Ye Yu-Qin, Wang Guan-Yi, Fan Ying-Nan, Feng Zhu-Sheng, Jia Yi-Bin, Bai Wei, Yang Yong-Xiang, He Xiao-Sheng
Department of Neurosurgery, Xijing Hospital, Air Force Medical University, Xi'an, China.
Department of Neurosurgery, PLA 921st Hospital, Changsha, China.
Front Neurol. 2025 Jul 10;16:1566557. doi: 10.3389/fneur.2025.1566557. eCollection 2025.
Neuronavigation is crucial for locating intracranial lesions in neurosurgery. However, it is unaffordable in numerous resource-limited areas. The emerging mobile augmented reality (AR) provides a low-cost alternative to locate lesions, but its accuracy still require improvement before widespread use. This study aimed to explore a novel smartphone AR solution for lesion localization based on a newly developed application and refined reference markers.
The smartphone AR solution and standard navigation were performed to locate intracranial lesions in 38 patients. The time required for AR and navigation, the deviation between lesion center points identified by AR and navigation, and the ratio of overlap region (ROR) between the lesion locations determined by both methods, were measured, respectively, to evaluate the AR performance in preoperative planning.
The average time required for AR was shorter than that for navigation (256.61 ± 69.75 s vs. 454.16 ± 78.85 s, < 0.05), indicating the favorable efficiency of AR. The average deviation and ROR were 3.55 ± 1.71 mm and 75.03% ± 18.56%, which were within the acceptable range of intracranial lesion surgery. The overall accurate localization rate of AR was 81.57%. Moreover, compared to the first stage of this study, the time required for AR and deviation in the second stage were significantly reduced, and ROR was notably increased ( < 0.05). It revealed that with the accumulation of experience, AR efficiency and accuracy were improved.
The smartphone AR-based solution provides a practical and reliable alternative to locate small intracranial lesions, especially in settings where neuronavigation is unavailable.
神经导航对于神经外科手术中颅内病变的定位至关重要。然而，在众多资源有限的地区，它难以负担得起。新兴的移动增强现实（AR）为病变定位提供了一种低成本的替代方案，但在广泛应用之前，其准确性仍有待提高。本研究旨在探索一种基于新开发的应用程序和改进的参考标记的新型智能手机AR病变定位解决方案。
对38例患者进行智能手机AR解决方案和标准导航以定位颅内病变。分别测量AR和导航所需的时间、AR和导航确定的病变中心点之间的偏差以及两种方法确定的病变位置之间的重叠区域比例（ROR），以评估AR在术前规划中的性能。
AR所需的平均时间短于导航（256.61±69.75秒对454.16±78.85秒，<0.05），表明AR具有良好的效率。平均偏差和ROR分别为3.55±1.71毫米和75.03%±18.56%，在颅内病变手术的可接受范围内。AR的总体准确定位率为81.57%。此外，与本研究的第一阶段相比，第二阶段AR所需的时间和偏差显著减少，ROR显著增加（<0.05）。这表明随着经验的积累，AR的效率和准确性得到了提高。
基于智能手机AR的解决方案为定位小的颅内病变提供了一种实用且可靠的替代方案，尤其是在无法进行神经导航的情况下。
