Artikel
Augmented reality (AR) guided ventricular puncture – design, implementation and initial evaluation
Augmented Reality (AR) geführte Ventrikelpunktion – Design, Implementierung und erste Bewertung
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Veröffentlicht: | 8. Mai 2019 |
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Objective: Augmented reality (AR) is a technique that superimposes virtual information into the real world. This can be achieved using AR glasses. Although being a routine procedure, ventricular drainages are only placed optimally in 60% of cases. Commercially available AR glasses are used as the sole active component in the operating room setup. Entry point and target area are visualised in a three-dimensional (3D) hologram that is projected onto the patient’s head. This-project aims to improve precision and safety of ventricular puncture through the use of AR, whilst simultaneously minimising disruption to the current workflow of this standard procedure.
Methods: Routine preoperative computed tomography (CT) data is utilised to reconstruct a 3D model of the cranial anatomy including the ventricular system. The entry point and target for the procedure are computed automatically before being reviewed by the surgeon. A passive tracking-marker is attached to the patient’s forehead. A surface matching algorithm running on the AR glasses is used to automatically register the marker system to the patient’s anatomy. This allows the projection of the holographic structures onto the patient’s head. Testing for computational speed of marker tracking and hologram rendering is conducted.
Results: Initial implementations and evaluations proved the feasibility of the proposed design. The AR device showed good performance and accurate visualisation with regard to hologram rendering and anatomical data presentation. Holograms of the visualised cranial anatomy could be positioned accurately and were stable during test procedures. Promising findings could be obtained with the evaluated marker system, tracking was successful at runtime. The ventricular system of a cranial model could be precisely punctured under AR guidance.
Conclusion: To our knowledge, this is the first implementation of an AR guided ventricular puncture procedure that employs real time patient tracking, using only the sensors of the AR glasses. The technique may increase the rate of correctly placed ventricular catheters and therefore make the procedure safer. Furthermore this approach has the potential to serve as a simple and compact navigation system in various emergency situations. Further applications beyond cranial surgery are being explored.