Background
The purpose of this study was to investigate the potential of a combination of 3D mixed-reality visualization of medical images using CarnaLife Holo (MedApp, Poland) system as a supporting tool for innovative, minimally invasive surgery/irreversible electroporation—IRA, Nano-Knife), microwave ablation (MWA)/for advanced gastrointestinal tumors. Eight liver and pancreatic tumor treatments were performed. In all of the patients undergoing laparoscopy or open surgery volume and margin were estimated by preoperative visualization. In all patients, neoplastic lesions were considered unresectable by standard methods.
Methods
Preoperative CT or MRI were transformed into holograms and displayed thanks to the HoloLens 2. During operation, the surgeon’s field of view was augmented with a 3D model of the patient’s relevant structures.
Results
The intraoperative hologram contributed to better presentation of tumor size and locations, more precise setting of needles used to irreversible electroporation and for determining ablation line in case of liver metastases. Surgeons could easily compare the real patient's anatomy to holographic visualization just before the operations.
Conclusions
The combination of 3D mixed-reality visualization using CarnaLife Holo with IRA, MWA and next systemic treatment (chemotherapy) might be a new way in personalized treatment of advanced cancers.
Devices and systems secured by biometric factors became a part of our lives because they are convenient, easy to use, reliable, and secure. They use information about unique features of our bodies in order to authenticate a user. It is possible to enhance the security of these devices by adding supplementary modality while keeping the user experience at the same level. Palm vein systems are based on infrared wavelengths used for capturing images of users’ veins. It is both convenient for the user, and it is one of the most secure biometric solutions. The proposed system uses IR and UV wavelengths; the images are then processed by a deep convolutional neural network for extraction of biometric features and authentication of users. We tested the system in a verification scenario that consisted of checking if the images collected from the user contained the same biometric features as those in the database. The True Positive Rate (TPR) achieved by the system when the information from the two modalities were combined was 99.5% by the threshold of acceptance set to the Equal Error Rate (EER).
Background
Three-dimensional (3D) echocardiographic data acquired from transesophageal (TEE) window are commonly used in planning and during percutaneous structural cardiac interventions (PSCI).
Purpose
We hypothesized that innovative, interactive mixed reality display can be integrated with procedural PSCI workflow to improve perception and interpretation of 3D data representing cardiac anatomy.
Methods
3D TEE datasets were acquired before, during and after the completion of PSCI in 8 patients (occluders: 2 atrial appendage, 2 patent foramen ovale and 3 atrial septal implantations and percutaneous mitral commissurotomy). 30 Carthesian DICOM files were used to test the feasibility of mixed reality with commercially available head-mounted device (overlying hologram of 3D TEE data onto real-world view) as display for the interventional or imaging operator. Dedicated software was used for files conversion and 3D rendering of data to display device (in 1 case real-time Wi-Fi streaming from echocardiograph) and spatial manipulation of hologram during PSCI. Custom viewer was used to perform volume rendering and adjustment (cropping, transparency and shading control).
Results
Pre- and intraprocedural 3D TEE was performed in all 8 patients (5 women, age 40–83). Thirty selected 3DTEE datasets were successfully transferred and displayed in mixed reality head-mounted device as a holographic image overlying the real world view. The analysis was performed both before and during the procedure and compared with flatscreen 2-D display of the echocardiograph. In one case, real-time data transfer was successfully implemented during mitral balloon commissurotomy. The quality of visualization was judged as good without diagnostic content loss in all (100%) datasets. Both target structures and additional anatomical details were clearly presented including fenestrations of atrial septal defect, prominent Eustachian valve and earlier cardiac implants. Volume rendered views were touchlessly manipulated and displayed with a selection of intensity windows, transfer functions, and filters. Detail display was judged comparable to current 2-D volume-rendering on commercial workstations and touchless user interface - comfortable for optimization of views during PSCI.
Conclusions
Mixed reality display using a commercially available head-mounted device can be successfully integrated with preparation and execution of PSCI. The benefits of this solution include touchless image control and unobstructed real world viewing facilitating intraprocedural use, thus showing superiority over virtual or enhanced reality solutions. Expected progress includes integration of color flow data and optimization of real-time streaming option.
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