Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
World Neurosurg. 2019 Aug;128:268-276. doi: 10.1016/j.wneu.2019.04.256. Epub 2019 May 17.
Virtual reality (VR) and augmented reality (AR) represent novel adjuncts for neurosurgical planning in neuro-oncology. In addition to established use in surgical and medical training, VR/AR are gaining traction for clinical use preoperatively and intraoperatively. To understand the utility of VR/AR in the clinical setting, we conducted a literature search in Ovid MEDLINE and EMBASE with various search terms designed to capture the use of VR/AR in neurosurgical procedures for resection of cranial tumors. The search retrieved 302 articles, of which 35 were subjected to full-text review; 19 full-text articles were included in the review. Key findings highlighted by the individual authors were extracted and summarized into themes to present the value of VR/AR in the clinical setting. These studies included various VR/AR systems applied to surgeries involving heterogeneous pathologies and outcome measures. Overall, VR/AR were found to be qualitatively advantageous due to enhanced visualization of complex anatomy and improved intraoperative lesion localization. When these technologies were compared with existing neuronavigation systems, quantitative clinical benefits were also reported. The capacity to visualize three-dimensional images superimposed on patient anatomy is a potentially valuable tool in complex neurosurgical environments. Surgical limitations may be addressed through future advances in image registration and tracking as well as intraoperatively acquired imaging with the ability to yield real-time virtual models.
虚拟现实 (VR) 和增强现实 (AR) 是神经肿瘤学中神经外科规划的新辅助手段。除了在手术和医学培训中的既定用途外,VR/AR 也越来越多地用于术前和术中的临床应用。为了了解 VR/AR 在临床环境中的实用性,我们在 Ovid MEDLINE 和 EMBASE 中进行了文献检索,使用了各种旨在捕获 VR/AR 在颅肿瘤切除神经外科手术中应用的搜索词。检索到 302 篇文章,其中 35 篇进行了全文审查;综述纳入了 19 篇全文文章。从各作者的关键发现中提取并总结了主题,以展示 VR/AR 在临床环境中的价值。这些研究包括应用于涉及异质病理学和结果测量的各种 VR/AR 系统的手术。总体而言,由于复杂解剖结构的可视化增强和术中病变定位的改善,VR/AR 被认为具有定性优势。当将这些技术与现有的神经导航系统进行比较时,也报告了定量的临床益处。将三维图像叠加在患者解剖结构上的可视化能力是复杂神经外科环境中的一个潜在有价值的工具。通过未来在图像配准和跟踪方面的进展以及术中获得的能够生成实时虚拟模型的成像,可以解决手术限制问题。
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