Comparison of Smartphone Augmented Reality, Smartglasses Augmented Reality, and 3D CBCT-guided Fluoroscopy Navigation for Percutaneous Needle Insertion: A Phantom Study

• Published in: Cardiovascular and interventional radiology Vol. 44; no. 5; pp. 774 - 781
• Main Authors: Long, Dilara J., Li, Ming, De Ruiter, Quirina M. B., Hecht, Rachel, Li, Xiaobai, Varble, Nicole, Blain, Maxime, Kassin, Michael T., Sharma, Karun V., Sarin, Shawn, Krishnasamy, Venkatesh P., Pritchard, William F., Karanian, John W., Wood, Bradford J., Xu, Sheng
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.05.2021; Springer Nature B.V
• Subjects: Augmented reality; Cardiology; Error analysis; Fluoroscopy; Imaging; Insertion; Laboratory Investigation; Medicine; Medicine & Public Health; Nuclear Medicine; Other; Placement; Radiation; Radiation effects; Radiology; Smartphones; Ultrasound; Variance analysis; Percutaneous needle biopsy; XperGuide; Interventional radiology; Smartglasses; HoloLens; Image guidance; Smartphone; Augmented reality; CBCT fluoroscopy
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-020-02760-7

Purpose To compare needle placement performance using an augmented reality (AR) navigation platform implemented on smartphone or smartglasses devices to that of CBCT-guided fluoroscopy in a phantom. Materials and Methods An AR application was developed to display a planned percutaneous needle trajectory on the smartphone (iPhone7) and smartglasses (HoloLens1) devices in real time. Two AR-guided needle placement systems and CBCT-guided fluoroscopy with navigation software (XperGuide, Philips) were compared using an anthropomorphic phantom (CIRS, Norfolk, VA). Six interventional radiologists each performed 18 independent needle placements using smartphone ( n  = 6), smartglasses ( n  = 6), and XperGuide ( n  = 6) guidance. Placement error was defined as the distance from the needle tip to the target center. Placement time was recorded. For XperGuide, dose-area product (DAP, mGy*cm 2 ) and fluoroscopy time (sec) were recorded. Statistical comparisons were made using a two-way repeated measures ANOVA. Results The placement error using the smartphone, smartglasses, or XperGuide was similar (3.98 ± 1.68 mm, 5.18 ± 3.84 mm, 4.13 ± 2.38 mm, respectively, p  = 0.11). Compared to CBCT-guided fluoroscopy, the smartphone and smartglasses reduced placement time by 38% ( p  = 0.02) and 55% ( p  = 0.001), respectively. The DAP for insertion using XperGuide was 3086 ± 2920 mGy*cm 2 , and no intra-procedural radiation was required for augmented reality. Conclusions Smartphone- and smartglasses-based augmented reality reduced needle placement time and radiation exposure while maintaining placement accuracy compared to a clinically validated needle navigation platform.