Virtual reality and artificial intelligence for 3-dimensional planning of lung segmentectomies

Abstract

Background: There has been an increasing trend toward pulmonary segmentectomies to treat early-stage lung cancer, small intrapulmonary metastases, and localized benign pathology. A complete preoperative understanding of pulmonary anatomy is essential for accurate surgical planning and case selection. Identifying intersegmental divisions is extremely difficult when performed on computed tomography. For the preoperative planning of segmentectomies, virtual reality (VR) and artificial intelligence could allow 3-dimensional visualization of the complex anatomy of pulmonary segmental divisions, vascular arborization, and bronchial anatomy. This technology can be applied by surgeons preoperatively to gain better insight into a patient's anatomy for planning segmentectomy.Methods: In this prospective observational pilot study, we aim to assess and demonstrate the technical feasibility and clinical applicability of the first dedicated artificial intelligence-based and immersive 3-dimensional-VR platform

Developing Virtual Reality Head Mounted Display (HMD) Set-Up for Thoracoscopic Surgery of Complex Congenital Lung MalFormations in Children

“…According to data from the literature in adult patients, intraoperative 3D guiding and 3D vision in VATS may contribute to the safety and accuracy of anatomic resection, VR HMD is described to be more helpful for VR-based segmentectomy planning tool in adults patients in case of pulmonary tumor resection. In adults, preoperative VR HMD navigation allows pulmonary resection, and essential changes of surgical strategy are reported in almost 40% of the cases [ 20 ]; segmentectomies were successfully performed and all the oncologic resections were adequately done in all cases preoperatively evaluated under VR navigation. These data suggest that the preoperative review of surgical strategy is suitable and it does not need more imaging from the consult of radiologists or imaging technicians.…”

“…Introduction of Virtual Reality HMD in Pediatric Surgery VATS allows the surgeon to be more confident in small thoracic spaces and promote a culture of safety and error trap monitoring. Such technology could help to bridge the gap in the treatment of a group of conditions that may be faced rarely also by experienced pediatric surgeons [ 20 ]. All the pediatric team may benefit of VR HDM in terms of amelioration of quality of care, and learning curve in supporting surgeon during VATS procedure.…”

The Combination of Artificial Intelligence and Extended Reality: A Systematic Review

“…However, automated AI-based imaging algorithms can increase the efficiency of XR by providing automatic visualization of target parts of structures. For example, in patient anatomy applications, the combination of XR and AI can add novelty to the thoracic surgeons' armamentarium by enabling 3D visualization of the complex anatomy of vascular arborization, pulmonary segmental divisions, and bronchial anatomy (Sadeghi et al, 2021). Finally, XR can be used to visualize the deep learning (DL) structure (Meissler et al, 2019;VanHorn et al, 2019…”

“…In this combination, AI can help XR to effectively communicate and interact with users. Conferring intelligence on XR can be useful for different applications, such as cancer detection (Chen et al, 2019), gaming (Turan and Çetin, 2019), advanced visualization (Sadeghi et al, 2021), driver training (Ropelato et al, 2018), andvirtual patient andmedical training (Gutiérrez-Maldonado et al, 2008). For example, in virtual patient applications, AI has been used to create Artificial Intelligence Dialogue Systems (Talbot et al, 2012).…”

Commentary: Ready Player One: A new “reality?”

“…Successful completion of these operations can be challenging owing not only to their technical complexity but also to the difficulty in accurately identifying the correct anatomic segment on standard preoperative imaging. In their very interesting article in this issue of JTCVS Techniques , Sadeghi and colleagues 5 describe a novel technique to aid the preoperative planning of these procedures. They have developed a virtual reality (VR)-based tool that uses artificial intelligence to create fully segmented and colorized reconstructions of preoperative computed tomography scans.…”