Gsaxner Christina, Li Jianning, Pepe Antonio, Jin Yuan, Kleesiek Jens, Schmalstieg Dieter, Egger Jan
Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria.
Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany.
Med Image Anal. 2023 Apr;85:102757. doi: 10.1016/j.media.2023.102757. Epub 2023 Jan 21.
The HoloLens (Microsoft Corp., Redmond, WA), a head-worn, optically see-through augmented reality (AR) display, is the main player in the recent boost in medical AR research. In this systematic review, we provide a comprehensive overview of the usage of the first-generation HoloLens within the medical domain, from its release in March 2016, until the year of 2021. We identified 217 relevant publications through a systematic search of the PubMed, Scopus, IEEE Xplore and SpringerLink databases. We propose a new taxonomy including use case, technical methodology for registration and tracking, data sources, visualization as well as validation and evaluation, and analyze the retrieved publications accordingly. We find that the bulk of research focuses on supporting physicians during interventions, where the HoloLens is promising for procedures usually performed without image guidance. However, the consensus is that accuracy and reliability are still too low to replace conventional guidance systems. Medical students are the second most common target group, where AR-enhanced medical simulators emerge as a promising technology. While concerns about human-computer interactions, usability and perception are frequently mentioned, hardly any concepts to overcome these issues have been proposed. Instead, registration and tracking lie at the core of most reviewed publications, nevertheless only few of them propose innovative concepts in this direction. Finally, we find that the validation of HoloLens applications suffers from a lack of standardized and rigorous evaluation protocols. We hope that this review can advance medical AR research by identifying gaps in the current literature, to pave the way for novel, innovative directions and translation into the medical routine.
HoloLens（微软公司，华盛顿州雷德蒙德）是一款头戴式、光学透视增强现实（AR）显示器，是近期医学AR研究热潮中的主要参与者。在本系统综述中，我们全面概述了第一代HoloLens在2016年3月发布至2021年期间在医学领域的使用情况。我们通过对PubMed、Scopus、IEEE Xplore和SpringerLink数据库进行系统检索，确定了217篇相关出版物。我们提出了一种新的分类法，包括用例、注册和跟踪的技术方法、数据源、可视化以及验证和评估，并据此分析检索到的出版物。我们发现，大部分研究集中在为干预过程中的医生提供支持，在这种情况下，HoloLens对于通常在无图像引导下进行的手术很有前景。然而，大家的共识是，其准确性和可靠性仍然太低，无法取代传统的引导系统。医学生是第二常见的目标群体，AR增强型医学模拟器成为一项很有前景的技术。虽然经常提到对人机交互、可用性和感知的担忧，但几乎没有提出任何克服这些问题的概念。相反，注册和跟踪是大多数综述出版物的核心，但其中只有少数在这个方向上提出了创新概念。最后，我们发现HoloLens应用的验证缺乏标准化和严格的评估协议。我们希望本综述能够通过找出当前文献中的差距来推动医学AR研究，为新的、创新的方向以及转化为医疗常规铺平道路。
