Impact of an Augmented Reality Navigation System (SIRIO) on Bone Percutaneous Procedures: A Comparative Analysis with Standard CT-Guided Technique

Abstract

(1) Background: The purpose of this study is to evaluate the impact of an augmented reality navigation system (SIRIO) for percutaneous biopsies and ablative treatments on bone lesions, compared to a standard CT-guided technique. (2) Methods: Bioptic and ablative procedures on bone lesions were retrospectively analyzed. All procedures were divided into SIRIO and Non-SIRIO groups and in <2 cm and >2 cm groups. Number of CT-scans, procedural time and patient’s radiation dose were reported for each group. Diagnostic accuracy was obtained for bioptic procedures. (3) Results: One-hundred-ninety-three procedures were evaluated: 142 biopsies and 51 ablations. Seventy-four biopsy procedures were performed using SIRIO and 68 under standard CT-guidance; 27 ablative procedures were performed using SIRIO and 24 under standard CT-guidance. A statistically significant reduction in the number of CT-scans, procedural time and radiation dose was observed for percutaneous procedures performed using SIRIO, in both <2 cm and >2 cm groups. The greatest difference in all variables examined was found for procedures performed on lesions <2 cm. Higher diagnostic accuracy was found for all SIRIO-assisted biopsies. No major or minor complications occurred in any procedures. (4) Conclusions: The use of SIRIO significantly reduces the number of CT-scans, procedural time and patient’s radiation dose in CT-guided percutaneous bone procedures, particularly for lesions <2 cm. An improvement in diagnostic accuracy was also achieved in SIRIO-assisted biopsies.

Lung Thermal Ablation: Comparison between an Augmented Reality Computed Tomography (CT) 3D Navigation System (SIRIO) and Standard CT-Guided Technique

“…In recent years, several guidance systems based on augmented reality navigation have been introduced in different surgical settings [20][21][22][23][24][25][26][27], including SIRIO, which has already been validated as an effective tool for the guidance of biopsy procedures on lung lesions [22,24]. To our knowledge, this is the first study in which SIRIO is evaluated as a tool to assist percutaneous LTA in comparison to standard CT-guidance which represents the most used technique.…”

“…Thus, navigation systems are emerging as a valid tool to reduce procedural times and administration of radiation doses, allowing electromagnetic [20,21], optical [22][23][24], or hybrid tracking [25][26][27] of the devices used during percutaneous interventions and their real-time visualization in a model obtained from a previously acquired CT scan.…”

User's image perception improved strategy and application of augmented reality systems in smart medical care: A review

“…(N) Screenshot of an operator introducing a 3rd Jamshidi needle by aligning it on the skin entry point (camera 4 in the bottom right corner), and using the other 3 cameras to ensure proper direction of the needle 72 . (O) SIRIO‐assisted needle positioning within a breast cancer metastasis of a lumbar vertebral body in order to perform an ablation procedure followed by cementoplasty 74 . (P) The real‐time video from the microscope 75 .…”

“…In this preliminary study, the AR‐HIP system provided more accurate information on acetabular cup placement angle than conventional methods. Faiella et al 74 . applied a Video‐based AR surgical navigation system for percutaneous biopsies and ablative treatments of bone lesions.…”

Treatment of Bone Metastasis

“…The decrease in visual analog scale score, following radiofrequency ablation, remained constant over time for up to one year, suggesting that pain relief was immediate and durable [ 21 ]. Faiella et al evaluated the impact of an augmented reality navigation system for percutaneous biopsies and ablative treatments on bone lesions, showing that the use of the augmented reality navigation system reduced the number of computer tomography scans, procedural time and patient’s radiation dose [ 22 ]. Campanacci et al treated 38 patients with bone metastases using electrochemotherapy [ 23 ].…”