Towards quantitative and intuitive percutaneous tumor puncture via augmented virtual reality

Area of Science:

• Medical Imaging and Image-Guided Therapy
• Augmented Reality in Surgery
• Minimally Invasive Procedures

Background:

• Radiofrequency ablation (RFA) is a common treatment for liver tumors, but precise percutaneous puncture is challenging under free-breathing conditions due to reliance on 2D CT imaging.
• Lack of spatial and dynamic information in traditional methods makes tumor puncture dependent on surgeon experience.

Purpose of the Study:

• To develop a novel quantitative and intuitive surgical navigation system using augmented virtual reality (AR) for percutaneous respiratory tumor puncture.
• To improve the precision and efficiency of radiofrequency ablation procedures by providing real-time, overlaid surgical guidance.

Main Methods:

• Pre-operative planning involved generating a 3D feasible puncture region using signed distance fields and determining optimal trajectories based on RFA specialist consensus.
• Intra-operative guidance utilized a virtual-real alignment method for precise overlay of virtual information onto the surgical scenario.
• A holographic interface provided real-time, step-by-step navigation for tumor puncture.

Main Results:

• The proposed planning strategy demonstrated superior accuracy compared to manual planning by experienced doctors.
• The holographic navigation modality effectively reduced the number of needle adjustments required for precise puncture.
• Validation on phantoms and in vivo models confirmed the system's accuracy and feasibility.

Conclusions:

• The augmented virtual reality navigation system offers quantitative planning and intuitive holographic guidance for percutaneous tumor ablation.
• The system reduces surgeon experience-dependence and minimizes needle adjustments, improving precision and reliability in RFA.
• This AR navigation approach has potential applications in other image-guided surgical tasks.