Three-Dimensional Augmented Reality Visualization Informs Locoregional Therapy in a Translational Model of Hepatocellular Carcinoma

• Published in: Journal of vascular and interventional radiology Vol. 31; no. 10; pp. 1612 - 1618.e1
• Main Authors: Park, Brian J., Perkons, Nicholas R., Profka, Enri, Johnson, Omar, Morley, Christopher, Appel, Scott, Nadolski, Gregory J., Hunt, Stephen J., Gade, Terence P.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.10.2020
• Subjects: AR; 3D; DAP; 2D; HCC; AK; DICOM
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2020.01.028

To evaluate the utility of visualizing preprocedural MR images in 3-dimensional (3D) space using augmented reality (AR) before transarterial embolization of hepatocellular carcinoma (HCC) in a preclinical model. A total of 28 rats with diethylnitrosamine-induced HCCs > 5 mm treated with embolization were included in a prospective study. In 12 rats, 3D AR visualization of preprocedural MR images was performed before embolization. Procedural metrics including catheterization time and radiation exposure were compared vs a prospective cohort of 16 rats in which embolization was performed without AR. An additional cohort of 15 retrospective cases was identified and combined with the prospective control cohort (n = 31) to improve statistical power. A 37% reduction in fluoroscopy time, from 11.7 min to 7.4 minutes, was observed with AR when compared prospectively, which did not reach statistical significance (P = .12); however, when compared with combined prospective and retrospective controls, the reduction in fluoroscopy time from 14.1 min to 7.4 minutes (48%) was significant (P = .01). A 27% reduction in total catheterization time, from 42.7 minutes to 31.0 minutes, was also observed with AR when compared prospectively, which did not reach statistical significance (P = .11). No significant differences were seen in dose–area product or air kerma prospectively. Three-dimensional AR visualization of preprocedural imaging may aid in the reduction of procedural metrics in a preclinical model of transarterial embolization. These data support the need for further studies to evaluate the potential of AR in endovascular oncologic interventions.