Grasso Rosario Francesco, Luppi Giacomo, Cazzato Roberto Luigi, Faiella Eliodoro, D'Agostino Francesco, Beomonte Zobel Daniela, De Lena Mario
Università Campus Bio-Medico, Via Alvaro Del Portillo 200, Rome, Italy.
Tumori. 2012 Nov;98(6):775-82. doi: 10.1177/030089161209800616.
"Augmented reality" is a technique to create a composite view by augmenting the real intervention field, visualized by the doctor, with additional information coming from a virtual volume generated using computed tomography (CT), magnetic resonance or ultrasound images previously acquired from the same patient. In the present study we verified the accuracy and validated the clinical use of an augmented reality navigation system produced to perform percutaneous CT-guided lung biopsies.
One hundred and eighty consecutive patients with solitary parenchymal lung lesions, enrolled using a nonrandom enrollment system, underwent percutaneous CT-guided aspiration and core biopsy using a traditional technique (group C, 90 patients) and navigation system assistance (group S, 90 patients). For each patient we recorded the largest lesion diameter, procedure time, overall number of CT scans, radiation dose, and complications. The entire experimental project was evaluated and approved by the local institutional review board (ethics committee).
Each procedure was concluded successfully and a pathological diagnosis was reached in 96% of cases in group S and 90% of cases in group C. Procedure time, overall number of CT scans and incident x-ray radiation dose (CTDIvol) were significantly reduced in navigation system-assisted procedures (P <0.001; z = 5.64) compared with traditional CT-guided procedures. The percentage of procedural complications was 14% in group S and 17% in group C.
The augmented reality navigation system used in this study was a highly safe, technically reliable and effective support tool in percutaneous CT-guided lung biopsy, allowing to shorten the procedure time and reduce the incident x-ray radiation dose to patients and the rate of insufficient specimens. Furthermore, it has the potential to increase the number of procedures executed in the allocated time without increasing the number of complications.
“增强现实”是一种通过将医生可视化的真实干预视野与来自使用计算机断层扫描（CT）、磁共振或先前从同一患者获取的超声图像生成的虚拟容积的附加信息相结合，来创建合成视图的技术。在本研究中，我们验证了为进行经皮CT引导下肺活检而生产的增强现实导航系统的准确性，并对其临床应用进行了验证。
采用非随机入组系统纳入180例连续性孤立性肺实质病变患者，分别使用传统技术（C组，90例患者）和导航系统辅助（S组，90例患者）进行经皮CT引导下穿刺抽吸和芯针活检。记录每位患者的最大病变直径、操作时间、CT扫描总数、辐射剂量和并发症。整个实验项目经当地机构审查委员会（伦理委员会）评估并批准。
每组手术均成功完成，S组96%的病例和C组90%的病例获得了病理诊断。与传统CT引导手术相比，导航系统辅助手术的操作时间、CT扫描总数和入射X线辐射剂量（CTDIvol）显著减少（P<0.001；z = 5.64）。S组手术并发症发生率为14%，C组为17%。
本研究中使用的增强现实导航系统在经皮CT引导下肺活检中是一种高度安全、技术可靠且有效的支持工具，可缩短操作时间，减少患者的入射X线辐射剂量和标本不足率。此外，它有可能在不增加并发症数量的情况下，增加在规定时间内执行的手术数量。
