A Novel Surgery Navigation System Combined with Augmented Reality Based on Image Target Positioning System

Chiou, Shin-Yan; Liu, Hao-Li; Lee, Chia‐Wei; Lee, Meng-Yuan; Tsai, Ching‐Yao; Fu, Chi-Lun; Chen, Pin-Yuan; Wei, Kuo‐Chen

doi:10.1109/iccece46942.2019.8941839

Cited by 2 publications

(3 citation statements)

References 3 publications

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“…The method proposed by Chiou et al [ 17 ] enables the instant display of DICOM-formatted images superimposed on the patient’s head. However, their method is only a concept, and can only place the identification map under the patient’s head.…”

Section: Discussionmentioning

confidence: 99%

“…Many AR applications in medical treatment are used for pre-surgical simulation and practice [ 14 , 15 , 16 ]. Chiou et al [ 17 ] proposed an augmented reality system based on image target positioning, which can superimpose digital imaging and communications in medicine (DICOM) images over the patient’s head to provide more intuitive surgical assistance. Konishi et al [ 11 ] performed pre-surgical computed tomography (CT) and magnetic resonance imaging (MRI) examinations on patients using body surface markers, with optical tracking used to create 3D reconstruction images which were then superimposed on the patient during subsequent surgery.…”

Section: Introductionmentioning

confidence: 99%

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Augmented Reality Surgical Navigation System for External Ventricular Drain

et al. 2022

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Augmented reality surgery systems are playing an increasing role in the operating room, but applying such systems to neurosurgery presents particular challenges. In addition to using augmented reality technology to display the position of the surgical target position in 3D in real time, the application must also display the scalpel entry point and scalpel orientation, with accurate superposition on the patient. To improve the intuitiveness, efficiency, and accuracy of extra-ventricular drain surgery, this paper proposes an augmented reality surgical navigation system which accurately superimposes the surgical target position, scalpel entry point, and scalpel direction on a patient’s head and displays this data on a tablet. The accuracy of the optical measurement system (NDI Polaris Vicra) was first independently tested, and then complemented by the design of functions to help the surgeon quickly identify the surgical target position and determine the preferred entry point. A tablet PC was used to display the superimposed images of the surgical target, entry point, and scalpel on top of the patient, allowing for correct scalpel orientation. Digital imaging and communications in medicine (DICOM) results for the patient’s computed tomography were used to create a phantom and its associated AR model. This model was then imported into the application, which was then executed on the tablet. In the preoperative phase, the technician first spent 5–7 min to superimpose the virtual image of the head and the scalpel. The surgeon then took 2 min to identify the intended target position and entry point position on the tablet, which then dynamically displayed the superimposed image of the head, target position, entry point position, and scalpel (including the scalpel tip and scalpel orientation). Multiple experiments were successfully conducted on the phantom, along with six practical trials of clinical neurosurgical EVD. In the 2D-plane-superposition model, the optical measurement system (NDI Polaris Vicra) provided highly accurate visualization (2.01 ± 1.12 mm). In hospital-based clinical trials, the average technician preparation time was 6 min, while the surgeon required an average of 3.5 min to set the target and entry-point positions and accurately overlay the orientation with an NDI surgical stick. In the preparation phase, the average time required for the DICOM-formatted image processing and program import was 120 ± 30 min. The accuracy of the designed augmented reality optical surgical navigation system met clinical requirements, and can provide a visual and intuitive guide for neurosurgeons. The surgeon can use the tablet application to obtain real-time DICOM-formatted images of the patient, change the position of the surgical entry point, and instantly obtain an updated surgical path and surgical angle. The proposed design can be used as the basis for various augmented reality brain surgery navigation systems in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Augmented Reality Surgical Navigation System for External Ventricular Drain

et al. 2022

View full text Add to dashboard Cite

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“…Many of AR in medical treatment are used for presimulation and practice [14][15][16]. Chiou et al [17] proposed an augmented reality technology based on image target positioning system in 2019, which can instantly display the image of Dicom superimposed on the patient's head to provide surgical assistance and let the doctor's operation vision more intuitive and focused. However, their method is only a concept, and can only place the identification map under the patient's head.…”

Section: Introductionmentioning

confidence: 99%

Clinical Testing on External Ventricular Drainage Guidance using Mixed Reality

Chiou

Zhang

Liu

et al. 2021

Preprint

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Augmented reality surgery systems have played an important role in assisting physicians in their operations. However, applying the system to brain neurosurgery is challenging. In addition to using the augmented reality technology to display the 3D position of the surgical target position in real time, we also need to consider the display of the scalpel entry point and scalpel orientation, and their accurate superposition on patients. This paper proposes a mixed reality surgical navigation system, which accurately superimposes the surgical target position, scalpel entry point and scalpel direction on a patient's head and displays it on a tablet, facilitating the visual and intuitive way for the brain neurosurgery. Based on the current neurosurgery navigation system, we integrated mixed reality technology on it. We first independently tested the accuracy of the optical measurement system-NDI Polaris Vicra, and then designed functions that a physician can quickly point out the surgical target position and decide an entry point position, and a tablet can display the superimposed images of surgical target, entry point, and scalpel, and perform the correctness of scalpel orientation. Then we used the Dicom of the patient CT to create a phantom and it’s AR model, imported this AR model into the APP, and installed and executed the APP on the tablet. In the preoperative phase, the technician first superimposed the AR image of head and the scalpel in 5-7 minutes, and then the physician point out and set the target position and entry point position in 2 minutes on a tablet, which then dynamically displayed the superimposed image of the head, target position, entry point position, and scalpel (including the scalpel tip and scalpel spatial direction). We successfully conducted multiple experiments on phantom and six experiments on clinical neurosurgical EVD practice. In the 2D-plane-superposition model (n = 60), the optical measurement system (NDI Polaris Vicra) was feasible of the visualization space with high accuracy (mean error ± standard deviation (SD): 2.013 ± 1.118 mm). In the clinical trials in the hospital (n = 4), the average technician preparation time was 6.317 minutes. The average time (n = 4) required for the physician to set the target position and the entry-point position and accurately overlay the orientation with a surgical stick was 3.5 minutes. In the preparation phase, the average time required for the Dicom image processing and program importing was 120 ± 30 minutes. The designed mixed reality optical surgical navigation system can successfully achieve clinical accuracy, and guide physicians to perform brain surgery visually and intuitively. In addition, the physician can use the APP of the tablet device to instantly obtain Dicom images with the designated patient, change the position of the surgical entry point, and instantly obtain the accurate surgical path and surgical angle after the modification. This design can be used as the basis for various AR or MR brain surgery navigation systems in the future.

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A Novel Surgery Navigation System Combined with Augmented Reality Based on Image Target Positioning System

Cited by 2 publications

References 3 publications

Augmented Reality Surgical Navigation System for External Ventricular Drain

Augmented Reality Surgical Navigation System for External Ventricular Drain

Clinical Testing on External Ventricular Drainage Guidance using Mixed Reality

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