PD45-09 APPLICATION RESEARCH OF ARTIFICIAL INTELLIGENCE FULL QUANTITATIVE MIXED REALITY TECHNOLOGY IN FUSION PUNCTURE NAVIGATION OF PCNL

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD45-09 APPLICATION RESEARCH OF ARTIFICIAL INTELLIGENCE FULL QUANTITATIVE MIXED REALITY TECHNOLOGY IN FUSION PUNCTURE NAVIGATION OF PCNL Yubao Liu and Jianxing Li Yubao LiuYubao Liu More articles by this author and Jianxing LiJianxing Li More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003358.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate the application value of artificial intelligence full quantitative mixed reality technology in real-time puncture guided by holographic image fused with ultrasound image during staghorn renal stones PCNL. METHODS: The clinical data of 16 patients with staghorn renal stones who underwent PCNL in our hospital from May 2021 to June 2022 were retrospectively analyzed. Before operation, two calibration patches were fixed on the skin area of bilateral iliopsoas muscle, and CTU examination was performed under prone position. DICOM data were exported and 3D imaging reconstruction was performed. Combined with AI-QMR, holographic three-dimensional images of body were projected in real space. The surgeon wore a mixed reality head-mounted display (HoloLens 2). Based on the calibration patches, combined with the position of the twelfth rib and lumbar vertebrae, the holographic model was visually matched with the real human body. Then, the ultrasound images were fused under the guidance of the virtual puncture path, and the needle was punctured into the collection system. When significant deviation occurred, the puncture direction was mainly adjusted under ultrasound. A questionnaire was designed to evaluate the satisfaction of surgeons with fusion puncture. The consistency rate of intraoperative fusion-guided puncture, puncture location time, postoperative complications, one-stage stone free rate and satisfaction were analyzed. RESULTS: Holograms were obtained in all 16 patients using QMR, and fusion puncture and one-stage operation were completed during the operation. In 6 patients, two standard channels were established and fusion puncture was performed 22 times. Among them, 4 fusion punctures showed significant deviation and were adjusted or re-punctured by ultrasound guidance. The consensus rate of fusion-guided puncture was 81.8%, the average puncture location time was 45.1s, and the first stage stone free rate was 91%. The subjective questionnaire showed that holography was helpful to improve the surgeon's cognition of puncture location and shorten the puncture location time. The satisfaction rate of matching and fusion-guided puncture was 82% and 90%, respectively. There were no Clavien-Dindo grade ≥Ⅱcomplications such as blood transfusion, organ injury and urosepsis. CONCLUSIONS: PCNL for staghorn renal stones has a long learning curve and high requirements for ultrasound-guided puncture. This technique can achieve the prediction and design of puncture path under the effect of 3D holographic image, and it can also be used to guide puncture by real-time fusion of ultrasound images. It shortens the learning curve of PCNL, effectively reduces the risk of complications, so as to achieve visual, quantifiable and controllable precision surgery, and improve the one-stage stone free rate. Source of Funding: The General Program of National Natural Science Foundation of China, 52175028 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1166 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yubao Liu More articles by this author Jianxing Li More articles by this author Expand All Advertisement PDF downloadLoading ...