Development of Innovative Neurosurgical Operation Support Method Using Mixed-Reality Computer Graphics

Koike, Tsukasa; Kin, Taichi; Tanaka, Shota; Takeda, Yasuhiro; Uchikawa, Hiroki; Shiode, Taketo; Saito, Toki; Takami, Hirokazu; Takayanagi, Shunsaku; Mukasa, Akitake; Oyama, Hiroshi; Saito, Nobuhito

doi:10.1016/j.wnsx.2021.100102

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…At the time of data abstraction, based on primary aims, studies were sub-grouped into the following categories: “ development” and “ intervention” . Ten (45%) studies ( 46 , 48 – 50 , 53 , 54 , 57 – 59 , 67 ) evaluated the technical design and suitability of AR for glioma surgery, principally assessing feasibility, accuracy, and/or reliability benchmarks (i.e., development). The remaining 12 (55%) studies ( 47 , 51 , 52 , 55 , 56 , 60 – 66 ) investigated the clinical utility of AR for glioma surgery, with a focus on feasibility, safety, and/or efficacy profiles (i.e., intervention).…”

Section: Resultsmentioning

confidence: 99%

Intra-operative applications of augmented reality in glioma surgery: a systematic review

Ragnhildstveit,

Li,

Zimmerman

et al. 2023

Front. Surg.

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BackgroundAugmented reality (AR) is increasingly being explored in neurosurgical practice. By visualizing patient-specific, three-dimensional (3D) models in real time, surgeons can improve their spatial understanding of complex anatomy and pathology, thereby optimizing intra-operative navigation, localization, and resection. Here, we aimed to capture applications of AR in glioma surgery, their current status and future potential.MethodsA systematic review of the literature was conducted. This adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. PubMed, Embase, and Scopus electronic databases were queried from inception to October 10, 2022. Leveraging the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) framework, study eligibility was evaluated in the qualitative synthesis. Data regarding AR workflow, surgical application, and associated outcomes were then extracted. The quality of evidence was additionally examined, using hierarchical classes of evidence in neurosurgery.ResultsThe search returned 77 articles. Forty were subject to title and abstract screening, while 25 proceeded to full text screening. Of these, 22 articles met eligibility criteria and were included in the final review. During abstraction, studies were classified as “development” or “intervention” based on primary aims. Overall, AR was qualitatively advantageous, due to enhanced visualization of gliomas and critical structures, frequently aiding in maximal safe resection. Non-rigid applications were also useful in disclosing and compensating for intra-operative brain shift. Irrespective, there was high variance in registration methods and measurements, which considerably impacted projection accuracy. Most studies were of low-level evidence, yielding heterogeneous results.ConclusionsAR has increasing potential for glioma surgery, with capacity to positively influence the onco-functional balance. However, technical and design limitations are readily apparent. The field must consider the importance of consistency and replicability, as well as the level of evidence, to effectively converge on standard approaches that maximize patient benefit.

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Section: Resultsmentioning

confidence: 99%

Intra-operative applications of augmented reality in glioma surgery: a systematic review

Ragnhildstveit,

Li,

Zimmerman

et al. 2023

Front. Surg.

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“…Compared to the conventional navigation system that uses infrared light or magnetic field guidance for topographic adjustment [ 31 ], our AR navigation system recognizes the gross landmarks of the anatomic structures and superimposes them on the created images, which has several advantages. First, in this AR navigation system, the created image is identical to the image of the surgical field [ 32 , 33 , 34 , 35 ]. Thus, it is easy to superimpose the image on the surgical anatomy, and we can comprehend the anatomy of the surgical field more intuitively, which is a major advantage of our system.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a Novel Augmented Reality Navigation System Using 3D Computer Graphic Modeling in Endoscopic Transsphenoidal Surgery for Sellar and Parasellar Tumors

Goto¹,

Kawaguchi²,

Inoue³

et al. 2023

Cancers

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In endoscopic transsphenoidal skull base surgery, knowledge of tumor location on imaging and the anatomic structures is required simultaneously. However, it is often difficult to accurately reconstruct the endoscopic vision of the surgical field from the pre-surgical radiographic images because the lesion remarkably displaces the geography of normal anatomic structures. We created a precise three-dimensional computer graphic model from preoperative radiographic data that was then superimposed on a visual image of the actual surgical field and displayed on a video monitor during endoscopic transsphenoidal surgery. We evaluated the efficacy of this augmented reality (AR) navigation system in 15 consecutive patients with sellar and parasellar tumors. The average score overall was 4.7 [95% confidence interval: 4.58–4.82], which indicates that the AR navigation system was as useful as or more useful than conventional navigation in certain patients. In two patients, AR navigation was assessed as less useful than conventional navigation because perception of the depth of the lesion was more difficult. The developed system was more useful than conventional navigation for facilitating an immediate three-dimensional understanding of the lesion and surrounding structures.

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“…The acquisition conditions for these data were derived from our group's previous report. 23 (1) MRI: A 3 Tesla MRI system (SIGNA™ 3.0T, GE Yokogawa Medical Systems Ltd, Tokyo, Japan) for head examinations with an 8-channel coil was used. Imaging parameters: (1a) Contrast-enhanced MRI: fast imaging employing steady-state acquisition.…”

Section: Images and Systemsmentioning

confidence: 99%

Development of a New Image-Guided Neuronavigation System: Mixed-Reality Projection Mapping Is Accurate and Feasible

Koike¹,

Kin²,

Tanaka³

et al. 2021

Operative Surg.

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BACKGROUND Image-guided systems improve the safety, functional outcome, and overall survival of neurosurgery but require extensive equipment. OBJECTIVE To develop an image-guided surgery system that combines the brain surface photographic texture (BSP-T) captured during surgery with 3-dimensional computer graphics (3DCG) using projection mapping. METHODS Patients who underwent initial surgery with brain tumors were prospectively enrolled. The texture of the 3DCG (3DCG-T) was obtained from 3DCG under similar conditions as those when capturing the brain surface photographs. The position and orientation at the time of 3DCG-T acquisition were used as the reference. The correct position and orientation of the BSP-T were obtained by aligning the BSP-T with the 3DCG-T using normalized mutual information. The BSP-T was combined with and displayed on the 3DCG using projection mapping. This mixed-reality projection mapping (MRPM) was used prospectively in 15 patients (mean age 46.6 yr, 6 males). The difference between the centerlines of surface blood vessels on the BSP-T and 3DCG constituted the target registration error (TRE) and was measured in 16 fields of the craniotomy area. We also measured the time required for image processing. RESULTS The TRE was measured at 158 locations in the 15 patients, with an average of 1.19 ± 0.14 mm (mean ± standard error). The average image processing time was 16.58 min. CONCLUSION Our MRPM method does not require extensive equipment while presenting information of patients’ anatomy together with medical images in the same coordinate system. It has the potential to improve patient safety.

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Development of Innovative Neurosurgical Operation Support Method Using Mixed-Reality Computer Graphics

Cited by 10 publications

References 30 publications

Intra-operative applications of augmented reality in glioma surgery: a systematic review

Intra-operative applications of augmented reality in glioma surgery: a systematic review

Efficacy of a Novel Augmented Reality Navigation System Using 3D Computer Graphic Modeling in Endoscopic Transsphenoidal Surgery for Sellar and Parasellar Tumors

Development of a New Image-Guided Neuronavigation System: Mixed-Reality Projection Mapping Is Accurate and Feasible

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