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Augmented Reality Navigation Systems in Health Care

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A special issue of Sensors (ISSN 1424-8220). This special issue belongs to the section "Biomedical Sensors".

Deadline for manuscript submissions: closed (30 October 2022) | Viewed by 11183

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Special Issue Editors

Dr. Mario Romero

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Guest Editor

Computational Science and Technology (CST), School of Electrical Engineering and Computer Science (EECS), KTH - Royal Institute of Technology, SE-164 40 Kista, Sweden
Interests: interactive computer graphics; virtual and augmented reality; human-computer interaction; data visualization; user experience; ubiquitous computing; accessible computing; technology-enhanced learning

Prof. Dr. Roger Härtl

E-Mail Website
Guest Editor

Weill Cornell Medicine Center for Comprehensive Spine Care, New York, NY 10022, USA
Interests: minimally invasive surgery; tubular surgery; 3-dimensional navigation; lateral approach surgeries; biological approaches for disc repair/regeneration; global neurosurgery; augmented reality

Dr. Erik Edström

E-Mail Website
Guest Editor

Department of Clinical Neuroscience, Karolinska Institutet, SE-171 65 Stockholm, Sweden
Interests: Spine surgery; Surgical navigation; neuronavigation; Augmented Reality; Virtual Reality; Mixed Reality; Patient tracking; Optical tracking; IR tracking; Cranial navigation; Endoscopy

Dr. Adrian Elmi-Terander

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Guest Editor

Dr. Benno Hendriks

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Guest Editor

Faculty of Mechanical Engineering BioMechanical Engineering, Delft University of Technology, Mekelweg 5, 2628 CD Delft, The Netherlands
Interests: Minimally Invasive Interventions; Image Guided Therapy; Augmented Reality; Optical Tracking; Smart Interventional Devices; Optical Spectroscopy; Workflow Efficiency

Dr. Ibrahim Hussain

E-Mail Website
Guest Editor

Weill Cornell Medicine Center for Comprehensive Spine Care, New York, NY 10022, USA
Interests: endoscopy; endoscopic fusion; minimally invasive surgery; enhanced recovery after surgery; 3-dimensional navigation; augmented reality; biologic approaches for disc repair/regeneration

Special Issue Information

Dear Colleagues,

The application of augmented reality technology to health care holds great promise in that it can provide users with pertinent visual information while they are performing manual tasks. Augmented reality means that virtual information is superimposed on live real-world information, typically in the user’s field of view using a head mounted display, a monitor or a projector. In surgery and interventional radiology, augmented reality is used to provide navigational feedback on instrument positions in relation to anatomical structures to assist the physician in carrying out a procedure with maximal accuracy. For the coming generations of augmented reality systems improved matching between the real world and superimposed data is essential. Sensors are needed that accurately decipher our three-dimensional environment. For this issue we welcome clinical papers describing new technical solutions for AR navigation in different surgical and interventional fields as well as technical papers on the design of new AR systems with special emphasis on patient recognition and tracking for accurate image overlay. Novel solutions or applications of intraoperative imaging modalities and sensor technologies for the visual, infrared, hyperspectral and X-ray spectra are of great interest.

Dr. Mario Romero
Prof. Dr. Roger Härtl
Dr. Erik Edström
Dr. Adrian Elmi-Terander
Dr. Benno Hendriks
Dr. Ibrahim Hussain
Guest Editors

Manuscript Submission Information

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Keywords

Augmented Reality
Virtual Reality
Mixed Reality
Surgery
Navigation
Sensors
X-ray
Optics
Hyperspectral imaging

Published Papers (4 papers)

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Research

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20 pages, 19958 KiB

Open AccessArticle

Augmented Reality to Compensate for Navigation Inaccuracies

by Miriam H. A. Bopp, Felix Corr, Benjamin Saß, Mirza Pojskic, André Kemmling and Christopher Nimsky

Sensors 2022, 22(24), 9591; https://0-doi-org.brum.beds.ac.uk/10.3390/s22249591 - 07 Dec 2022

Cited by 2 | Viewed by 2156

Abstract

This study aims to report on the capability of microscope-based augmented reality (AR) to evaluate registration and navigation accuracy with extracranial and intracranial landmarks and to elaborate on its opportunities and obstacles in compensation for navigation inaccuracies. In a consecutive single surgeon series of 293 patients, automatic intraoperative computed tomography-based registration was performed delivering a high initial registration accuracy with a mean target registration error of 0.84 ± 0.36 mm. Navigation accuracy is evaluated by overlaying a maximum intensity projection or pre-segmented object outlines within the recent focal plane onto the in situ patient anatomy and compensated for by translational and/or rotational in-plane transformations. Using bony landmarks (85 cases), there was two cases where a mismatch was seen. Cortical vascular structures (242 cases) showed a mismatch in 43 cases and cortex representations (40 cases) revealed two inaccurate cases. In all cases, with detected misalignment, a successful spatial compensation was performed (mean correction: bone (6.27 ± 7.31 mm), vascular (3.00 ± 1.93 mm, 0.38° ± 1.06°), and cortex (5.31 ± 1.57 mm, 1.75° ± 2.47°)) increasing navigation accuracy. AR support allows for intermediate and straightforward monitoring of accuracy, enables compensation of spatial misalignments, and thereby provides additional safety by increasing overall accuracy. Full article

(This article belongs to the Special Issue Augmented Reality Navigation Systems in Health Care)

