Chilappa Rishit, Kapuria Abhi, Norwood Jefferson, Yao Athena, Vestal Matthew, Zafar Muhammad Shahzad
Department of Neurosurgery, Duke University Hospital, Durham, North Carolina, USA.
Department of Neurology, Duke University Hospital, Durham, North Carolina, USA.
Epileptic Disord. 2025 Apr;27(2):235-243. doi: 10.1002/epd2.20322. Epub 2024 Dec 10.
The aim of this paper was to visualize 3-dimensional (3-D) brain and electrode placement data for epilepsy surgery within an augmented reality (AR) environment using a wearable headset, with the ultimate goal of enhancing presurgical planning for epilepsy surgery and understanding the efficiency and utility of such a program in a clinical setting. The evaluation process for surgical intervention in epilepsy cases involves a series of extensive tests, including EEG, MRI, PET, SPECT, and fMRI. A second phase of assessment incorporates the placement of depth electrodes within the brain to record seizure activity. The culmination of these complex data is presented to the neurosurgery team for the formulation of a surgical plan. However, the conventional presentation of intricate 3-D data on a 2-dimensional (2-D) computer monitor limits the ability to convey the full depth and detail of the patient's brain and electrode data.
Five images were selected from a cohort of patients being evaluated for refractory epilepsy at a single center. Their presurgical MRI scans, SEEG electrode data, and CT scans were utilized to generate 3-D AR representations, which were uploaded onto the Duke Augmented Reality Epilepsy Planner (AREP), an application on the Microsoft HoloLens 2. A survey was administered to faculty members to determine usability and effectiveness of the application.
AR images of the brain and electrodes, allowing resizing, movement, and rotation, with distinct colors differentiating tissue and electrodes, were presented in AREP. The application featured an interactive image manipulation menu. Survey results from 18 faculty members regarding seven questions indicated that AREP was user-friendly and can be effective in presurgical planning moving forward.
AR integration of medical imaging data for epilepsy surgery transcends its role as a communication tool. It provides a deeper representation of surgical anatomy and serves as a valuable method for fostering communication among clinicians.
本文旨在使用可穿戴头显在增强现实（AR）环境中可视化癫痫手术的三维（3-D）大脑和电极放置数据，最终目标是加强癫痫手术的术前规划，并了解该程序在临床环境中的效率和实用性。癫痫病例的手术干预评估过程涉及一系列广泛的测试，包括脑电图（EEG）、磁共振成像（MRI）、正电子发射断层扫描（PET）、单光子发射计算机断层扫描（SPECT）和功能磁共振成像（fMRI）。评估的第二阶段包括在大脑内放置深度电极以记录癫痫发作活动。这些复杂数据的最终结果会呈现给神经外科团队以制定手术计划。然而，在二维（2-D）计算机显示器上传统呈现复杂的3-D数据限制了传达患者大脑和电极数据完整深度和细节的能力。
从一个单一中心正在接受难治性癫痫评估的患者队列中选择了五张图像。利用他们的术前MRI扫描、立体定向脑电图（SEEG）电极数据和CT扫描生成3-D AR表示，并上传到杜克增强现实癫痫规划器（AREP）上，这是微软HoloLens 2上的一个应用程序。对教职员工进行了一项调查，以确定该应用程序的可用性和有效性。
AREP中呈现了大脑和电极的AR图像，允许调整大小、移动和旋转，不同颜色区分组织和电极。该应用程序具有交互式图像操作菜单。18名教职员工对七个问题的调查结果表明，AREP用户友好，并且在未来的术前规划中可能有效。
癫痫手术医学成像数据的AR整合超越了其作为通信工具的作用。它提供了手术解剖结构的更深入表示，并成为促进临床医生之间沟通的宝贵方法。
