Abstract No. 506 Holographic visualization for performance of percutaneous ablation of solid liver tumors: from development, to bench testing, to first-in-human evaluation

Abstract

Currently, 2D screens are used for image guidance of percutaneous ablation of solid tumors, an inherently 3D task. This can lead to inaccurate ablation probe placement which can cause inadequate treatment and subsequent tumor recurrence, among other complications. The purpose of our project was to develop and evaluate true 3D holographic guidance for PTA (“3D HPA”) from bench to first-in-human clinical evaluation, and analyze its potential to increase ablation accuracy and usability. We developed a 3D HPA prototype with our augmented-reality (AR) platform for medical applications. Holograms of the patient’s anatomy and of mini-GPS-tracked ablation probes were registered and projected directly onto the operative site with HoloLens (Microsoft, WA, USA), an untethered, head-mounted display for AR. Probe placement accuracy was first assessed on the bench by targeting 1-cm-diameter spherical simulated tumors in an anthropomorphic phantom. Next, early in vivo feasibility was evaluated in an IRB-approved clinical study while adhering to current standard of care. HoloLens video captures were recorded and reviewed from this first-in-human evaluation to analyze accuracy. During bench testing using 3D HPA, the probe tip was placed accurately within 9/9 target spheres located at depths ranging from 3 to 15 cm within the phantom. Our first attempt in vivo was also successful, as defined by placement of the ablation probe within the tumor in the location targeted by the clinician. Initial testing with our 3D HPA prototype demonstrated accurate placement of ablation probes in both phantom and in vivo settings, supporting its potential to improve accuracy of percutaneous tumor ablation, which could lead to better-quality patient care as well as potential benefits for the global health care system. Further evaluation of 3D HPA and development of applications for use of holographic visualization in other types of procedures is ongoing.