Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain.
Sensors (Basel). 2021 Feb 15;21(4):1370. doi: 10.3390/s21041370.
During the last decade, orthopedic oncology has experienced the benefits of computerized medical imaging to reduce human dependency, improving accuracy and clinical outcomes. However, traditional surgical navigation systems do not always adapt properly to this kind of interventions. Augmented reality (AR) and three-dimensional (3D) printing are technologies lately introduced in the surgical environment with promising results. Here we present an innovative solution combining 3D printing and AR in orthopedic oncological surgery. A new surgical workflow is proposed, including 3D printed models and a novel AR-based smartphone application (app). This app can display the patient's anatomy and the tumor's location. A 3D-printed reference marker, designed to fit in a unique position of the affected bone tissue, enables automatic registration. The system has been evaluated in terms of visualization accuracy and usability during the whole surgical workflow. Experiments on six realistic phantoms provided a visualization error below 3 mm. The AR system was tested in two clinical cases during surgical planning, patient communication, and surgical intervention. These results and the positive feedback obtained from surgeons and patients suggest that the combination of AR and 3D printing can improve efficacy, accuracy, and patients' experience.
在过去的十年中，骨肿瘤学受益于计算机医学成像，以减少对人的依赖，提高准确性和临床效果。然而，传统的手术导航系统并不总是能很好地适应这种干预。增强现实（AR）和三维（3D）打印技术是最近引入手术环境的，具有很大的发展前景。在此，我们提出了一种将 3D 打印和 AR 结合应用于骨肿瘤外科的创新解决方案。我们提出了一种新的手术流程，包括 3D 打印模型和一种新颖的基于 AR 的智能手机应用程序（app）。该应用程序可以显示患者的解剖结构和肿瘤的位置。设计了一个 3D 打印的参考标记，以适应受影响骨组织的独特位置，实现自动注册。在整个手术流程中，我们对该系统的可视化准确性和可用性进行了评估。在六个真实的模型上进行的实验中，可视化误差低于 3 毫米。AR 系统在两个临床病例中进行了测试，包括手术规划、医患沟通和手术干预。这些结果以及外科医生和患者的积极反馈表明，AR 和 3D 打印的结合可以提高手术效果、准确性和患者体验。
