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International Journal of Computer Assisted Radiology and Surgery

Erschienen in:

01.11.2015 | Original Article

Augmented reality in neurovascular surgery: feasibility and first uses in the operating room

verfasst von: Marta Kersten-Oertel, Ian Gerard, Simon Drouin, Kelvin Mok, Denis Sirhan, David S. Sinclair, D. Louis Collins

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 11/2015

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Abstract

Purpose

The aim of this report is to present a prototype augmented reality (AR) intra-operative brain imaging system. We present our experience of using this new neuronavigation system in neurovascular surgery and discuss the feasibility of this technology for aneurysms, arteriovenous malformations (AVMs), and arteriovenous fistulae (AVFs).

Methods

We developed an augmented reality system that uses an external camera to capture the live view of the patient on the operating room table and to merge this view with pre-operative volume-rendered vessels. We have extensively tested the system in the laboratory and have used the system in four surgical cases: one aneurysm, two AVMs and one AVF case.

Results

The developed AR neuronavigation system allows for precise patient-to-image registration and calibration of the camera, resulting in a well-aligned augmented reality view. Initial results suggest that augmented reality is useful for tailoring craniotomies, localizing vessels of interest, and planning resection corridors.

Conclusion

Augmented reality is a promising technology for neurovascular surgery. However, for more complex anomalies such as AVMs and AVFs, better visualization techniques that allow one to distinguish between arteries and veins and determine the absolute depth of a vessel of interest are needed.

https://www.opengl.org/documentation/glsl/.

Edwards P, Hawkes D, Hill D, Jewell D, Spink R, Strong A, Gleeson M (1995) Augmentation of reality using an operating microscope for otolaryngology and neurosurgical guidance. J Image Guid Surg 1(3):172–178CrossRefPubMed

Stieg P, Batjer H, Samson D (2007) Intracranial arteriovenous malformations. CRC Press, New York

Hope TA, Hope MD, Purcell DD, von Morze C, Vigneron DB, Alley MT, Dillon WP (2010) Evaluation of intracranial stenoses and aneurysms with accelerated 4D flow. Magn Reson Imaging 28:41–46CrossRefPubMed

Spetzler RF, Kondziolka DS, Higashida RT, Kalani MYS (2014) Comprehensive management of arteriovenous malformations of the brain and spine. Cambridge University Press, CambridgeCrossRef

Kersten-Oertel M, Jannin P, Collins DL (2013) The state of the art of visualization in mixed reality image guided surgery. Comput Med Imaging Graph 37:98–112CrossRefPubMed

Kawamata T, Iseki H, Shibasaki T, Hori T (2002) Endoscopic augmented reality navigation system for endonasal transsphenoidal surgery to treat pituitary tumors: technical note. Neurosurgery 50:1393–1397PubMed

Cabrilo I, Bijlenga P, Schaller K (2014) Augmented reality in the surgery of cerebral aneurysms: a technical report. Neurosurgery 10(Suppl. 2):252–260; discussion 260–261

Cabrilo I, Bijlenga P, Schaller K (2014) Augmented reality in the surgery of cerebral arteriovenous malformations: technique assessment and considerations. Acta Neurochir (Wien) 156:1769–1774CrossRef

Paul P, Fleig O, Jannin P (2005) Augmented virtuality based on stereoscopic reconstruction in multimodal image-guided neurosurgery: methods and performance evaluation. IEEE Trans Med Imaging 24:1500–1511CrossRefPubMed

10.

Rosahl SK, Shahidi R (2008) The virtual operating field—how image guidance can become integral to microneurosurgery. In: Ramina R, de Aguiar PHP, Tatagiba M (eds) Samii’s essentials in neurosurgery. Springer, Berlin, pp 11–20

11.

Shahidi R, Bax MR, Maurer CR Jr, Johnson JA, Wilkinson EP, Bai W, West JB, Citardi MJ, Manwaring KH, Khadem R (2002) Implementation, calibration and accuracy testing of an image-enhanced endoscopy system. Med Imaging IEEE Trans 21:1524–1535CrossRef

12.

King AP, Edwards PJ, Maurer CR, de Cunha DA, Gaston RP, Clarkson M, Hill DLG, Hawkes DJ, Fenlon MR, Strong AJ, Cox TCS, Gleeson MJ (2000) Stereo augmented reality in the surgical microscope. Presence-Teleoperators Virtual Environ 9:360–368CrossRef

13.

Gleason PL, Kikinis R, Altobelli D, Wells W, Alexander E, Black PM, Jolesz F (1994) Video registration virtual reality for nonlinkage stereotactic surgery. Stereotact Funct Neurosurg 63:139–143

14.

Edwards PJ, King AP, Hawkes DJ, Fleig O, Maurer CR Jr, Hill DL, Fenlon MR, de Cunha DA, Gaston RP, Chandra S, Mannss J, Strong AJ, Gleeson MJ, Cox TC (1999) Stereo augmented reality in the surgical microscope. Stud Health Technol Inform 62:102–108

15.

