Towards X‐ray free endovascular interventions – using HoloLens for on‐line holographic visualisation

Abstract

A major challenge during endovascular interventions is visualising the position and orientation of the catheter being inserted. This is typically achieved by intermittent X-ray imaging. Since the radiation exposure to the surgeon is considerable, it is desirable to reduce X-ray exposure to the bare minimum needed. Additionally, transferring two-dimensional (2D) X-ray images to 3D locations is challenging. The authors present the development of a real-time navigation framework, which allows a 3D holographic view of the vascular system without any need of radiation. They extract the patient's surface and vascular tree from pre-operative computed tomography data and register it to the patient using a magnetic tracking system. The system was evaluated on an anthropomorphic full-body phantom by experienced clinicians using a four-point questionnaire. The average score of the system (maximum of 20) was found to be 17.5. The authors’ approach shows great potential to improve the workflow for endovascular procedures, by simultaneously reducing X-ray exposure. It will also improve the learning curve and help novices to more quickly master the required skills.

Assessing Accuracy and Precision of 3D Augmented Reality Holographic models derived from DICOM data

“…Currently, there is little existing literature assessing the accuracy of the 3D hologram derived from DICOM data.There have been some studies investigating the reliability of applications of AR in the medical workspace. A 2017 study evaluated the utility of AR in endovascular interventions using the HMD (7). CT data was utilized to reproduce a hologram of vasculature superimposed on a phantom, and a two-step calibration employing a tracked catheter demonstrated the plausibility of visualizing endovascular procedures without the use of x-ray.…”

“…Recent advances in technology have allowed for increased portability of augmented reality hardware, making more widespread utilization possible 8,9. While preliminary investigation of accuracy and precision of augmented reality models has been described with large, projection based equipment 10, only limited data exists for accuracy and precision of head mounted display (HMD)-based conversion of Digital Imaging and Communications in Medicine (DICOM) medical imaging information into augmented reality models (7). The aim of this study was to assess the accuracy and precision of the DICOM-derived 3D holographic models data on a HMD using a proprietary C# programming language-based software application and to determine if any statistically signi cant differences exist between gold-standard physical measurements, Picture Archiving and Communication System (PACS)-based measurements, and Augmented Reality holographic measurements.…”

A hand‐eye calibration method for augmented reality applied to computer‐assisted orthopedic surgery

“…The pose of the HoloLens is determined by a proprietary algorithm for Simultaneous localization and mapping (SLAM), which estimates the estates (i.e., position, orientation, linear accelerations, and angular velocities) of the headset with respect to the physical space by combining multi‐sensor data fusion techniques, e.g., inertial, depth, and visual cues. Recently, several studies have explored the possibility of using the Microsoft HoloLens in neurosurgery, reconstructive and plastic surgery, liver cancer surgery, endovascular surgery, and in telemedicine . In all these previously mentioned studies, the authors have not estimated the transformation between the physical and virtual reference frames.…”

Mixed reality application to support infrastructure maintenance

“…The application presented in this paper relies on 3D holographic views of an infrastructure. This infrastructure can be compared with a living organism with veins and arteries, as the one projected in a hologram by researchers at the University of Lübeck [1], as shown in Fig. 1.…”