Augmented reality head-mounted display–based incision planning in cranial neurosurgery: a prospective pilot study

OBJECTIVE Monitor and wand–based neuronavigation stations (MWBNSs) for frameless intraoperative neuronavigation are routinely used in cranial neurosurgery. However, they are temporally and spatially cumbersome; the OR must be arranged around the MWBNS, at least one hand must be used to manipulate the MWBNS wand (interrupting a bimanual surgical technique), and the surgical workflow is interrupted as the surgeon stops to “check the navigation” on a remote monitor. Thus, there is need for continuous, real-time, hands-free, neuronavigation solutions. Augmented reality (AR) is poised to streamline these issues. The authors present the first reported prospective pilot study investigating the feasibility of using the OpenSight application with an AR head-mounted display to map out the borders of tumors in patients undergoing elective craniotomy for tumor resection, and to compare the degree of correspondence with MWBNS tracing. METHODS Eleven consecutive patients undergoing elective craniotomy for brain tumor resection were prospectively identified and underwent circumferential tumor border tracing at the time of incision planning by a surgeon wearing HoloLens AR glasses running the commercially available OpenSight application registered to the patient and preoperative MRI. Then, the same patient underwent circumferential tumor border tracing using the StealthStation S8 MWBNS. Postoperatively, both tumor border tracings were compared by two blinded board-certified neurosurgeons and rated as having an excellent, adequate, or poor correspondence degree based on a subjective sense of the overlap. Objective overlap area measurements were also determined. RESULTS Eleven patients undergoing craniotomy were included in the study. Five patient procedures were rated as having an excellent correspondence degree, 5 had an adequate correspondence degree, and 1 had poor correspondence. Both raters agreed on the rating in all cases. AR tracing was possible in all cases. CONCLUSIONS In this small pilot study, the authors found that AR was implementable in the workflow of a neurosurgery OR, and was a feasible method of preoperative tumor border identification for incision planning. Future studies are needed to identify strategies to improve and optimize AR accuracy.

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Augmented reality visualization of hyperspectral imaging classifications for image-guided brain tumor resection

Medical Imaging 2020: Image-Guided Procedures, Robotic Interventions, and Modeling ◽

10.1117/12.2549041 ◽

2020 ◽

Author(s):

James Huang ◽

Martin Halicek ◽

Maysam Shahedi ◽

Baowei Fei

Keyword(s):

Brain Tumor ◽

Augmented Reality ◽

Hyperspectral Imaging ◽

Tumor Resection ◽

Image Guided ◽

Brain Tumor Resection

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The Role of Augmented Reality in Training the Planning of Brain Tumor Resection

Augmented Reality Environments for Medical Imaging and Computer-Assisted Interventions - Lecture Notes in Computer Science ◽

10.1007/978-3-642-40843-4_26 ◽

2013 ◽

pp. 241-248 ◽

Cited By ~ 6

Author(s):

Kamyar Abhari ◽

John S. H. Baxter ◽

Elvis S. Chen ◽

Ali R. Khan ◽

Chris Wedlake ◽

...

Keyword(s):

Brain Tumor ◽

Augmented Reality ◽

Tumor Resection ◽

Brain Tumor Resection

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Increased complication and mortality among non-index hospital readmissions after brain tumor resection is associated with low-volume readmitting hospitals

Journal of Neurosurgery ◽

10.3171/2019.6.jns183469 ◽

2020 ◽

Vol 133 (5) ◽

pp. 1332-1344

Author(s):

Casey A. Jarvis ◽

Joshua Bakhsheshian ◽

Li Ding ◽

Timothy Wen ◽

Austin M. Tang ◽

...

Keyword(s):

