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增强现实导航引导下的术中肺结节定位:一项初步研究。

Augmented reality navigation-guided intraoperative pulmonary nodule localization: a pilot study.

作者信息

Li Chengqiang, Ji Anqi, Jian Zheng, Zheng Yuyan, Feng Xijia, Guo Wei, Lerut Toni, Lin Jules, Li Hecheng

机构信息

Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Thoracic Surgery, Cancer Hospital of Guangxi Medical University, Nanning, China.

出版信息

Transl Lung Cancer Res. 2023 Aug 30;12(8):1728-1737. doi: 10.21037/tlcr-23-201. Epub 2023 Aug 4.


DOI:10.21037/tlcr-23-201
PMID:37691871
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10483087/
Abstract

BACKGROUND: With the increasing number of small pulmonary nodules detected, effective localization of pulmonary nodules has become an issue. The goal of this study is to determine the safety and feasibility of a newly developed augmented reality navigation technology for intraoperative localization of small pulmonary nodules. METHODS: We conducted a prospective single-center feasibility study of a novel augmented reality navigation system and lung localization (LungBrella) marker on ten patients between July and October 2020. For augmented reality navigation-guided localization, a preoperative chest computed tomography scan was performed to generate 3-dimensional (3D) virtual images and individualized localization plan, which were uploaded into Hololens (a head-mounted augmented reality device). Under the guidance of established procedure plan displayed by HoloLens, localization marker was placed in operating room. Segmentectomy or wedge resection was subsequently performed. The primary endpoint was the localization procedure success rate, and the secondary endpoints were localization time, operation time, and complications. RESULTS: Localization was successful in seven of the ten procedures. Due to different reasons, failures were noted in three cases, after which immediate adjustments were made. In the successful cases, the LungBrella marker was positioned at a median of 5.8 mm (range, 0-10 mm) from the edge of the nodule. Median localization time was 9.4 min (range, 5-19 min), and median operation time was 172.9 min (range, 105-200 min). There were no complications during the entire process. CONCLUSIONS: This exploratory study suggests that augmented reality navigation-guided pulmonary nodule localization is a safe and feasible technique (ClinicalTrials.gov identifier, NCT04211051).

摘要

背景:随着检测出的小肺结节数量不断增加,肺结节的有效定位已成为一个问题。本研究的目的是确定一种新开发的增强现实导航技术用于小肺结节术中定位的安全性和可行性。 方法:2020年7月至10月期间,我们对10例患者进行了一项关于新型增强现实导航系统和肺部定位(LungBrella)标记物的前瞻性单中心可行性研究。对于增强现实导航引导下的定位,术前行胸部计算机断层扫描以生成三维(3D)虚拟图像和个性化定位计划,并上传至HoloLens(一种头戴式增强现实设备)。在HoloLens显示的既定程序计划引导下,在手术室放置定位标记物。随后进行肺段切除术或楔形切除术。主要终点是定位程序成功率,次要终点是定位时间、手术时间和并发症。 结果:10例手术中有7例定位成功。由于不同原因,3例出现失败,之后立即进行了调整。在成功的病例中,LungBrella标记物位于距结节边缘的中位数为5.8毫米(范围为0 - 10毫米)处。定位时间中位数为9.4分钟(范围为5 - 19分钟),手术时间中位数为172.9分钟(范围为105 - 200分钟)。整个过程中无并发症发生。 结论:这项探索性研究表明,增强现实导航引导下的肺结节定位是一种安全可行的技术(ClinicalTrials.gov标识符,NCT04211051)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/989e91b70525/tlcr-12-08-1728-vid1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/51f695b960f2/tlcr-12-08-1728-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/17738fc61fc2/tlcr-12-08-1728-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/1482cbdb2ada/tlcr-12-08-1728-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/3f775a54f932/tlcr-12-08-1728-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/989e91b70525/tlcr-12-08-1728-vid1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/51f695b960f2/tlcr-12-08-1728-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/17738fc61fc2/tlcr-12-08-1728-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/1482cbdb2ada/tlcr-12-08-1728-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/3f775a54f932/tlcr-12-08-1728-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0903/10483087/989e91b70525/tlcr-12-08-1728-vid1.jpg

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引用本文的文献

[1]
The Positioning Method of Pulmonary Nodules in Thoracoscopic Surgery Based on CT Simulation Positioning System for Radiotherapy.

Ann Thorac Cardiovasc Surg. 2025

[2]
Is Overlain Display a Right Choice for AR Navigation? A Qualitative Study of Head-Mounted Augmented Reality Surgical Navigation on Accuracy for Large-Scale Clinical Deployment.

CNS Neurosci Ther. 2025-1

[3]
Advances in the localization of pulmonary nodules: a comprehensive review.

J Cardiothorac Surg. 2024-6-27

[4]
What's new in minimally invasive thoracic surgery? Clinical application of augmented reality and learning opportunities in surgical simulation.

Front Surg. 2023-11-2

本文引用的文献

[1]
NCCN Guidelines® Insights: Non-Small Cell Lung Cancer, Version 2.2023.

J Natl Compr Canc Netw. 2023-4

[2]
Minimally Invasive Anatomical Segmentectomy versus Lobectomy in Stage IA Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis.

Cancers (Basel). 2022-12-14

[3]
Computed tomography-guided localization of pulmonary nodules prior to thoracoscopic surgery.

Thorac Cancer. 2023-1

[4]
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Quant Imaging Med Surg. 2022-11

[5]
One-off low-dose CT for lung cancer screening in China: a multicentre, population-based, prospective cohort study.

Lancet Respir Med. 2022-4

[6]
Augmented reality navigation-guided pulmonary nodule localization in a canine model.

Transl Lung Cancer Res. 2021-11

[7]
Vision-based tracking system for augmented reality to localize recurrent laryngeal nerve during robotic thyroid surgery.

Sci Rep. 2020-5-21

[8]
HoloLens-Based Vascular Localization System: Precision Evaluation Study With a Three-Dimensional Printed Model.

J Med Internet Res. 2020-4-17

[9]
Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial.

N Engl J Med. 2020-1-29

[10]
Preoperative Dye Localization for Thoracoscopic Lung Surgery: Hybrid Versus Computed Tomography Room.

Ann Thorac Surg. 2018-9-12

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