Vertebrae segmentation in reduced radiation CT imaging for augmented reality applications

Schonfeld, Ethan; Lotbinière-Bassett, Madeleine de; Jansen, Tatiana; Anthony, Diana; Veeravagu, Anand

doi:10.1007/s11548-022-02561-y

Cited by 6 publications

(1 citation statement)

References 25 publications

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“…Since the first clinically applied spinal navigation technique in 1995, 1-3 navigation technology, especially spinal navigation, has been constantly evolving, providing innovative ways to accurately diagnose, plan, simulate, and perform surgical procedures. [4][5][6][7] Although the two general methods of preoperatively acquired CT imaging-based navigation 2,3 and intraoperatively acquired (2D/3D fluoroscopy) imaging navigation 2,3,[8][9][10][11] are still in use today, the integration of augmented reality (AR), virtual reality, and mixed reality 12 into navigation systems is the subject of new innovative developments, which also improve the spatial awareness of surgeons and create an immersive, interactive experience. 13 Mixed reality is attractive in that it is an extension of AR and allows real and virtual elements to interact in an environment.…”

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confidence: 99%

Mixed reality for spine surgery: a step into the future with a human cadaveric accuracy study

Winkler,

Kropla,

Busse

et al. 2024

Neurosurgical Focus

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OBJECTIVE Current application of mixed reality as a navigation aid in the field of spinal navigation points to the potential of this technology in spine surgery. Crucial factors for acceptance include intuitive workflow, system stability, reliability, and accuracy of the method. The authors therefore aimed to investigate the accuracy of the system in visualization of anatomical structures using mixed reality in the example of pedicles of the thoracic spine in a human cadaveric study. Potential difficulties and limitations are discussed. METHODS CT scans of a human cadaveric spinal column specimen were performed. After segmentation and import into the advanced HoloLens 2 software, the vertebrae were exposed. The vertebral arches were preserved on one side for a landmark-based surface registration, whereas pedicles were exposed on the other side in order to measure and evaluate deviation of the overlay holographs with regard to the exact anatomical structure. Accuracy was measured and statistically evaluated. RESULTS In this work it was demonstrated that the overlay of the virtual 3D model pedicles with the real anatomical structures with anatomical landmark registration was within an acceptable surgical accuracy with the mean value of 2.1 mm (maximum 3.8 mm, minimum 1.2 mm). The highest accuracy was registered at the medial and lateral pedicle wall, and the measurement results were best in the region of the middle thoracic spine. CONCLUSIONS The accuracy analysis for mixed reality (i.e., between the virtual and real anatomical situation of the thoracic spine) showed a very good agreement when focus was on the pedicles. This work is thus a rare proof of the precision of segmentation to the potential surgical area. The results encourage researchers to open up mixed reality technology in its development and application for spinal navigation.

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