Ultrasound-guided interventions with augmented reality in situ visualisation: a proof-of-mechanism phantom study

Abstract

Background Ultrasound (US) images are currently displayed on monitors, and their understanding needs good orientation skills. Direct overlay of US images onto the according anatomy is possible with augmented reality (AR) technologies. Our purpose was to explore the performance of US-guided needle placement with and without AR in situ US viewing. Methods Three untrained operators and two experienced radiologists performed 200 US-guided punctures: 100 with and 100 without AR in situ US. The punctures were performed in two different phantoms, a leg phantom with soft tissue lesions and a vessel phantom. Time to puncture and number of needle passes were recorded for each puncture. Data are reported as median [range] according to their non-normal distribution. Results AR in situ US resulted in reduced time (median [range], 13 s [3–101] versus 14 s [3–220]) and number of needle passes (median [range], 1 [1–4] versus 1 [1–8]) compared to the conventional technique. The initial gap in performance of untrained versus experienced operators with the conventional US (time, 21.5 s [3–220] versus 10.5 s [3–94] and needle passes 1 [1–8] versus 1 [1, 2]) was reduced to 12.5 s [3–101] versus 13 s [3–100] and 1 [1–4] versus 1 [1–4] when using AR in situ US, respectively. Conclusion AR in situ US could be a potential breakthrough in US applications by simplifying operator’s spatial orientation and reducing experience-based differences in performance of US-guided interventions. Further studies are needed to confirm these preliminary phantom results.

Evaluation of how users interface with holographic augmented reality surgical scenes: Interactive planning MR‐Guided prostate biopsies

“…29 Another study by Amacker et al used the HoloLens for ultrasound-guided needle placement on the leg and vessel phantoms. 30 These preliminary studies demonstrated the potential use of improving the operator's spatial orientation. Similar studies have shown the usage of the HoloLens in lumbar facet joint injections, 31 CT-guided lesion targeting, 32 and radiofrequency ablations for liver tumours.…”

Image-guided Sports Medicine and Musculoskeletal Tumor Interventions: A Patient-Centered Model

“…93 Artificial intelligence algorithms promise automated needle tracking and dynamic updating of image plane adjustments for constant visualization of the needle profile in the image plane. Holographic lenses and three-dimensional holograms, 94 as well as virtual and augmented reality, 95,96 may improve target visualization and appreciation of regional anatomy, targeting, training, and operator confidence. 97,98…”

In Situ Visualization for 3D Ultrasound-Guided Interventions with Augmented Reality Headset

“…Overcoming such issues entails using AR HMDs to simplify the learning and performing of ultrasound-guided interventions [19][20][21][22]. Head-mounted displays (VST in [19][20][21] and OST in [22]) are used to visualize data from a 2D ultrasound probe.…”

“…Overcoming such issues entails using AR HMDs to simplify the learning and performing of ultrasound-guided interventions [19][20][21][22]. Head-mounted displays (VST in [19][20][21] and OST in [22]) are used to visualize data from a 2D ultrasound probe. The ultrasound image is directly superimposed on the patient's anatomy in a 1:1 ratio so that the hand-eye coordination process is simplified as "the operator can directly aim the tip of the needle into the ultrasound image" [22].…”

“…Head-mounted displays (VST in [19][20][21] and OST in [22]) are used to visualize data from a 2D ultrasound probe. The ultrasound image is directly superimposed on the patient's anatomy in a 1:1 ratio so that the hand-eye coordination process is simplified as "the operator can directly aim the tip of the needle into the ultrasound image" [22]. Rosenthal et al [21] made a quantitative study of 50 biopsies (25 performed with the traditional approach and 25 with the aid of an AR VST headset) and showed that the mean error in terms of deviation from the desired target was statistically significantly smaller in the HMD method than in the standard one.…”