Head-Mounted Display-Based Augmented Reality for Image-Guided Media Delivery to the Heart: A Preliminary Investigation of Perceptual Accuracy.

Mitchell Doughty,Nilesh R Ghugre

doi:10.3390/jimaging8020033

Abstract

By aligning virtual augmentations with real objects, optical see-through head-mounted display (OST-HMD)-based augmented reality (AR) can enhance user-task performance. Our goal was to compare the perceptual accuracy of several visualization paradigms involving an adjacent monitor, or the Microsoft HoloLens 2 OST-HMD, in a targeted task, as well as to assess the feasibility of displaying imaging-derived virtual models aligned with the injured porcine heart. With 10 participants, we performed a user study to quantify and compare the accuracy, speed, and subjective workload of each paradigm in the completion of a point-and-trace task that simulated surgical targeting. To demonstrate the clinical potential of our system, we assessed its use for the visualization of magnetic resonance imaging (MRI)-based anatomical models, aligned with the surgically exposed heart in a motion-arrested open-chest porcine model. Using the HoloLens 2 with alignment of the ground truth target and our display calibration method, users were able to achieve submillimeter accuracy (0.98 mm) and required 1.42 min for calibration in the point-and-trace task. In the porcine study, we observed good spatial agreement between the MRI-models and target surgical site. The use of an OST-HMD led to improved perceptual accuracy and task-completion times in a simulated targeting task.

Highlights

Heart disease is the leading cause of global mortality and a significant precursor to heart failure (HF) [1]
We evaluated and compared the target registration error (TRE) (Euclidean error), RMS TRE RMSE = μ2 + σ2, average symmetric surface distance (ASSD), time-to-task completion, and calibration time
We measured the perceptual accuracy of several different guidance paradigms through an extensive user-study and demonstrated the potential for their use in displaying magnetic resonance imaging (MRI)-derived virtual models, aligned with myocardial scar tissue, in an in-situ porcine model

Summary

Introduction

Heart disease is the leading cause of global mortality and a significant precursor to heart failure (HF) [1]. Heart failure arises because of damage to the heart muscle and replacement with non-contractile scar tissue, predominantly caused by coronary artery disease and myocardial infarction (MI) [2]. In addition to the optimization of the proposed therapy and dose, these approaches require the accurate placement, distribution, and retention of delivered media across myocardial scar and border zone tissue [7]. Due to the diffusion characteristics of scar, targeted injections, which are spaced ~1 cm apart, have been shown to maximize the functional potential of the delivered therapy [8]. The trans-epicardial delivery pathway, where media-injections are made directly into scars on the epicardial surface of the beating or arrested heart via open chest surgery (Figure 1a), provides the highest media retention rate and potential for positive effect of current delivery strategies [9]

Objectives

Methods

Conclusion