Medical Radiation Science, McMaster University, Hamilton, ON, Canada; Department of Diagnostic Imaging, Trillium Health Partners, Mississauga, ON, Canada.
Medical Science, Western University, London, ON, Canada.
J Med Imaging Radiat Sci. 2024 Mar;55(1):125-133. doi: 10.1016/j.jmir.2023.12.006. Epub 2024 Jan 29.
Interventional radiology employs minimally invasive image-guided procedures for diagnosing and treating various conditions. Among these procedures, alcohol and thermal ablation techniques have shown high efficacy. However, these procedures present challenges such as increased procedure time, radiation dose, and risk of tissue injury. This scoping review aims to explore how augmented reality (AR) can mitigate these challenges and improve the accuracy, precision, and efficiency of image-guided tumor ablation while improving patient outcomes.
A scoping review of the literature was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline to identify published literature investigating AR in image-guided tumor ablations. We conducted our electronic searches using PubMed, Scopus, Web of Sciences and CINAHL from inception to April 27th, 2023. The following Boolean terms were used for the search: ("augmented reality" OR "AR" OR "navigation system" OR "head mounted device" OR "HMD") AND ("tumor ablation" OR "radiofrequency tumor ablation" OR "microwave tumor ablation" OR "cryoablation"). We considered articles eligible for our scoping review if they met the following conditions: (1) published in English only, (2) focused on image-guided tumour ablations, (3) incorporated AR techniques in their methodology, (4) employed an aspect of AR in image-guided tumour ablations, and (5) exclusively involved human subjects. Publications were excluded if there was no mention of applying AR, or if the study investigated interventions other than image-guided tumour ablations.
Our search results yielded 1,676 articles in our initial search of the databases. Of those, 409 studies were removed as duplicates. 1,243 studies were excluded during the title and abstract screening. 24 studies were assessed for eligibility in the full-text stage. 19 studies were excluded, resulting in a final selection of only five studies that satisfied our inclusion criteria. The studies aimed to assess AR's efficacy in tumor ablations. Two studies compared an optical-based AR system with CT guidance. Two studies used a head-mounted AR device, while one used a dual-camera setup. Various tumor types were examined, including bone, abdominal soft tissue, breast, hepatic, renal, colorectal, and lung lesions. All studies showed positive results, including reduced radiation exposure, shorter procedures, and improved navigation, and targeting assistance.
AR systems enhance image-guided tumor ablations by improving the accuracy of ablation probe placements and increasing efficiency. They offer real-time guidance, enhanced visualization, and improved navigation, resulting in optimal needle placement. AR reduces radiation exposure and shortens procedure times compared to traditional CT-guided techniques. However, limitations like small sample sizes and technical challenges require further research. Despite this, AR shows potential benefits and larger, diverse studies are needed for validation.
介入放射学采用微创影像引导程序来诊断和治疗各种病症。在这些程序中，酒精和热消融技术已显示出很高的疗效。然而，这些程序存在一些挑战，如增加手术时间、辐射剂量和组织损伤风险。本范围综述旨在探讨增强现实（AR）如何减轻这些挑战，并提高影像引导肿瘤消融的准确性、精度和效率，同时改善患者的预后。
根据系统评价和荟萃分析扩展的首选报告项目（PRISMA-ScR）指南进行文献范围综述，以确定已发表的研究 AR 在影像引导肿瘤消融中的文献。我们使用 PubMed、Scopus、Web of Sciences 和 CINAHL 进行电子搜索，从成立到 2023 年 4 月 27 日。搜索中使用了以下布尔术语：（“增强现实”或“AR”或“导航系统”或“头戴式设备”或“HMD”）和（“肿瘤消融”或“射频肿瘤消融”或“微波肿瘤消融”或“冷冻消融”）。如果符合以下条件，我们认为文章有资格进行范围综述：（1）仅以英文发表，（2）专注于影像引导肿瘤消融，（3）在其方法中纳入 AR 技术，（4）在影像引导肿瘤消融中使用 AR 技术的某个方面，以及（5）仅涉及人类受试者。如果没有提到应用 AR，或者研究涉及除影像引导肿瘤消融以外的干预措施，则排除出版物。
我们在数据库中的初始搜索中产生了 1676 篇文章，其中 409 篇文章是重复的。在标题和摘要筛选过程中删除了 1243 项研究。在全文阶段评估了 24 项研究的资格。排除了 19 项研究，最终仅选择了符合纳入标准的 5 项研究。这些研究旨在评估 AR 在肿瘤消融中的疗效。两项研究比较了基于光学的 AR 系统与 CT 引导。两项研究使用了头戴式 AR 设备，而一项研究使用了双摄像头设置。检查了各种肿瘤类型，包括骨、腹部软组织、乳房、肝脏、肾脏、结直肠和肺部病变。所有研究均显示出积极的结果，包括减少辐射暴露、缩短手术时间和提高导航和靶向辅助。
AR 系统通过提高消融探头放置的准确性和提高效率来增强影像引导的肿瘤消融。它们提供实时指导、增强可视化和改善导航，从而实现最佳的针放置。与传统的 CT 引导技术相比，AR 可减少辐射暴露并缩短手术时间。然而，样本量小和技术挑战等限制因素仍需要进一步研究。尽管如此，AR 显示出了潜在的益处，需要进行更大规模、更多样化的研究来验证。
