Neuroblastoma is the most common type of extracranial solid tumor in children and can often result in death if not treated. High-intensity focused ultrasound (HIFU) is a non-invasive technique for treating tissue that is deep within the body. It avoids the use of ionizing radiation, avoiding long-term side-effects of these treatments. The goal of this project was to develop the rendering component of an augmented reality (AR) system with potential applications for image-guided HIFU treatment of neuroblastoma. Our project focuses on taking 3D models of neuroblastoma lesions obtained from PET/CT and displaying them in our AR system in near real-time for use by physicians. We used volume ray casting with raster graphics as our preferred rendering method, as it allows for the real-time editing of our 3D radiologic data. Some unique features of our AR system include intuitive hand gestures and virtual user interfaces that allow the user to interact with the rendered data and process PET/CT images for optimal visualization. We implemented the feature to set a custom transfer function, set custom intensity cutoff points, and region-of-interest extraction via cutting planes. In the future, we hope to incorporate this work as part of a complete system for focused ultrasound treatment by adding ultrasound simulation, visualization, and deformable registration.
Biopsies play a crucial role in diagnosis of various diseases including cancers. In this study, we developed an augmented reality (AR) system to improve biopsy procedures and increase targeting accuracy. Our AR-guided biopsy system uses a high-speed motion tracking technology and an AR headset to display a holographic representation of the organ, lesions, and other structures of interest superimposed on real physical objects. The first application of our AR system is prostate biopsy. By incorporating preoperative scans, such as computed tomography (CT) or magnetic resonance imaging (MRI), into real-time ultrasound-guided procedures, this innovative AR-guided system enables clinicians to see the lesion as well as the organs in real time. With the enhanced visualization of the prostate, lesion, and surrounding organs, surgeons can perform prostate biopsies with an increased accuracy. Our AR-guided biopsy system yielded an average targeting accuracy of 2.94 ± 1.04 mm and can be applied for real-time guidance of prostate biopsy as well as other biopsy procedures.
While minimally invasive laparoscopic surgery can help reduce blood loss, reduce hospital time, and shorten recovery time compared to open surgery, it has the disadvantages of limited field of view and difficulty in locating subsurface targets. Our proposed solution applies an augmented reality (AR) system to overlay pre-operative images, such as those from magnetic resonance imaging (MRI), onto the target organ in the user’s real-world environment. Our system can provide critical information regarding the location of subsurface lesions to guide surgical procedures in real time. An infrared motion tracking camera system was employed to obtain real-time position data of the patient and surgical instruments. To perform hologram registration, fiducial markers were used to track and map virtual coordinates to the real world. In this study, phantom models of each organ were constructed to test the reliability and accuracy of the AR-guided laparoscopic system. Root mean square error (RMSE) was used to evaluate the targeting accuracy of the laparoscopic interventional procedure. Our results demonstrated a registration error of 2.42 ± 0.79 mm and a procedural targeting error of 4.17 ± 1.63 mm using our AR-guided laparoscopic system that will be further refined for potential clinical procedures.
Phantoms are invaluable tools broadly used for research and training purposes designed to mimic tissues and structures in the body. In this paper, polyvinyl chloride (PVC)-plasticizer and silicone rubbers were explored as economical materials to reliably create long-lasting, realistic kidney phantoms with contrast under both ultrasound (US) and X-ray imaging. The radiodensity properties of varying formulations of soft PVC-based gels were characterized to allow adjustable image intensity and contrast. Using this data, a phantom creation workflow was established which can be easily adapted to match radiodensity values of other organs and soft tissues in the body. Internal kidney structures such as the medulla and ureter were created using a two-part molding process to allow greater phantom customization. The kidney phantoms were imaged under US and X-ray scanners to compare the contrast enhancement of a PVC-based medulla versus a silicone-based medulla. Silicone was found to have higher attenuation than plastic under X-ray imaging, but poor quality under US imaging. PVC was found to exhibit good contrast under X-ray imaging and excellent performance for US imaging. Finally, the durability and shelf life of our PVC-based phantoms were observed to be vastly superior to that of common agar-based phantoms. The work presented here allows extended periods of usage and storage for each kidney phantom while simultaneously preserving anatomical detail, contrast under dual-modality imaging, and low cost of materials.
Cardiac catheterization is a delicate strategy often used during various heart procedures. However, the procedure carries a myriad of risks associated with it, including damage to the vessel or heart itself, blood clots, and arrhythmias. Many of these risks increase in probability as the length of the operation increases, creating a demand for a more accurate procedure while reducing the overall time required. To this end, we developed an adaptable virtual reality simulation and visualization method to provide essential information to the physician ahead of time with the goal of reducing potential risks, decreasing operation time, and improving the accuracy of cardiac catheterization procedures. We additionally conducted a phantom study to evaluate the impact of using our virtual reality system prior to a procedure
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