4:03 PM Abstract No. 30 Augmented virtual reality assisted treatment planning for splenic artery aneurysms: a pilot study

Abstract

To evaluate the utility of augmented virtual reality (VR) in preprocedural planning for endovascular repair of splenic artery aneurysms (SAA) as compared to standard volume-rendering (SR) software. Preprocedural computed tomographic angiography (CTA) images of 14 patients with 17 SAA who had undergone endovascular repair were reconstructed using True 3D (EchoPixel, Inc., CA), a VR visualization software system. AquariusNet (TeraRecon, CA) was used for standard volume-rendering image interpretation. Three radiologists independently evaluated the number of inflow and outflow arteries using both VR and SR. Procedural angiographic images served as the gold standard. Improvement in operator confidence of VR over SR was measured on a four-point scale (1 no change, 4 significant). Clinical utility was objectively measured by VR’s ability to accurately identify all inflow and outflow arteries associated with the SAA and subjectively by operator confidence. There were 17 inflow and 22 outflow arteries associated with the SAA. The overall sensitivity, accuracy and positive predictive value for VR was similar to that of SR (91.3%, 89.7%, 84% and 88.9%, 88.9%, 84.6%, p = 0.14, respectively). However, the ability to view and manipulate images in true three-dimensions using VR markedly improved operator confidence with 93% receiving a score of at least 3 (71% = 3, 21% = 4). SAA have complex anatomy necessitating meticulous preprocedure planning. VR allows holographic visualization of images as if they were real physical objects, providing information critical for endovascular repair of SAA and thus significantly increasing operator confidence.