Abstract
Nowadays, ultrasound (US) is increasingly being chosen as imaging modality for both diagnostic and interventional applications, owing to its positive characteristics in terms of safety, low footprint, and low cost. The combination of this imaging modality with wearable augmented reality (AR) systems, such as the head-mounted displays (HMD), comes forward as a breakthrough technological solution, as it allows for hands-free interaction with the augmented scene, which is an essential requirement for the execution of high-precision manual tasks, such as in surgery. What we propose in this study is the integration of an AR navigation system (HMD plus dedicated platform) with a 3D US imaging system to guide a dissection task that requires maintaining safety margins with respect to unexposed anatomical or pathological structures. For this purpose, a standard scalpel was sensorized to provide real-time feedback on the position of the instrument during the execution of the task. The accuracy of the system was quantitatively assessed with two different experimental studies: a targeting experiment, which revealed a median error of 2.53 mm in estimating the scalpel to target distance, and a preliminary user study simulating a dissection task that requires reaching a predefined distance to an occult lesion. The second experiment results showed that the system can be used to guide a dissection task with a mean accuracy of 0.65 mm, with a mean angular error between the ideal and actual cutting plane of 2.07°. The results encourage further studies to fully exploit the potential of wearable AR and intraoperative US imaging to accurately guide deep surgical tasks, such as to guide the excision of non-palpable breast tumors ensuring optimal margin clearance.
Highlights
Ultrasound (US) has become a mainstay both as a diagnostic modality and as an intraoperative imaging modality for image-guided interventions
For each pose of the visor, the error over all nine vertices of the comb was evaluated and the results are reported in terms of maximum value, median and interquartile range (IQR)
In recent times, US imaging is emerging as both diagnostic and interventional tool due to its non-ionizing nature, the small footprint and high availability of the associated equipment, and its cost-effectiveness compared to other imaging technologies
Summary
Ultrasound (US) has become a mainstay both as a diagnostic modality and as an intraoperative imaging modality for image-guided interventions. The user study showed that the 80% of participants were able to perform the biopsy task on a 5 mm lesion, proving the accuracy of the proposed system of 2.5 mm This approach, based on the viewfinders, works properly even in the absence of real-time visual feedback of the actual pose and depth reached by the instrument, as the biopsy need is to insert the needle along the right trajectory. The real-time movements performed to reach the right trajectory are not important, as it is sufficient to correctly align the instrument along the planned direction and to proceed with the insertion (guided by means of the viewfinders) up to the target In this new work, we investigate whether the integration of 3D US systems and AR HMDs can offer both the accuracy and the AR guidance information to guide a surgical dissection. This system yields as output an externally processable DICOM volume of approximately 38 mm x 91 mm x 27 mm along the x-axis, y-axis, and z-axis, respectively
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