Logistic Regression ◽

Brain Tumor ◽

Hospital Readmission ◽

Tumor Resection ◽

Factors Associated ◽

Major Complications ◽

Brain Tumor Resection ◽

Procedure Volume ◽

Index Hospital ◽

Craniotomy For Tumor Resection

OBJECTIVEFragmentation of care following craniotomy for tumor resection is increasingly common with the regionalization of neurosurgery. Hospital readmission to a hospital (non-index) other than the one from which patients received their original care (index) has been associated with increases in both morbidity and mortality for cancer patients. The impact of non-index readmission after surgical management of brain tumors has not previously been evaluated. The authors set out to determine rates of non-index readmission following craniotomy for tumor resection and evaluated outcomes following index and non-index readmissions.METHODSRetrospective analyses of data from cases involving resection of a primary brain tumor were conducted using data from the Nationwide Readmissions Database (NRD) for 2010–2014. Multivariate logistic regression was used to evaluate the independent association of patient and hospital factors with readmission to an index versus non-index hospital. Further analysis evaluated association of non-index versus index hospital readmission with mortality and major complications during readmission. Effects of readmission hospital procedure volume on mortality and morbidity were evaluated in post hoc analysis.RESULTSIn a total of 17,459 unplanned readmissions, 84.4% patients were readmitted to index hospitals and 15.6% to non-index hospitals. Patient factors associated with increased likelihood of non-index readmission included older age (75+: OR 1.44, 95% CI 1.19–1.75), elective index admission (OR 1.19, 95% CI 1.08–1.30), increased Elixhauser comorbidity score ≥2 (OR 1.18, 95% CI 1.01–1.37), and malignant tumor diagnosis (OR 1.32, 95% CI 1.19–1.45) (all p < 0.04). Readmission to a non-index facility was associated with a 28% increase in major complications (OR 1.28, 95% CI 1.14–1.43, p < 0.001) and 21% increase in mortality (OR 1.21, 95% CI 1.02–1.44, p = 0.032) in initial analysis. Following a second multivariable logistic regression analysis including the readmitting hospital characteristics, low procedure volume of a readmitting facility was significantly associated with non-index readmission (p < 0.001). Readmission to a lower-procedure-volume facility was associated with a 46%–75% increase in mortality (OR 1.46–1.75, p < 0.005) and a 21%–35% increase in major complications (OR 1.21–1.34, p < 0.005). Following adjustment for volume at a readmitting facility, admission to a non-index facility was no longer associated with mortality (OR 0.90, 95% CI 0.71–1.14, p = 0.378) or major complications (OR 1.09, CI 0.94–1.26, p = 0.248).CONCLUSIONSOf patient readmissions following brain tumor resection, 15.6% occur at a non-index facility. Low procedure volume is a confounder for non-index analysis and is associated with an increased likelihood of major complications and mortality, as compared to readmission to high-procedure-volume hospitals. Further studies should evaluate interventions targeting factors associated with unplanned readmission.

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Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study

Surgical Neurology International ◽

10.4103/2152-7806.170023 ◽

2015 ◽

Vol 6 (1) ◽

pp. 172 ◽

Cited By ~ 17

Author(s):

Parviz Dolati ◽

Abdulkerim Gokoglu ◽

Daniel Eichberg ◽

Amir Zamani ◽

Alexandra Golby ◽

...

Keyword(s):

Pilot Study ◽

Skull Base ◽

Cranial Nerve ◽

Tumor Resection ◽

Skull Base Tumor ◽

Prospective Pilot Study

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Feasibility and safety of augmented-reality glass for computed tomography-assisted percutaneous revascularization of coronary chronic total occlusion: A single center prospective pilot study

Journal of Cardiovascular Computed Tomography ◽

10.1016/j.jcct.2017.09.013 ◽

2017 ◽

Vol 11 (6) ◽

pp. 489-496 ◽

Cited By ~ 8

Author(s):

Maksymilian P. Opolski ◽

Artur Debski ◽

Bartosz A. Borucki ◽

Adam D. Staruch ◽

Cezary Kepka ◽

...

Keyword(s):

Computed Tomography ◽

Pilot Study ◽

Augmented Reality ◽

Chronic Total Occlusion ◽

Single Center ◽

Total Occlusion ◽

Prospective Pilot Study ◽

Percutaneous Revascularization

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Soft Tissue Pushing Operation Using a Haptic Interface for Simulation of Brain Tumor Resection

Journal of Robotics and Mechatronics ◽

10.20965/jrm.2006.p0634 ◽

2006 ◽

Vol 18 (5) ◽

pp. 634-642 ◽

Cited By ~ 14

Author(s):

Daisuke Sato ◽

◽

Ryosuke Kobayashi ◽

Akira Kobayashi ◽

Shohei Fujino ◽

...

Keyword(s):

Brain Tumor ◽

Brain Tissue ◽

Virtual Environment ◽

Reaction Force ◽

Tumor Resection ◽

Brain Surgery ◽

Surgical Instrument ◽

Head Mounted Display ◽

Brain Tumor Resection ◽

Surgery Simulator

The goal of this research is development of a surgery simulator to train surgeons concretely in brain surgery under microscope so that they can pick up the skills needed for brain tumor resection more skillfully and in less time. For achieving this objective, in this paper, basic operations are selected for brain tumor resection based on actual surgery skills. To provide the visual and tactile sensations of brain surgery, we develop an interface consisting of a stereoptic head mounted display and a 6-DOF haptic device that feeds back position and force from a virtual environment. The models used to develop the virtual brain microsurgery environment include a geometrical model to produce numerical model shapes, a physical model to calculate model deformation and reaction force and collision detection used for simulating contact between the brain tissue model and the surgical instrument model. We also model brain tissue deformation for pushing aside tissues by a surgical instrument (brain spatula) to widen the operative field. Consequently, a system of surgery simulator is constructed by combining the interface with the virtual environment. The two experiments we conducted confirmed the feasibility of our proposed surgery simulator. One involves deformation and reaction force of brain tissue when an operator pushes two numerical models having different physical parameters. The other involves pushing aside brain tissue using brain spatula.

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