Development of pre-procedure virtual simulation for challenging interventional procedures: an experimental study with...

Area of Science:

• Medical Simulation
• Interventional Pain Management
• Medical Imaging

Background:

• C-arm fluoroscopy presents challenges in interpreting 3D anatomy on 2D X-ray images for complex pain procedures.
• Experienced clinicians face difficulties in accurately visualizing anatomy during interventional pain procedures.
• Virtual simulators offer a potential solution to enhance understanding and guidance in challenging pain management interventions.

Purpose of the Study:

• To develop a virtual simulator for pain management procedures.
• To demonstrate the clinical applicability of the developed virtual simulator.
• To overcome the limitations of 2D imaging in complex interventional pain procedures.

Main Methods:

• A computer program was developed to simulate the procedural environment using computed tomography (CT) Digital Imaging and Communications in Medicine (DICOM) data.
• Virtual needle placement was simulated for optimal positioning.
• A virtual C-arm was used to identify optimal visualization angles for the needle, clarifying positional relationships between anatomy and the needle.

Main Results:

• CT DICOM data from outpatient clinic patients were utilized for simulation.
• Simulated C-arm views were matched with actual intra-procedural C-arm images.
• The virtual simulator aided in the successful execution of challenging procedures, including transforaminal epidural injection for spinal deformity, superior hypogastric plexus block, and Gasserian ganglion block.

Conclusions:

• A pre-procedural virtual simulation tool was successfully created.
• The virtual simulation demonstrated successful application in patients undergoing complex and challenging procedures.
• The developed simulator shows promise in improving outcomes for difficult interventional pain procedures.