Design and validation of a surgical navigation system for brachytherapy based on mixed reality

Abstract

Purpose An accurate position of the needle is vitally important in low‐dose‐rate seed implantation brachytherapy. Our paper aims to implement a mixed reality navigation system to assist with the placement of the I125 seed implantation thoracoabdominal tumor brachytherapy needle and to validate the accuracy and quality of this type of method. Methods With the surgical navigation system, based on mixed reality through a novel modified multi‐information fusion method, the fusion of virtual organs and a preoperative plan for a real patient and the tracking of surgical tools in real time were achieved. Personalized image recognition and pose estimation were used to track needle punctures in real time and to perform registration processes. After a one‐time registration with a hexagonal prism tracker that used an iterative closest point algorithm, all information, including medical images and volume renderings of organs, needles, and seeds, was precisely merged with the patient. Doctors were able to observe the tumor target and to visualize the preoperative plan. This system was validated in both phantom and animal experiments. The accuracy of this system was validated by calculating the positional and rotational error of each needle insertion. The accuracy of implantation of each seed was determined in an animal experiment to test the accuracy in low‐dose‐rate brachytherapy. The efficiency of this system was also validated through time consumption assessments. Results In the phantom experiment, the average error of the needle locations was 0.664 mm and the angle error was 4.74°, average time consumption was 16.1 min with six needles inserted. Based on the results of the animal experiment, the accuracy of the needle insertion was 1.617 mm, while the angle error was 5.574° and the average error of the seed positions was 1.925 mm. Conclusions This paper describes the design and experimental validation of a novel surgical navigation system based on mixed reality for I125 seed brachytherapy for thoracoabdominal tumors. This system was validated through a series of experiments, including phantom experiments and animal experiments. Compared with the traditional image‐guided system, the procedure presented here is convenient, displays clinically acceptable accuracy and reduces the number of CT scans, allowing doctors to perform surgery based on a visualized plan. All the experimental results indicated that the procedure is ready to be applied in further clinical studies.

Puncture and Dose Accuracies of Navigation-Assisted 3D-Printing Templates Combined with Computed Tomography Guided Radioactive Iodine-125 Seed Implantation in the Treatment of Malignant Tumors

“…Thus, the mean error of the angle was < 1°, and the mean error of distance was approximately 3 mm. Compared with the previous studies on 3DPT and/or INS assisted brachytherapy (the average tip error was 0.86-7 mm, and the average angle error was 1.9-5.6°), the accuracy of our study was similar or even better [3,[16][17][18]. Good accuracy contributes to reducing the times of CT scan con rmation and shortening the operation time.…”

The status of medical physics in radiotherapy in China

“…The top three subspecialties are radiation imaging (218 papers), radiation therapy (70 papers), and magnetic resonance (42 papers). Within the subspecialty of radiation therapy, the number of publications are 15 papers in the field of clinical implementation [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55], 11 papers in the field of plan optimization [56][57][58][59][60][61][62][63][64][65][66], 14 papers in the field of plan evaluation [67][68][69][70][71][72][73][74][75][76][77][78][79][80], and 12 papers in the field of quality assurance [81][82][83][84][85][86][87][88]…”

Effect of marker position and size on the registration accuracy of HoloLens in a non-clinical setting with implications for high-precision surgical tasks

“…Emerging augmented reality (AR) technologies such as holographic headsets allow the overlay of patient-specific virtual models obtained from medical scans on the patient’s body surface in a predefined position [ 1 ]. This helps to transfer image data produced during the planning of the surgery (e.g.…”

“…Few studies have systematically analysed the accuracy that can be achieved with the combined use of image-pattern-recognition algorithms and holographic headsets [ 20 ]. These studies did not measure the effect of image marker position and size on registration accuracy [ 1 ]. However, understanding this effect is the key to implement these systems in clinical practice as low accuracy may lead to errors in the position and dimensions with which the virtual models are perceived by surgeons during surgery.…”