Liu Shifeng, Wang Hong, Wang Congxiao, Zhang Wei, Chen Gao, Hu Xiaokun
Interventional Center, the Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Dermatology, Qingdao No. 6 People's Hospital, Qingdao, China.
J Contemp Brachytherapy. 2021 Apr;13(2):205-210. doi: 10.5114/jcb.2021.105289. Epub 2021 Apr 14.
The study investigated whether intra-operative 3D hologram, a computer graphics model of the brain, with mixed reality (MR) technique based on computed tomography-magnetic resonance imaging (CT-MRI) fusion images could be helpful during brachytherapy for brain metastasis.
A patient with relapsed brain metastasis was reported. Pre-operative CT and MRI image fusion was performed, with software developed by our center and the Chinese University of Hong Kong. 3D polygon data segmented from pre-operative CT-MRI fusion images were registered into HoloLens (Microsoft Corporation, Redmond, WA, USA). I seed implantation was performed under MR guidance.
Interventional surgeons could share the same hologram and move the hologram from their respective angles, while wearing the HoloLens without any monitors. The intra-operative hologram offered good visualization of the skull, tumor location, and main vessels around the tumor during brain brachytherapy of a patient with brain metastasis. The interventional surgeons could easily compare the patient's actual anatomy with the hologram before and during the brain brachytherapy procedure. D and V of post-operative plan and pre-operative plan were 131.8 Gy vs. 132.0 Gy and 94.8% vs. 94.0%, respectively. The patient's imaging findings together with clinical symptoms were greatly improved at 3 and 6 months after the implantation.
This initial experience suggests that the use of the intra-operative hologram with MR technique based on CT-MRI fusion images helped in brachytherapy guidance. Further research is needed to explore the potential of this approach in neuro-navigation.
本研究调查了基于计算机断层扫描-磁共振成像（CT-MRI）融合图像的术中三维全息图（一种大脑计算机图形模型）与混合现实（MR）技术在脑转移瘤近距离放射治疗中是否有帮助。
报告了一名复发性脑转移瘤患者。使用本中心和香港中文大学开发的软件进行术前CT和MRI图像融合。将从术前CT-MRI融合图像中分割出的三维多边形数据注册到HoloLens（美国华盛顿州雷德蒙德微软公司）中。在MR引导下进行碘-125粒子植入。
介入外科医生可以共享相同的全息图，并在不使用任何监视器的情况下佩戴HoloLens从各自角度移动全息图。术中全息图在一名脑转移瘤患者的脑近距离放射治疗过程中，能很好地显示颅骨、肿瘤位置以及肿瘤周围的主要血管。介入外科医生在脑近距离放射治疗过程中及之前，能够轻松地将患者的实际解剖结构与全息图进行比较。术后计划和术前计划的D值分别为131.8 Gy和132.0 Gy，V值分别为94.8%和94.0%。植入后3个月和6个月，患者的影像学表现及临床症状均有明显改善。
这一初步经验表明，基于CT-MRI融合图像的术中全息图与MR技术有助于近距离放射治疗的引导。需要进一步研究来探索这种方法在神经导航中的潜力。
