Christoph Rüger1,2,3, Markus A Feufel4, Simon Moosburner1, Christopher Özbek2, Johann Pratschke1,5, Igor M Sauer6,7. 1. Department of Surgery, Campus Charité Mitte | Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany. 2. Scopis GmbH, Heinrich-Heine-Platz 10, 10179, Berlin, Germany. 3. Technische Universität Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany. 4. Division of Ergonomics, Department of Psychology and Ergonomics (IPA), Technische Universität Berlin, Marchstr. 23, MAR 3-2, 10587, Berlin, Germany. 5. Cluster of Excellence Matters of Activity, Image Space Material Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) Under Germany's Excellence Strategy - EXC 2025, Augustenburger Platz 1, 13353, Berlin, Germany. 6. Department of Surgery, Campus Charité Mitte | Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany. igor.sauer@charite.de. 7. Cluster of Excellence Matters of Activity, Image Space Material Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) Under Germany's Excellence Strategy - EXC 2025, Augustenburger Platz 1, 13353, Berlin, Germany. igor.sauer@charite.de.
Abstract
PURPOSE:Augmented reality (AR) and head-mounted displays (HMD) in medical practice are current research topics. A commonly proposed use case of AR-HMDs is to display data in image-guided interventions. Although technical feasibility has been thoroughly shown, effects of AR-HMDs on interventions are not yet well researched, hampering clinical applicability. Therefore, the goal of this study is to better understand the benefits and limitations of this technology in ultrasound-guided interventions. METHODS: We used an AR-HMD system (based on the first-generation Microsoft Hololens) which overlays live ultrasound images spatially correctly at the location of the ultrasound transducer. We chose ultrasound-guided needle placements as a representative task for image-guided interventions. To examine the effects of the AR-HMD, we used mixed methods and conducted two studies in a lab setting: (1) In a randomized crossover study, we asked participants to place needles into a training model and evaluated task duration and accuracy with the AR-HMD as compared to the standard procedure without visual overlay and (2) in a qualitative study, we analyzed the user experience with AR-HMD using think-aloud protocols during ultrasound examinations and semi-structured interviews after the task. RESULTS: Participants (n = 20) placed needles more accurately (mean error of 7.4 mm vs. 4.9 mm, p = 0.022) but not significantly faster (mean task duration of 74.4 s vs. 66.4 s, p = 0.211) with the AR-HMD. All participants in the qualitative study (n = 6) reported limitations of and unfamiliarity with the AR-HMD, yet all but one also clearly noted benefits and/or that they would like to test the technology in practice. CONCLUSION: We present additional, though still preliminary, evidence that AR-HMDs provide benefits in image-guided procedures. Our data also contribute insights into potential causes underlying the benefits, such as improved spatial perception. Still, more comprehensive studies are needed to ascertain benefits for clinical applications and to clarify mechanisms underlying these benefits.
RCT Entities:
PURPOSE: Augmented reality (AR) and head-mounted displays (HMD) in medical practice are current research topics. A commonly proposed use case of AR-HMDs is to display data in image-guided interventions. Although technical feasibility has been thoroughly shown, effects of AR-HMDs on interventions are not yet well researched, hampering clinical applicability. Therefore, the goal of this study is to better understand the benefits and limitations of this technology in ultrasound-guided interventions. METHODS: We used an AR-HMD system (based on the first-generation Microsoft Hololens) which overlays live ultrasound images spatially correctly at the location of the ultrasound transducer. We chose ultrasound-guided needle placements as a representative task for image-guided interventions. To examine the effects of the AR-HMD, we used mixed methods and conducted two studies in a lab setting: (1) In a randomized crossover study, we asked participants to place needles into a training model and evaluated task duration and accuracy with the AR-HMD as compared to the standard procedure without visual overlay and (2) in a qualitative study, we analyzed the user experience with AR-HMD using think-aloud protocols during ultrasound examinations and semi-structured interviews after the task. RESULTS:Participants (n = 20) placed needles more accurately (mean error of 7.4 mm vs. 4.9 mm, p = 0.022) but not significantly faster (mean task duration of 74.4 s vs. 66.4 s, p = 0.211) with the AR-HMD. All participants in the qualitative study (n = 6) reported limitations of and unfamiliarity with the AR-HMD, yet all but one also clearly noted benefits and/or that they would like to test the technology in practice. CONCLUSION: We present additional, though still preliminary, evidence that AR-HMDs provide benefits in image-guided procedures. Our data also contribute insights into potential causes underlying the benefits, such as improved spatial perception. Still, more comprehensive studies are needed to ascertain benefits for clinical applications and to clarify mechanisms underlying these benefits.
Authors: Christian Boedecker; Florentine Huettl; Patrick Saalfeld; Markus Paschold; Werner Kneist; Janine Baumgart; Bernhard Preim; Christian Hansen; Hauke Lang; Tobias Huber Journal: Langenbecks Arch Surg Date: 2021-03-12 Impact factor: 3.445
Authors: Felix von Haxthausen; Rafael Moreta-Martinez; Alicia Pose Díez de la Lastra; Javier Pascau; Floris Ernst Journal: Int J Comput Assist Radiol Surg Date: 2022-07-01 Impact factor: 3.421
Authors: D Amiras; T J Hurkxkens; D Figueroa; P J Pratt; B Pitrola; C Watura; S Rostampour; G J Shimshon; M Hamady Journal: Eur Radiol Date: 2021-06-10 Impact factor: 5.315