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Towards a First-Person Perspective Mixed Reality Guidance System for Needle Interventions.

Leah Groves1, Natalie Li1, Terry M Peters1,2

  • 1School of Biomedical Engineering, Western University, London, ON N6A 3K7, Canada.

Journal of Imaging
|January 20, 2022
PubMed
Summary

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Mixed-reality systems, particularly head-mounted displays (HMDs), significantly improve ultrasound-guided central venous catheterization success rates by aligning visual and motor fields. This advanced guidance reduces complications compared to traditional ultrasound methods.

Area of Science:

  • Medical Imaging
  • Surgical Navigation
  • Mixed Reality

Background:

  • Ultrasound (US) guidance reduces complications in central venous catheterization but has non-negligible error rates.
  • Mixed-reality (MR) systems offer potential for enhanced surgical navigation and reduced procedural risks.

Purpose of the Study:

  • To evaluate the effectiveness of a surgical navigation system rendering calibrated US images and needle trajectories within a mixed-reality head-mounted display (HMD).
  • To compare HMD-guided visualization against standard US-guidance and monitor-based visualization for central venous catheterization.

Main Methods:

  • A phantom-based user study involving 31 expert clinicians and 20 medical students.
  • Participants performed needle insertions using three visualization modes: US-only, monitor-based MR, and HMD-based MR.
Keywords:
central venous catheterizationimage guided interventionmixed reality systemsquantitative skills assessmentsurgical navigationultrasound

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  • Success rates and needle positioning accuracy were measured for each mode.

    • Main Results:

    • HMD-guidance significantly improved success rates for both experts (94% vs. 70%) and students (70% vs. 25%) compared to US-guidance.
    • Needle placement was more consistently centered within the vessel's lumen under HMD-guidance.
    • Monitor-based MR guidance showed performance comparable to US-only guidance.

    Conclusions:

    • Head-mounted display (HMD) guidance enhances needle guidance accuracy and success rates in central venous catheterization.
    • Aligning visual and motor fields through HMDs is crucial for improving procedural outcomes.
    • Further research into HMD-based surgical navigation is warranted to optimize patient safety and procedural efficiency.