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. 2022 Aug;45(8):1173-1177.
doi: 10.1007/s00270-022-03195-y. Epub 2022 Jun 24.

Augmented Reality-Assisted CT-Guided Puncture: A Phantom Study

Vincent Van den Bosch #  1 , Hizirwan Shukri Salim #  2 , Njin-Zu Chen  2 , Otto Stroosma  2 , Philipp Bruners  3 , Christiane K Kuhl  3 , Federico Pedersoli #  3 , Peter Isfort #  3
Affiliations

Augmented Reality-Assisted CT-Guided Puncture: A Phantom Study

Vincent Van den Bosch et al. Cardiovasc Intervent Radiol. 2022 Aug.

Abstract

Purpose: To investigate the feasibility of a novel augmented reality system for CT-guided liver interventions and to compare it with free-hand interventions in a phantom setting.

Methods and materials: A newly developed augmented reality interface was used, with projection of CT-imaging in multiplanar reconstruction and live rendering of the needle position, a bull`s eye view of the needle trajectory and a visualization of the distance to the target. Punctures were performed on a custom-made abdominal phantom by three interventional radiologists with different levels of expertise. Time and needle placement accuracy were measured. Two-tailed Wilcoxon signed rank test (p < 0.05) was performed to evaluate intraparticipant difference.

Results: Intraparticipant puncture times were significantly shorter for each operator in the augmented reality condition (< 0.001 for the resident, < 0.001 for the junior staff member and 0.027 for the senior staff member). The junior staff member had an improvement in accuracy of 1 mm using augmented reality (p 0.026); the other two participants showed no significant improvement regarding accuracy.

Conclusion: In this small series, it appears that the novel augmented reality system may improve the speed of CT-guided punctures in the phantom model compared to the free-hand procedure while maintaining a similar accuracy.

Keywords: Augmented reality; Image-guided biopsy; Imaging; Phantoms; Punctures.

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Conflict of interest statement

Hizirwan Shukri Salim, Njin-Zu Chen, and Otto Stroosma are currently employed by Philips Research Europe.

Figures

Fig. 1
Fig. 1
Seven essential steps in creating the CT-simulator: 1 Acquiring a sequence of CT-images. 2 Segmenting the CT-images using 3D-Slicer. 3 Creating the 3D model with marker holder in blender. 4 3D printing the phantom and placing the marker. 5 Creating the needle with markers. 6 Tracking the phantom and needle with NDI system. 7 Using the tracking information to simulate the needle position over the CT-sequences
Fig. 2
Fig. 2
AR-interface as seen by the operator. It consists of an axial CT (top left), a sagittal CT (top right) as well as a bull’s eye with slider. Note the live rendering of the needle and the red dot in both CT-images, being the point-shaped target
Fig. 3
Fig. 3
a. Graph displaying every single puncture in the experiment with regard to duration and accuracy. b. Combination of two box plot graphs and a table describing mean duration and accuracy results for each operator as well as the intraparticipant comparison values. AR: augmented reality; FH: freehand; JSM: junior staff member (yellow); RR: resident radiologist (red); SD: standard deviation; SSM: senior staff member (green)
See this image and copyright information in PMC

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