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基于增强现实和光学跟踪的导航系统在介入放射学经皮手术中的接受度与可行性——一项基于模拟体模的研究

Acceptance and feasibility of an augmented reality-based navigation system with optical tracking for percutaneous procedures in interventional radiology - a simulation-based phantom study.

作者信息

Rohmer Karl, Becker Mathias, Georgiades Marilena, March Christine, Melekh Bohdan, Sperka Piotr, Spinczyk Dominik, Wolińska-Sołtys Anna, Pech Maciej

机构信息

University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.

Holo4Med Spółka S. A., Holo4Med Spółka S. A., Białystok, Poland.

出版信息

Rofo. 2024 Oct 4. doi: 10.1055/a-2416-1080.

Abstract

Augmented reality (AR) projects additional information into the user's field of view during interventions. The aim was to evaluate the acceptance and clinical feasibility of an AR system and to compare users with different levels of experience. A system was examined that projects a CT-generated 3D model of a phantom into the field of view using a HoloLens 2, whereby the tracked needle is displayed and navigated live. A projected ultrasound image is used for live control of the needle positioning. This should minimize radiation exposure and improve orientation.The acceptance and usability of the AR navigation system was evaluated by 10 physicians and medical students with different levels of experience by performing punctures with the system in a phantom. The required time was then compared and a questionnaire was completed to assess clinical acceptance and feasibility. For statistical analysis, frequencies for qualitative characteristics, location and dispersion measures for quantitative characteristics and Spearman rank correlations for correlations were calculated.9 out of 10 subjects hit all 5 target regions in the first attempt, taking an average of 29:39 minutes for all punctures. There was a significant correlation between previous experience in interventional radiology, years in the profession, and the time required. Overall, the time varied from an average of 43:00 min. for medical students to 15:00 min. for chief physicians. All test subjects showed high acceptance of the system and rated especially the potential clinical feasibility, the simplification of the puncture, and the image quality positively. However, the majority require further training for sufficient safety in use.The system offers distinct advantages for navigation and orientation, facilitates percutaneous interventions during training and enables professionally experienced physicians to achieve short intervention times. In addition, the system improves ergonomics during the procedure by making important information always directly available in the field of view and has the potential to reduce the radiation exposure of staff in particular by combining AR and sonography and thus shortening CT-fluoroscopy times. · AR navigation offers advantages for orientation during percutaneous radiological interventions.. · The subjects would like to use the AR system in everyday clinical practice on patients.. · AR improves ergonomics by making important information directly available in the field of view.. · The combination of AR and sonography can significantly reduce radiation exposure for staff.. · Rohmer K, Becker M, Georgiades M et al. Acceptance and feasibility of an augmented reality-based navigation system with optical tracking for percutaneous procedures in interventional radiology - a simulation-based phantom study. Fortschr Röntgenstr 2024; DOI 10.1055/a-2416-1080.

摘要

增强现实(AR)在干预过程中将额外信息投射到用户的视野中。目的是评估AR系统的可接受性和临床可行性,并比较不同经验水平的用户。研究了一种使用HoloLens 2将CT生成的体模3D模型投射到视野中的系统,在该系统中,跟踪的针会实时显示并导航。使用投射的超声图像对针的定位进行实时控制。这应能最大限度地减少辐射暴露并改善定位。10名具有不同经验水平的医生和医学生通过在体模中使用该系统进行穿刺,评估了AR导航系统的可接受性和可用性。然后比较所需时间,并完成一份问卷以评估临床可接受性和可行性。进行统计分析时,计算了定性特征的频率、定量特征的位置和离散度测量值以及相关性的Spearman等级相关性。10名受试者中有9名在首次尝试时就命中了所有5个目标区域,所有穿刺的平均时间为29分39秒。介入放射学的既往经验、从业年限与所需时间之间存在显著相关性。总体而言,时间从医学生的平均43分钟到主任医师的15分钟不等。所有测试对象对该系统都表现出高度接受度,尤其对潜在的临床可行性、穿刺的简化以及图像质量给予了积极评价。然而,大多数人需要进一步培训以确保使用时的足够安全性。该系统在导航和定位方面具有明显优势,便于培训期间的经皮干预,并使经验丰富的专业医生能够缩短干预时间。此外,该系统通过使重要信息始终直接在视野中可用,改善了操作过程中的人体工程学,并且通过结合AR和超声检查,尤其有可能减少工作人员的辐射暴露,从而缩短CT透视时间。·AR导航在经皮放射学干预过程中的定位方面具有优势。·受试者希望在日常临床实践中对患者使用AR系统。·AR通过使重要信息直接在视野中可用而改善了人体工程学。·AR和超声检查的结合可显著减少工作人员的辐射暴露。·罗默K、贝克尔M、乔治亚德斯M等。基于增强现实的光学跟踪导航系统在介入放射学经皮手术中的可接受性和可行性——一项基于模拟的体模研究。《Fortschr Röntgenstr》2024年;DOI 10.1055/a - 2416 - 1080。

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