Clinical evaluation of augmented reality-based 3D navigation system for brachial plexus tumor surgery

Abstract

Background Augmented reality (AR), a form of 3D imaging technology, has been preliminarily applied in tumor surgery of the head and spine, both are rigid bodies. However, there is a lack of research evaluating the clinical value of AR in tumor surgery of the brachial plexus, a non-rigid body, where the anatomical position varies with patient posture. Methods Prior to surgery in 8 patients diagnosed with brachial plexus tumors, conventional MRI scans were performed to obtain conventional 2D MRI images. The MRI data were then differentiated automatically and converted into AR-based 3D models. After point-to-point relocation and registration, the 3D models were projected onto the patient’s body using a head-mounted display for navigation. To evaluate the clinical value of AR-based 3D models compared to the conventional 2D MRI images, 2 senior hand surgeons completed questionnaires on the evaluation of anatomical structures (tumor, arteries, veins, nerves, bones, and muscles), ranging from 1 (strongly disagree) to 5 (strongly agree). Results Surgeons rated AR-based 3D models as superior to conventional MRI images for all anatomical structures, including tumors. Furthermore, AR-based 3D models were preferred for preoperative planning and intraoperative navigation, demonstrating their added value. The mean positional error between the 3D models and intraoperative findings was approximately 1 cm. Conclusions This study evaluated, for the first time, the clinical value of an AR-based 3D navigation system in preoperative planning and intraoperative navigation for brachial plexus tumor surgery. By providing more direct spatial visualization, compared with conventional 2D MRI images, this 3D navigation system significantly improved the clinical accuracy and safety of tumor surgery in non-rigid bodies.

The Novel Impact of Augmented Reality and 3D Printing in the Diagnosis of Complex Acetabular Fractures: A Comparative Randomized Study in Orthopedic Residents

“…Three-dimensional volume rendering reconstruction helps visualize the sense of spatial anatomy and, likewise, pathology. This visionary process is described by many authors of different surgical and clinical specialties, not just for traumatology planning purposes, [ 8 , 9 ] but also for purposes from vascular neurosurgery to lung imaging [ 26 , 27 , 28 ].…”

Oncologia e Hematologia - Edição VI

“…As imagens de Ressonância Magnética (RM) podem ser reconstruídas em imagens 3D, no entanto, são apresentadas geralmente em formato 2D, a falta de representação espacial 3D limita o valor da aplicação da RM no planejamento pré-operatório e na navegação intraoperatória (ZHAO et al, 2024). Espera-se que a utilização destas visualizações 3D melhore a compreensão da localização precisa dos tumores e ajude na avaliação de estruturas anatômicas vitais, incluindo artérias, veias e nervos.…”

“…No pré-operatório, os modelos 3D representavam com precisão a morfologia do tumor, permitindo a avaliação das variações anatômicas dos doentes e orientando o desenho das incisões cirúrgicas mais adequadas (ZHAO et al, 2024). No intraoperatório, os modelos 3D foram projetados no corpo do doente através de HMD, permitindo a visualização simultânea do campo cirúrgico e dos modelos de navegação no mesmo campo de visão.…”