- 5.03% with VR (p<0.001). 3DP and VR permitted significantly faster interpretation (p<0.001), with significantly better ease and confidence. Immersive 3D significantly narrowed gap between consultants and trainees. Conclusion: Immersive 3D visualisation of volumetric cardiovascular imaging can enhance spatial understanding of complex CHD morphology, overcoming challenges in spatial ability, experience, expertise.