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Navigation of frameless fixation for gamma knife radiosurgery using fixed augmented reality
Hyeong Cheol Moon1, Sang Joon Park2, Young Deok Kim2
1Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Republic of Korea.
Scientific Reports
|March 17, 2022
Summary
This study shows augmented reality (AR) navigation with 3D models is accurate for frameless gamma knife radiosurgery (GKRS). This method allows for precise patient repositioning without repeated CT scans, reducing treatment time.
Area of Science:
- Medical Physics
- Neurosurgery
- Medical Imaging
Background:
- Augmented reality (AR) presents novel approaches for medical treatments.
- Frameless fixation in gamma knife radiosurgery (GKRS) aims to improve patient comfort and reduce procedure time.
- Accurate patient positioning is critical for effective radiosurgery.
Purpose of the Study:
- To evaluate the accuracy of frameless (mask) fixation navigation using a 3D-printed patient model with fixed-AR technology for GKRS.
- To assess the feasibility of using 3D-scanning and cone-beam computed tomography (CBCT) derived virtual models for AR-guided GKRS.
- To determine if AR navigation can enable accurate re-fixation without the need for CBCT.
Main Methods:
- Developed fixed-AR navigation using inside-out visual inertial odometry and a flexible Quick Response marker.
- Created virtual 3D-patient models using 3D-scanning (TrueDepth) and CBCT for AR rendering.
- Validated registration accuracy between initial and re-fixation using a 3D-printed model, visualization, and quantitative metrics (setup errors, fiducial marker coordinates, HDMM).
Main Results:
- Frameless fixation with fixed-AR navigation demonstrated accurate registration between 3D-printed and virtual models.
- Both 3D-scanning and CBCT virtual models were sufficient for frameless re-fixation.
- Quantitative validation showed mean setup errors within 1 mm and 1.5°, fiducial marker differences within 2.5 mm, and HDMM differences within 1.5 mm.
Conclusions:
- Fixed-AR navigation using 3D models provides sufficient accuracy for frameless GKRS re-fixation.
- This approach may allow for repositioning without CBCT, beneficial for patients with large metastases requiring fractionated treatment.
- The system offers potential for novel GKRS navigation, reducing preparation time and improving patient experience.
