Use of mixed reality for improved spatial understanding of liver anatomy

• Published in: Minimally invasive therapy and allied technologies Vol. 29; no. 3; pp. 154 - 160
• Main Authors: Pelanis, Egidijus, Kumar, Rahul P., Aghayan, Davit L., Palomar, Rafael, Fretland, Åsmund A., Brun, Henrik, Elle, Ole Jakob, Edwin, Bjørn
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.06.2020
• Subjects: 3D model; Liver surgery; mixed reality; parenchyma sparing; segmentation; parenchyma sparing; 3D model; segmentation; Liver surgery; mixed reality
• ISSN: 1364-5706; 1365-2931; 1365-2931
• DOI: 10.1080/13645706.2019.1616558

Introduction: In liver surgery, medical images from pre-operative computed tomography and magnetic resonance imaging are the basis for the decision-making process. These images are used in surgery planning and guidance, especially for parenchyma-sparing hepatectomies. Though medical images are commonly visualized in two dimensions (2D), surgeons need to mentally reconstruct this information in three dimensions (3D) for a spatial understanding of the anatomy. The aim of this work is to investigate whether the use of a 3D model visualized in mixed reality with Microsoft HoloLens increases the spatial understanding of the liver, compared to the conventional way of using 2D images. Material and methods: In this study, clinicians had to identify liver segments associated to lesions. Results: Twenty-eight clinicians with varying medical experience were recruited for the study. From a total of 150 lesions, 89 were correctly assigned without significant difference between the modalities. The median time for correct identification was 23.5 [4-138] s using the magnetic resonance imaging images and 6.00 [1-35] s using HoloLens (p < 0.001). Conclusions: The use of 3D liver models in mixed reality significantly decreases the time for tasks requiring a spatial understanding of the organ. This may significantly decrease operating time and improve use of resources.