Abstract：
OBJECTIVE: Targeting accuracy determines outcomes for percutaneous needle interventions. Augmented reality (AR) in IR may improve procedural guidance and facilitate access to complex locations. This study aimed to evaluate percutaneous needle placement accuracy using a goggle-based AR system compared to an ultrasound (US)-based fusion navigation system.
METHODS: Six interventional radiologists performed 24 independent needle placements in an anthropomorphic phantom (CIRS 057A) in four needle guidance cohorts (n = 6 each): (1) US-based fusion, (2) goggle-based AR with stereoscopically projected anatomy (AR-overlay), (3) goggle AR without the projection (AR-plain), and (4) CT-guided freehand. US-based fusion included US/CT registration with electromagnetic (EM) needle, transducer, and patient tracking. For AR-overlay, US, EM-tracked needle, stereoscopic anatomical structures and targets were superimposed over the phantom. Needle placement accuracy (distance from needle tip to target center), placement time (from skin puncture to final position), and procedure time (time to completion) were measured.
RESULTS: Mean needle placement accuracy using US-based fusion, AR-overlay, AR-plain, and freehand was 4.5 ± 1.7 mm, 7.0 ± 4.7 mm, 4.7 ± 1.7 mm, and 9.2 ± 5.8 mm, respectively. AR-plain demonstrated comparable accuracy to US-based fusion (p = 0.7) and AR-overlay (p = 0.06). Excluding two outliers, AR-overlay accuracy became 5.9 ± 2.6 mm. US-based fusion had the highest mean placement time (44.3 ± 27.7 s) compared to all navigation cohorts (p < 0.001). Longest procedure times were recorded with AR-overlay (34 ± 10.2 min) compared to AR-plain (22.7 ± 8.6 min, p = 0.09), US-based fusion (19.5 ± 5.6 min, p = 0.02), and freehand (14.8 ± 1.6 min, p = 0.002).
CONCLUSIONS: Goggle-based AR showed no difference in needle placement accuracy compared to the commercially available US-based fusion navigation platform. Differences in accuracy and procedure times were apparent with different display modes (with/without stereoscopic projections). The AR-based projection of the US and needle trajectory over the body may be a helpful tool to enhance visuospatial orientation. Thus, this study refines the potential role of AR for needle placements, which may serve as a catalyst for informed implementation of AR techniques in IR.
METHODS: Six interventional radiologists performed 24 independent needle placements in an anthropomorphic phantom (CIRS 057A) in four needle guidance cohorts (n = 6 each): (1) US-based fusion, (2) goggle-based AR with stereoscopically projected anatomy (AR-overlay), (3) goggle AR without the projection (AR-plain), and (4) CT-guided freehand. US-based fusion included US/CT registration with electromagnetic (EM) needle, transducer, and patient tracking. For AR-overlay, US, EM-tracked needle, stereoscopic anatomical structures and targets were superimposed over the phantom. Needle placement accuracy (distance from needle tip to target center), placement time (from skin puncture to final position), and procedure time (time to completion) were measured.
RESULTS: Mean needle placement accuracy using US-based fusion, AR-overlay, AR-plain, and freehand was 4.5 ± 1.7 mm, 7.0 ± 4.7 mm, 4.7 ± 1.7 mm, and 9.2 ± 5.8 mm, respectively. AR-plain demonstrated comparable accuracy to US-based fusion (p = 0.7) and AR-overlay (p = 0.06). Excluding two outliers, AR-overlay accuracy became 5.9 ± 2.6 mm. US-based fusion had the highest mean placement time (44.3 ± 27.7 s) compared to all navigation cohorts (p < 0.001). Longest procedure times were recorded with AR-overlay (34 ± 10.2 min) compared to AR-plain (22.7 ± 8.6 min, p = 0.09), US-based fusion (19.5 ± 5.6 min, p = 0.02), and freehand (14.8 ± 1.6 min, p = 0.002).
