Augmented reality surgical navigation system based on the spatial drift compensation method for glioma resection surgery

Abstract

Background The number of patients who suffer from glioma has been increasing, and this malignancy is a serious threat to human health. The mainstream treatment for glioma is surgical resection; therefore, accurate resection can improve postoperative patient recovery. Purpose Many studies have investigated surgical navigation guided by mixed reality, with good outcomes. However, the limitations of mixed reality, such as spatial drift caused by environmental changes, limit its clinical application. Therefore, we present a mixed reality surgical navigation system for glioma resection. Preoperative information can be fused precisely with the real patient with the spatial compensation method to achieve clinically suitable accuracy. Methods A head‐mounted device was used to display virtual information, and a markerless spatial registration method was applied to precisely align the virtual anatomy with the real patient preoperatively. High‐accuracy preoperative and intraoperative movement and spatial drift compensation methods were used to increase the positional accuracy of the mixed reality‐guided glioma resection system when the patient's head is fixed to the bed frame. Several experiments were designed to validate the accuracy and efficacy of this system. Results Phantom experiments were performed to test the efficacy and accuracy of this system under ideal conditions, and clinical tests were conducted to assess the performance of this system in clinical application. The accuracy of spatial registration was 1.18 mm in the phantom experiments and 1.86 mm in the clinical application. Conclusions Herein, we present a mixed reality‐based multimodality‐fused surgical navigation system for assisting surgeons in intuitively identifying the glioma boundary intraoperatively. The experimental results indicate that this system has suitable accuracy and efficacy for clinical usage.

Evaluation Metrics for Augmented Reality in Neurosurgical Preoperative Planning, Surgical Navigation, and Surgical Treatment Guidance: A Systematic Review

“…In 30 studies (38%), the use of a head-mounted device for neurosurgery was evaluated ( Supplemental Digital Content 2, Table 1 , http://links.lww.com/ONS/B48). 10-86 In most of these studies, the HoloLens (Microsoft) was used for AR visualization. In 26 studies (32%), an image overlay, for either the microscopic or endoscopic field of view, was used.…”

“…Most of the studies reported on multiple evaluation metrics ( Supplemental Digital Content 3, Table 2 , http://links.lww.com/ONS/B49). 10-83,85-90 Based on the results of this review, the following evaluation categories have been defined: (1) registration accuracy, (2) clinical outcome, (3) time measurements, (4) task performance, (5) technical reliability, and (6) user perception (Table).…”

“…In four studies (5%), an AR application for preoperative visualization of imaging data was described ( Supplemental Digital Content 4, Table 3 , http://links.lww.com/ONS/B50). 10-83,85-90 Their most frequently described evaluation metrics were user perception metrics (Table). Clinical outcome was mentioned in one study.…”

Visualization, registration and tracking techniques for augmented reality guided surgery: a review

“…Compared to ARToolkit, Vuforia SDK can Some articles also proposed their own tracking methods using custom-designed markers. An AR-guided neurosurgical navigation system for glioma resection was developed, and the HoloLens recovery accuracy of 0.88 mm was measured by using a marker pose estimation method (Zhou et al 2022). Custom-designed markers were also used by XVision, which was the first FDA-approved AR device for spine surgery, and the initial clinical experience showed good outcomes (Dibble and Molina 2021).…”

Microsoft HoloLens 2 in Medical and Healthcare Context: State of the Art and Future Prospects

“…Most of the studies [ 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 ] in this review are focused on application of HoloLens 2 in surgical navigation in the operating room and in the emergency department. The use of the AR/MR based system in this context provided the user with computer-generated information superimposed to real-world environment and improved accuracy, safety and efficacy of surgical procedures [ 86 ].…”