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9 pages, 1583 KiB

Open AccessArticle

Accuracy Assessment of Percutaneous Pedicle Screw Placement Using Cone Beam Computed Tomography with Metal Artifact Reduction

by Yann Philippe Charles, Rawan Al Ansari, Arnaud Collinet, Pierre De Marini, Jean Schwartz, Rami Nachabe, Dirk Schäfer, Bernhard Brendel, Afshin Gangi and Roberto Luigi Cazzato

Sensors 2022, 22(12), 4615; https://0-doi-org.brum.beds.ac.uk/10.3390/s22124615 - 18 Jun 2022

Cited by 1 | Viewed by 1948

Abstract

Metal artifact reduction (MAR) algorithms are used with cone beam computed tomography (CBCT) during augmented reality surgical navigation for minimally invasive pedicle screw instrumentation. The aim of this study was to assess intra- and inter-observer reliability of pedicle screw placement and to compare the perception of baseline image quality (NoMAR) with optimized image quality (MAR). CBCT images of 24 patients operated on for degenerative spondylolisthesis using minimally invasive lumbar fusion were analyzed retrospectively. Images were treated using NoMAR and MAR by an engineer, thus creating 48 randomized files, which were then independently analyzed by 3 spine surgeons and 3 radiologists. The Gertzbein and Robins classification was used for screw accuracy rating, and an image quality scale rated the clarity of pedicle screw and bony landmark depiction. Intra-class correlation coefficients (ICC) were calculated. NoMAR and MAR led to similarly good intra-observer (ICC > 0.6) and excellent inter-observer (ICC > 0.8) assessment reliability of pedicle screw placement accuracy. The image quality scale showed more variability in individual image perception between spine surgeons and radiologists (ICC range 0.51–0.91). This study indicates that intraoperative screw positioning can be reliably assessed on CBCT for augmented reality surgical navigation when using optimized image quality. Subjective image quality was rated slightly superior for MAR compared to NoMAR. Full article

(This article belongs to the Special Issue Augmented Reality Navigation Systems in Health Care)

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12 pages, 3481 KiB

Open AccessArticle

Feasibility and Accuracy of Thoracolumbar Pedicle Screw Placement Using an Augmented Reality Head Mounted Device

by Henrik Frisk, Eliza Lindqvist, Oscar Persson, Juliane Weinzierl, Linda K. Bruetzel, Paulina Cewe, Gustav Burström, Erik Edström and Adrian Elmi-Terander

Sensors 2022, 22(2), 522; https://0-doi-org.brum.beds.ac.uk/10.3390/s22020522 - 11 Jan 2022

Cited by 14 | Viewed by 2590

Abstract

Background: To investigate the accuracy of augmented reality (AR) navigation using the Magic Leap head mounted device (HMD), pedicle screws were minimally invasively placed in four spine phantoms. Methods: AR navigation provided by a combination of a conventional navigation system integrated with the Magic Leap head mounted device (AR-HMD) was used. Forty-eight screws were planned and inserted into Th11-L4 of the phantoms using the AR-HMD and navigated instruments. Postprocedural CT scans were used to grade the technical (deviation from the plan) and clinical (Gertzbein grade) accuracy of the screws. The time for each screw placement was recorded. Results: The mean deviation between navigation plan and screw position was 1.9 ± 0.7 mm (1.9 [0.3–4.1] mm) at the entry point and 1.4 ± 0.8 mm (1.2 [0.1–3.9] mm) at the screw tip. The angular deviation was 3.0 ± 1.4° (2.7 [0.4–6.2]°) and the mean time for screw placement was 130 ± 55 s (108 [58–437] s). The clinical accuracy was 94% according to the Gertzbein grading scale. Conclusion: The combination of an AR-HMD with a conventional navigation system for accurate minimally invasive screw placement is feasible and can exploit the benefits of AR in the perspective of the surgeon with the reliability of a conventional navigation system. Full article

(This article belongs to the Special Issue Augmented Reality Navigation Systems in Health Care)

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Review

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20 pages, 400 KiB

Open AccessReview

Extended Reality in Neurosurgical Education: A Systematic Review

by Alessandro Iop, Victor Gabriel El-Hajj, Maria Gharios, Andrea de Giorgio, Fabio Marco Monetti, Erik Edström, Adrian Elmi-Terander and Mario Romero

Sensors 2022, 22(16), 6067; https://0-doi-org.brum.beds.ac.uk/10.3390/s22166067 - 14 Aug 2022

Cited by 18 | Viewed by 3403

Abstract

Surgical simulation practices have witnessed a rapid expansion as an invaluable approach to resident training in recent years. One emerging way of implementing simulation is the adoption of extended reality (XR) technologies, which enable trainees to hone their skills by allowing interaction with virtual 3D objects placed in either real-world imagery or virtual environments. The goal of the present systematic review is to survey and broach the topic of XR in neurosurgery, with a focus on education. Five databases were investigated, leading to the inclusion of 31 studies after a thorough reviewing process. Focusing on user performance (UP) and user experience (UX), the body of evidence provided by these 31 studies showed that this technology has, in fact, the potential of enhancing neurosurgical education through the use of a wide array of both objective and subjective metrics. Recent research on the topic has so far produced solid results, particularly showing improvements in young residents, compared to other groups and over time. In conclusion, this review not only aids to a better understanding of the use of XR in neurosurgical education, but also highlights the areas where further research is entailed while also providing valuable insight into future applications. Full article

(This article belongs to the Special Issue Augmented Reality Navigation Systems in Health Care)

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