Borde Tabea, Saccenti Laetitia, Li Ming, Varble Nicole A, Hazen Lindsey A, Kassin Michael T, Ukeh Ifechi N, Horton Keith M, Delgado Jose F, Martin Charles, Xu Sheng, Pritchard William F, Karanian John W, Wood Bradford J
Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320, MSC 1182, Bethesda, MD, 20892, USA.
Henri Mondor Biomedical Research Institute, Inserm U955, Team N°18, Créteil, France.
Int J Comput Assist Radiol Surg. 2025 Jan;20(1):107-115. doi: 10.1007/s11548-024-03148-5. Epub 2024 May 30.
Targeting accuracy determines outcomes for percutaneous needle interventions. Augmented reality (AR) in IR may improve procedural guidance and facilitate access to complex locations. This study aimed to evaluate percutaneous needle placement accuracy using a goggle-based AR system compared to an ultrasound (US)-based fusion navigation system.
Six interventional radiologists performed 24 independent needle placements in an anthropomorphic phantom (CIRS 057A) in four needle guidance cohorts (n = 6 each): (1) US-based fusion, (2) goggle-based AR with stereoscopically projected anatomy (AR-overlay), (3) goggle AR without the projection (AR-plain), and (4) CT-guided freehand. US-based fusion included US/CT registration with electromagnetic (EM) needle, transducer, and patient tracking. For AR-overlay, US, EM-tracked needle, stereoscopic anatomical structures and targets were superimposed over the phantom. Needle placement accuracy (distance from needle tip to target center), placement time (from skin puncture to final position), and procedure time (time to completion) were measured.
Mean needle placement accuracy using US-based fusion, AR-overlay, AR-plain, and freehand was 4.5 ± 1.7 mm, 7.0 ± 4.7 mm, 4.7 ± 1.7 mm, and 9.2 ± 5.8 mm, respectively. AR-plain demonstrated comparable accuracy to US-based fusion (p = 0.7) and AR-overlay (p = 0.06). Excluding two outliers, AR-overlay accuracy became 5.9 ± 2.6 mm. US-based fusion had the highest mean placement time (44.3 ± 27.7 s) compared to all navigation cohorts (p < 0.001). Longest procedure times were recorded with AR-overlay (34 ± 10.2 min) compared to AR-plain (22.7 ± 8.6 min, p = 0.09), US-based fusion (19.5 ± 5.6 min, p = 0.02), and freehand (14.8 ± 1.6 min, p = 0.002).
Goggle-based AR showed no difference in needle placement accuracy compared to the commercially available US-based fusion navigation platform. Differences in accuracy and procedure times were apparent with different display modes (with/without stereoscopic projections). The AR-based projection of the US and needle trajectory over the body may be a helpful tool to enhance visuospatial orientation. Thus, this study refines the potential role of AR for needle placements, which may serve as a catalyst for informed implementation of AR techniques in IR.
靶向准确性决定了经皮穿刺针干预的结果。介入放射学中的增强现实（AR）可能会改善操作引导并便于进入复杂部位。本研究旨在评估与基于超声（US）的融合导航系统相比，使用基于护目镜的AR系统进行经皮穿刺针放置的准确性。
六位介入放射科医生在一个拟人化模型（CIRS 057A）中进行了24次独立的针放置，分为四个针引导队列（每组n = 6）：（1）基于US的融合，（2）具有立体投影解剖结构的基于护目镜的AR（AR叠加），（3）无投影的护目镜AR（AR普通），以及（4）CT引导徒手操作。基于US的融合包括US/CT配准以及电磁（EM）针、换能器和患者跟踪。对于AR叠加，将US、EM跟踪的针、立体解剖结构和目标叠加在模型上。测量针放置的准确性（针尖到目标中心的距离）、放置时间（从皮肤穿刺到最终位置）和操作时间（完成时间）。
使用基于US的融合、AR叠加、AR普通和徒手操作的平均针放置准确性分别为4.5±1.7毫米、7.0±4.7毫米、4.7±1.7毫米和9.2±5.8毫米。AR普通显示出与基于US的融合（p = 0.7）和AR叠加（p = 0.06）相当的准确性。排除两个异常值后，AR叠加的准确性变为5.9±2.6毫米。与所有导航队列相比，基于US的融合的平均放置时间最长（44.3±27.7秒）（p < 0.001）。与AR普通（22.7±8.6分钟，p = 0.09）、基于US的融合（19.5±5.6分钟，p = 0.02）和徒手操作（14.8±1.6分钟，p = 0.002）相比，AR叠加记录的操作时间最长（34±10.2分钟）。
与市售的基于US的融合导航平台相比，基于护目镜的AR在针放置准确性上没有差异。不同显示模式（有/无立体投影）下，准确性和操作时间存在明显差异。US和针轨迹在身体上的基于AR的投影可能是增强视觉空间定向的有用工具。因此，本研究细化了AR在针放置中的潜在作用，这可能成为在介入放射学中明智地实施AR技术的催化剂。