CONCLUSIONS: Goggle-based AR showed no difference in needle placement accuracy compared to the commercially available US-based fusion navigation platform. Differences in accuracy and procedure times were apparent with different display modes (with/without stereoscopic projections). The AR-based projection of the US and needle trajectory over the body may be a helpful tool to enhance visuospatial orientation. Thus, this study refines the potential role of AR for needle placements, which may serve as a catalyst for informed implementation of AR techniques in IR.
摘要：
目的：目标准确性决定经皮穿刺介入治疗的结局。IR中的增强现实（AR）可以改善程序指导并促进对复杂位置的访问。这项研究旨在与基于超声（US）的融合导航系统相比，使用基于护目镜的AR系统评估经皮针头放置准确性。
方法：六名介入放射科医生在四个针引导队列（每个n=6）中的拟人化体模（CIRS057A）中进行了24个独立的针放置：（1）基于US的融合，(2)具有立体投影解剖结构的基于护目镜的AR(AR-overlay)，(3)没有投影的护目镜AR(AR-plain)，和（4）CT引导徒手。基于US的融合包括与电磁（EM）针的US/CT配准，传感器,患者追踪对于AR覆盖，US,EM跟踪针,立体解剖结构和目标叠加在体模上。针头放置精度（从针尖到目标中心的距离），放置时间（从皮肤穿刺到最终位置），和程序时间（完成时间）进行测量。
结果：使用基于US的融合的平均针头放置精度，AR叠加,AR-plain,徒手为4.5±1.7毫米，7.0±4.7mm,4.7±1.7mm,和9.2±5.8毫米，分别。AR-plain显示出与基于US的融合（p=0.7）和AR叠加（p=0.06）相当的准确性。排除两个异常值，AR叠加精度变为5.9±2.6mm。与所有导航队列相比，基于US的融合具有最高的平均放置时间（44.3±27.7s）（p<0.001）。与AR-plain（22.7±8.6分钟，p=0.09),基于美国的融合（19.5±5.6分钟，p=0.02),徒手（14.8±1.6分钟，p=0.002)。
结论：与市售的基于美国的融合导航平台相比，基于护目镜的AR在针头放置精度上没有差异。对于不同的显示模式(有/没有立体投影),准确度和操作时间的差异是明显的。基于AR的US和针轨迹在身体上的投影可能是增强视觉空间取向的有用工具。因此，这项研究细化了AR对针头放置的潜在作用，这可以作为在IR中知情实施AR技术的催化剂。
方法：六名介入放射科医生在四个针引导队列（每个n=6）中的拟人化体模（CIRS057A）中进行了24个独立的针放置：（1）基于US的融合，(2)具有立体投影解剖结构的基于护目镜的AR(AR-overlay)，(3)没有投影的护目镜AR(AR-plain)，和（4）CT引导徒手。基于US的融合包括与电磁（EM）针的US/CT配准，传感器,患者追踪对于AR覆盖，US,EM跟踪针,立体解剖结构和目标叠加在体模上。针头放置精度（从针尖到目标中心的距离），放置时间（从皮肤穿刺到最终位置），和程序时间（完成时间）进行测量。
结果：使用基于US的融合的平均针头放置精度，AR叠加,AR-plain,徒手为4.5±1.7毫米，7.0±4.7mm,4.7±1.7mm,和9.2±5.8毫米，分别。AR-plain显示出与基于US的融合（p=0.7）和AR叠加（p=0.06）相当的准确性。排除两个异常值，AR叠加精度变为5.9±2.6mm。与所有导航队列相比，基于US的融合具有最高的平均放置时间（44.3±27.7s）（p<0.001）。与AR-plain（22.7±8.6分钟，p=0.09),基于美国的融合（19.5±5.6分钟，p=0.02),徒手（14.8±1.6分钟，p=0.002)。
结论：与市售的基于美国的融合导航平台相比，基于护目镜的AR在针头放置精度上没有差异。对于不同的显示模式(有/没有立体投影),准确度和操作时间的差异是明显的。基于AR的US和针轨迹在身体上的投影可能是增强视觉空间取向的有用工具。因此，这项研究细化了AR对针头放置的潜在作用，这可以作为在IR中知情实施AR技术的催化剂。
