Abstract:Aims
Proof of concept and feasibility study for preoperative diagnostic use of mixed reality (MR) holograms of individual 3D heart models from standard cardiac computed tomography angiograms (CTA) images. Optimal repair for complex congenital heart disease poses high demands on 3D anatomical imagination. Three-dimensional printed heart models are increasingly used for improved morphological understanding during surgical and interventional planning. Holograms are a dynamic and interactive alte… Show more
“…In a patient with congenitally corrected transposition of the great arteries, augmented reality was used to guide transcatheter pacemaker implantation (28). Mixed reality using HoloLens® has helped surgeons understand the complex morphologies of CHD (29).…”
Recently improved three-dimensional (3D) cardiac imaging technologies are triggering the medical use of advanced visualization techniques including augmented reality, mixed reality, virtual reality, and 3D printing. The driving factor is the vast number of 3D cardiac images, acquired from patients with congenital heart disease (CHD), serving as a source of data for these new visualization techniques. Non-invasive visualization of accurate patient-specific cardiovascular anatomy is essential for the diagnosis and treatment of CHD, not only for accessing morphological complexity but also due to the difficulty deciding among the available treatment
“…In a patient with congenitally corrected transposition of the great arteries, augmented reality was used to guide transcatheter pacemaker implantation (28). Mixed reality using HoloLens® has helped surgeons understand the complex morphologies of CHD (29).…”
Recently improved three-dimensional (3D) cardiac imaging technologies are triggering the medical use of advanced visualization techniques including augmented reality, mixed reality, virtual reality, and 3D printing. The driving factor is the vast number of 3D cardiac images, acquired from patients with congenital heart disease (CHD), serving as a source of data for these new visualization techniques. Non-invasive visualization of accurate patient-specific cardiovascular anatomy is essential for the diagnosis and treatment of CHD, not only for accessing morphological complexity but also due to the difficulty deciding among the available treatment
“…Over 50 pasienter er inkludert i en studie av nytten av holografisk visualisering før hjertekirurgi. Tidlige resultater viser at teknologien er enkel i bruk og gir god dybdeopplevelse (7). Erfaringer fra enkelttilfeller viser at hologram kan forenkle forståelsen av komplekse medfødte hjertemisdannelser.…”
Section: Planlegging Navigering Og Visualiseringunclassified
Henrik Brun er overlege ved Barnekardiologisk avdeling, Oslo universitetssykehus, Rikshospitalet og postdoktorstipendiat ved Intervensjonssenteret, Oslo universitetssykehus. Forfatteren har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Han er medoppfinner av teknologi lisensiert til selskapet HoloCare AS og eier aksjer i selskapet indirekte via Inven2 AS. EGIDIJUS PELANIS Egidijus Pelanis er lege og forsker ved Intervensjonssenteret, Oslo universitetssykehus og ph.d.stipendiat ved Institutt for klinisk medisin, Universitetet i Oslo. Forfatteren har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Han er medoppfinner av teknologi lisensiert til selskapet HoloCare AS og eier aksjer i selskapet indirekte via Inven2 AS. OLA WIIG Ola Wiig er overlege ved Ortopedisk avdeling, Oslo universitetssykehus, Rikshospitalet. Forfatteren har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Han er medoppfinner av teknologi lisensiert til selskapet HoloCare AS og eier aksjer i selskapet indirekte via Inven2 AS. JAVIER ARMANDO LUZON Javier Armando Luzon er lege i spesialisering ved Gastrokirurgisk avdeling, Akershus universitetssykehus og klinisk ph.d.-stipendiat og lektor ved Institutt for klinisk medisin, Universitetet i Oslo. Forfatteren har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Han er medoppfinner av teknologi lisensiert til selskapet HoloCare AS og eier aksjer i selskapet indirekte via Inven2 AS. SIGURD BIRKELAND Sigurd Birkeland er overlege ved Seksjon for medfødte hjertefeil, Oslo universitetssykehus, Rikshospitalet. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. RAHUL PRASANNA KUMAR Rahul Prasanna Kumar er ingeniør og postdoktorstipendiat ved Intervensjonssenteret, Oslo universitetssykehus. Forfatteren har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Han er medoppfinner av teknologi lisensiert til selskapet HoloCare AS og eier aksjer i selskapet indirekte via Inven2 AS. ÅSMUND AVDEM FRETLAND Åsmund Avdem Fretland er overlege ved Intervensjonssenteret og Seksjon for lever-og pancreaskirurgi, Oslo universitetssykehus, Rikshospitalet. Forfatteren har fylt ut ICMJE-skjemaet og oppgiringen interessekonflikter.
“…The emergence of commercially available optical seethrough head-mounted display (HMD) systems has led to development of AR solutions for various image-guided surgical disciplines, including percutaneous vertebroplasty, kyphoplasty, lumbar facet joint injection, orthopedic fracture management, bone cancer treatment, total hip arthroplasty (THA), interlocking nailing, cardiovascular surgeries, and surgical education [26], [27], [28], [29], [30], [31], [32], [33], [16].…”
Suboptimal interaction with patient data and challenges in mastering 3D anatomy based on ill-posed 2D interventional images are essential concerns in image-guided therapies. Augmented reality (AR) has been introduced in the operating rooms in the last decade; however, in image-guided interventions, it has often only been considered as a visualization device improving traditional workflows. As a consequence, the technology is gaining minimum maturity that it requires to redefine new procedures, user interfaces, and interactions. The main contribution of this paper is to reveal how exemplary workflows are redefined by taking full advantageof head-mounted displays when entirely co-registered with the imaging system at all times. The awareness of the system from the geometric and physical characteristics of X-ray imaging allows the exploration of different human-machine interfaces. Our system achieved an error of 4.76 ± 2.91 mm for placing K-wire in a fracture management procedure, and yielded errors of 1.57 ± 1.16° and 1.46 ± 1.00° in the abduction and anteversion angles, respectively, for total hip arthroplasty (THA). We compared the results with the outcomes from baseline standard operative and non-immersive AR procedures, which had yielded errors of [4.61mm, 4.76°, 4.77°] and [5.13 mm, 1.78°, 1.43°], respectively, for wire placement, and abduction and anteversion during THA. We hope that our holistic approach towards improving the interface of surgery not only augments the surgeon’s capabilities but also augments the surgical team’s experience in carrying out an effective intervention with reduced complications and provide novel approaches of documenting procedures for training purposes.
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