Xu-Jun Shu1,2, Yu Wang3, Hao Xin3, Zhi-Zhong Zhang2, Zhe Xue2, Fu-Yu Wang2, Bai-Nan Xu4. 1. Medical School of Chinese PLA, Beijing, 100853, China. 2. Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, No.28, Fuxing Road, Beijing, 100853, China. 3. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100032, China. 4. Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, No.28, Fuxing Road, Beijing, 100853, China. xubain301@126.com.
Abstract
OBJECTIVE: A smartphone augmented reality (AR) application (app) was explored for clinical use in presurgical planning and lesion scalp localization. METHODS: We programmed an AR App on a smartphone. The accuracy of the AR app was tested on a 3D-printed head model, using the Euclidean distance of displacement of virtual objects. For clinical validation, 14 patients with brain tumors were included in the study. Preoperative MRI images were used to generate 3D models for AR contents. The 3D models were then transferred to the smartphone AR app. Tumor scalp localization was marked, and a surgical corridor was planned on the patient's head by viewing AR images on the smartphone screen. Standard neuronavigation was applied to evaluate the accuracy of the smartphone. Max-margin distance (MMD) and area overlap ratio (AOR) were measured to quantitatively validate the clinical accuracy of the smartphone AR technique. RESULTS: In model validation, the total mean Euclidean distance of virtual object displacement using the smartphone AR app was 4.7 ± 2.3 mm. In clinical validation, the mean duration of AR app usage was 168.5 ± 73.9 s. The total mean MMD was 6.7 ± 3.7 mm, and total mean AOR was 79%. CONCLUSIONS: The smartphone AR app provides a new way of experience to observe intracranial anatomy in situ, and it makes surgical planning more intuitive and efficient. Localization accuracy is satisfactory with lesions larger than 15 mm.
OBJECTIVE: A smartphone augmented reality (AR) application (app) was explored for clinical use in presurgical planning and lesion scalp localization. METHODS: We programmed an AR App on a smartphone. The accuracy of the AR app was tested on a 3D-printed head model, using the Euclidean distance of displacement of virtual objects. For clinical validation, 14 patients with brain tumors were included in the study. Preoperative MRI images were used to generate 3D models for AR contents. The 3D models were then transferred to the smartphone AR app. Tumor scalp localization was marked, and a surgical corridor was planned on the patient's head by viewing AR images on the smartphone screen. Standard neuronavigation was applied to evaluate the accuracy of the smartphone. Max-margin distance (MMD) and area overlap ratio (AOR) were measured to quantitatively validate the clinical accuracy of the smartphone AR technique. RESULTS: In model validation, the total mean Euclidean distance of virtual object displacement using the smartphone AR app was 4.7 ± 2.3 mm. In clinical validation, the mean duration of AR app usage was 168.5 ± 73.9 s. The total mean MMD was 6.7 ± 3.7 mm, and total mean AOR was 79%. CONCLUSIONS: The smartphone AR app provides a new way of experience to observe intracranial anatomy in situ, and it makes surgical planning more intuitive and efficient. Localization accuracy is satisfactory with lesions larger than 15 mm.