Chen Ji-Gang, Han Kai-Wei, Zhang Dan-Feng, Li Zhen-Xing, Li Yi-Ming, Hou Li-Jun
Department of Neurosurgery, Shanghai Neurosurgical Institute, Changzheng Hospital, Shanghai, China.
Department of Neurosurgery, Shanghai Neurosurgical Institute, Changzheng Hospital, Shanghai, China.
World Neurosurg. 2017 Oct;106:193-197. doi: 10.1016/j.wneu.2017.06.146. Epub 2017 Jul 1.
Neuronavigation systems are used widely in the localization of intracranial lesions with satisfactory accuracy. However, they are expensive and difficult to learn. Therefore, a simple and practical augmented reality (AR) system using mobile devices might be an alternative technique.
We introduce a mobile AR system for the localization of supratentorial lesions. Its practicability and accuracy were examined by clinical application in patients and comparison with a standard neuronavigation system.
A 3-dimensional (3D) model including lesions was created with 3D Slicer. A 2-dimensional image of this 3D model was obtained and overlapped on the patient's head with the Sina app. Registration was conducted with the assistance of anatomical landmarks and fiducial markers. The center of lesion projected on scalp was identified with our mobile AR system and standard neuronavigation system, respectively. The difference in distance between the centers identified by these 2 systems was measured.
Our mobile AR system was simple and accurate in the localization of supratentorial lesions with a mean distance difference of 4.4 ± 1.1 mm. Registration added on an average of 141.7 ± 39 seconds to operation time. There was no statistically significant difference for the required time among 3 registrations (P = 0.646).
The mobile AR system presents an alternative technology for image-guided neurosurgery and proves to be practical and reliable. The technique contributes to optimal presurgical planning for supratentorial lesions, especially in the absence of a neuronavigation system.
神经导航系统广泛应用于颅内病变的定位，准确性令人满意。然而，它们价格昂贵且难以掌握。因此，一种使用移动设备的简单实用的增强现实（AR）系统可能是一种替代技术。
我们介绍一种用于幕上病变定位的移动AR系统。通过在患者中的临床应用并与标准神经导航系统进行比较，检验其实用性和准确性。
使用3D Slicer创建包含病变的三维（3D）模型。获取该3D模型的二维图像，并通过新浪应用程序将其叠加在患者头部。在解剖标志和基准标记的辅助下进行配准。分别使用我们的移动AR系统和标准神经导航系统确定投射在头皮上的病变中心。测量这两种系统确定的中心之间的距离差异。
我们的移动AR系统在幕上病变定位方面简单且准确，平均距离差异为4.4±1.1毫米。配准平均增加手术时间141.7±39秒。三次配准所需时间之间无统计学显著差异（P = 0.646）。
移动AR系统为图像引导神经外科手术提供了一种替代技术，且被证明是实用和可靠的。该技术有助于幕上病变的最佳术前规划，尤其是在没有神经导航系统的情况下。
