Enkaoua Aure, Ramalhinho João, Islam Mobarakol, Marcus Hani J, Clarkson Matthew J
UCL Hawkes Institute, Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
National Hospital for Neurology and Neurosurgery, London, UK.
Int J Comput Assist Radiol Surg. 2025 Jun;20(6):1301-1305. doi: 10.1007/s11548-025-03384-3. Epub 2025 May 11.
Endoscopic pituitary surgery is a minimally invasive technique to remove pituitary tumours through the nose. Currently, image guidance may be used in the form of a tracked pointer to help surgeons navigate the region and avoid damage to critical structures. However, the pointer method is mentally demanding as the pointer location is displayed in a different modality and disrupts the surgical workflow due to the setup time and frequent tool removal.
We propose an Augmented Reality (AR) system where information from the pre-operative scan is displayed directly onto the endoscopic video. Our system features an on-board tracking system, allowing for the registration process to be performed automatically.
We evaluated the accuracy of our system and compared it to an AR system that uses an infrared (IR) camera to track an endoscope with reflective markers. Our system gave an accuracy of 1.1 (± 0.4) mm, compared to 2.4 (± 0.9) mm in the IR-tracked endoscope approach.
Our Augmented Reality system is a more compact and transportable setup which outperformed the IR-tracked endoscope. The automatic registration method can save time in the operating room as well as increase AR overlay accuracy, improving the translation of these technologies.
内镜垂体手术是一种通过鼻腔切除垂体肿瘤的微创技术。目前，图像引导可采用跟踪指针的形式，以帮助外科医生在该区域进行操作并避免损伤关键结构。然而，指针方法对思维要求较高，因为指针位置以不同的模态显示，并且由于设置时间和频繁的工具移除而扰乱了手术流程。
我们提出了一种增强现实（AR）系统，其中术前扫描的信息直接显示在内窥镜视频上。我们的系统具有机载跟踪系统，允许自动执行配准过程。
我们评估了我们系统的准确性，并将其与使用红外（IR）相机跟踪带有反射标记的内窥镜的AR系统进行了比较。我们的系统的准确性为1.1（±0.4）毫米，而红外跟踪内窥镜方法的准确性为2.4（±0.9）毫米。
我们的增强现实系统是一种更紧凑、便于携带的设置，其性能优于红外跟踪内窥镜。自动配准方法可以节省手术室时间，并提高AR叠加的准确性，从而改进这些技术的应用。