Birkfellner W, Figl M, Matula C, Hummel J, Hanel R, Imhof H, Wanschitz F, Wagner A, Watzinger F, Bergmann H (2003) Computer-enhanced stereoscopic vision in a head-mounted operating binocular. Phys Med Biol 48:N49–N57CrossRefPubMed

16.

Birkfellner W, Figl M, Huber K, Watzinger F, Wanschitz F, Hummel J, Hanel R, Greimel W, Homolka P, Ewers R, Bergmann H (2002) A head-mounted operating binocular for augmented reality visualization in medicine—design and initial evaluation. IEEE Trans Med Imaging 21:991–997CrossRefPubMed

17.

Mercier L, Del Maestro RF, Petrecca K, Kochanowska A, Drouin S, Yan CX, Janke AL, Chen SJ, Collins DL (2011) New prototype neuronavigation system based on preoperative imaging and intraoperative freehand ultrasound: system description and validation. Int J Comput Assist Radiol Surg 6:507–522CrossRefPubMed

18.

Gerard I, Collins DL (2015) An analysis of tracking error in image guided neurosurgery. IJCARS 9. doi:10.1007/s11548-014-1145-2

19.

Zhang Z (2004) Camera calibration with one-dimensional objects. IEEE Trans Pattern Anal Mach Intell 26:892–899CrossRefPubMed

20.

Moghari MH, Abolmaesumi P (2010) Understanding the effect of bias in fiducial localization error on point-based rigid-body registration. IEEE Trans Med Imaging 29:1730–1738CrossRefPubMed

21.

Labadie RF, Davis BM, Fitzpatrick JM (2005) Image-guided surgery: what is the accuracy? Curr Opin Otolaryngol Head Neck Surg 13:27–31CrossRefPubMed

22.

Liu W, Ding H, Han H, Xue Q, Sun Z, Wang G (2009) The study of fiducial localization error of image in point-based registration. Conf Proc IEEE Eng Med Biol Soc 2009:5088–5091PubMed

23.

Kersten-Oertel M, Jannin P, Collins DL (2012) DVV: a taxonomy for mixed reality visualization in image guided surgery. IEEE Trans Vis Comput Graph 18:332–352

24.

Drouin S, Kersten-Oertel M, Chen SJS, Collins DL (2012) A realistic test and development environment for mixed reality in neurosurgery. In: Linte CA, Moore JT, Chen ECS, Holmes DR III (eds) Augmented environments for computer-assisted interventions (AE-CAI). Lecture notes in computer science, vol 7264, pp 13–23

25.

Hansen C, Wieferich J, Ritter F, Rieder C, Peitgen HO (2010) Illustrative visualization of 3D planning models for augmented reality in liver surgery. Int J Comput Assist Radiol Surg 5:133–141CrossRefPubMed

26.

Johnson L, Edwards P, Hawkes D (2002) Surface transparency makes stereo overlays unpredictable: the implications for augmented reality. Stud Health Technol Inform 94:131–136

27.

Lerotic M, Chung AJ, Mylonas G, Yang GZ (2007) Pq-space based non-photorealistic rendering for augmented reality. Med Image Comput Comput Assist Interv 10:102–109PubMed

28.

Kersten-Oertel M, Chen SJ, Collins DL (2014) An evaluation of depth enhancing perceptual cues for vascular volume visualization in neurosurgery. IEEE Trans Vis Comput Graph 20(3):391–403CrossRefPubMed

29.

Kersten-Oertel M, Chen SJ, Collins DL (2013) An evaluation of depth enhancing perceptual cues for vascular volume visualization in neurosurgery. IEEE Trans Vis Comput Graph 20:391–403CrossRef

30.

Kersten-Oertel M, Gerard I, Mok K, Sirhan D, Sinclair D, Collins DL (2014) Augmented reality in neurovascular surgery: first experiences. In: Linte CA, Yaniv Z, Fallavollita P, Abolmaesumi P, Holmes DR III (eds) Augmented environments for computer-assisted interventions (AE-CAI). Lecture notes in computer science, vol 8678, pp 80–89

31.

Aschke M, Wirtz CR, Raczkowsky J, Worn H, Kunze S (2003) Augmented reality in operating microscopes for neurosurgical interventions. In: Neural engineering, 2003. Conference Proceedings. First international IEEE EMBS conference on, pp 652–655

Titel: Augmented reality in neurovascular surgery: feasibility and first uses in the operating room
verfasst von: Marta Kersten-Oertel
Ian Gerard
Simon Drouin
Kelvin Mok
Denis Sirhan
David S. Sinclair
D. Louis Collins
Publikationsdatum: 01.11.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 11/2015
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-015-1163-8

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Augmented reality in neurovascular surgery: feasibility and first uses in the operating room