Augmented reality for interventional oncology: proof-of-concept study of a novel high-end guidance system platform

BackgroundTo assess the feasibility of a novel system that uses augmented reality to guide interventional oncology procedures.MethodsThis study was conducted in accordance to the guidelines of the local institutional review boards. Evaluation of an augmented reality system based upon a tablet, a needle handle and a set of markers was performed in three experimental models. Initially, a male anthropomorphic trunk phantom equipped with five polyvinyl chloride bars (two of 16 cm in length and 3 cm in diameter and four of 45, 30 or 20 cm in length and 2 cm in diameter) was used to study the accuracy of the system without respiratory motion or tissue compression. Next, small metallic targets were placed in a porcine model to evaluate how respiration affects the system accuracy. Finally, the performance of the system on a more complete model, a cadaver with liver metastasis, was tested.ResultsIn all experimental settings, extremely high targeting accuracy of < 5 mm in all cases was achieved: 2.0 ± 1.5 mm (mean ± standard deviation) for the anthropomorphic model, 3.9 ± 0.4 mm for the porcine model, and 2.5 mm and 2.8 mm for the two metastases in the cadaver model.ConclusionsAugmented reality can assist with needle guidance with great target accuracy for interventional procedures by simultaneously visualising three-dimensional reconstructed anatomical structures, tumour targets and interventional devices on a patient’s body, enabling performance of procedures in a simple and confident way.

[1]  Eun Sun Lee,et al.  Image Fusion of Real-Time Ultrasonography with Computed Tomography: Factors Affecting the Registration Error and Motion of Focal Hepatic Lesions. , 2017, Ultrasound in medicine & biology.

[2]  Waleed Brinjikji,et al.  Navigational Tools for Interventional Radiology and Interventional Oncology Applications , 2015, Seminars in Interventional Radiology.

[3]  Luigi Solbiati,et al.  Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice? , 2007, Hepatology.

[4]  Gabor Fichtinger,et al.  Augmented reality visualization with use of image overlay technology for MR imaging-guided interventions: assessment of performance in cadaveric shoulder and hip arthrography at 1.5 T. , 2012, Radiology.

[5]  Salvatore Gitto,et al.  Dynamic high-resolution ultrasound of intrinsic and extrinsic ligaments of the wrist: How to make it simple. , 2017, European journal of radiology.

[6]  Francesco Sardanelli,et al.  Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis , 2017, European Radiology.

[7]  Kevin Cleary,et al.  Technologies for guidance of radiofrequency ablation in the multimodality interventional suite of the future. , 2007, Journal of vascular and interventional radiology : JVIR.

[8]  Luigi Solbiati,et al.  Small liver colorectal metastases treated with percutaneous radiofrequency ablation: local response rate and long-term survival with up to 10-year follow-up. , 2012, Radiology.

[9]  Giovanni Mauri,et al.  Ultrasound-guided percutaneous laser ablation is safe and effective in the treatment of small renal tumors in patients at increased bleeding risk , 2018, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[10]  S. Nahum Goldberg,et al.  Real-Time US-CT/MRI Image Fusion for Guidance of Thermal Ablation of Liver Tumors Undetectable with US: Results in 295 Cases , 2015, CardioVascular and Interventional Radiology.

[11]  Arianeb Mehrabi,et al.  Towards markerless navigation for percutaneous needle insertions , 2015, International Journal of Computer Assisted Radiology and Surgery.

[12]  Jacob Sosna,et al.  Evaluation of an electromagnetic image-fusion navigation system for biopsy of small lesions: assessment of accuracy in an in vivo swine model. , 2013, Academic radiology.

[13]  H. Fernando,et al.  Electromagnetic navigation to aid radiofrequency ablation and biopsy of lung tumors. , 2010, The Annals of thoracic surgery.

[14]  Servet Tatli,et al.  Percutaneous imaging-guided cryoablation of liver tumors: predicting local progression on 24-hour MRI. , 2014, AJR. American journal of roentgenology.

[15]  Ieva Kurilova,et al.  The Role of Percutaneous Image-Guided Thermal Ablation for the Treatment of Pulmonary Malignancies. , 2017, AJR. American journal of roentgenology.

[16]  Claudio M Pacella Image-guided thermal ablation of benign thyroid nodules , 2017, Journal of Ultrasound.

[17]  Leonardo Forzoni,et al.  Virtual navigator automatic registration technology in abdominal application , 2014, 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[18]  Julius Chapiro,et al.  From the Guest Editor: Interventional Oncology: The Fourth Pillar of Oncology. , 2016, Cancer journal.

[19]  Graham Lawton,et al.  Through the HoloLens™ looking glass: augmented reality for extremity reconstruction surgery using 3D vascular models with perforating vessels , 2018, European Radiology Experimental.

[20]  Makoto Satoh,et al.  The Trans-Visible Navigator: A See-Through Neuronavigation System Using Augmented Reality. , 2016, World neurosurgery.