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Augmented reality for sentinel lymph node biopsy.

Peter A von Niederhäusern1, Carlo Seppi2, Robin Sandkühler2

  • 1Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland. peter.vonniederhaeusern@unibas.ch.

International Journal of Computer Assisted Radiology and Surgery
|September 25, 2023
PubMed
Summary
This summary is machine-generated.

This study introduces an augmented reality (AR) system to improve sentinel lymph node biopsy for oral cancer. The AR visualization reduces surgeon cognitive load by directly displaying radioactive tracer locations, aiding lymph node identification.

Keywords:
ARAugmented realityGamma cameraGamma detectorInverse problemNuclear medicineSNBSentinel lymph node biopsy

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Area of Science:

  • Medical Imaging
  • Surgical Technology
  • Oncology

Background:

  • Sentinel lymph node biopsy (SLNB) is crucial for staging oral and oropharyngeal squamous cell carcinoma.
  • Current SLNB methods using radioactive tracers and audio probes increase surgeon cognitive load.
  • Augmented reality (AR) offers a potential solution to visualize tracer accumulation and reduce cognitive burden.

Purpose of the Study:

  • To develop and validate a proof-of-concept AR system for SLNB in oral cancer.
  • To assess the system's ability to reconstruct and visualize radioactive tracer locations.
  • To evaluate the impact of AR on reducing surgeon cognitive load during biopsies.

Main Methods:

  • Ex vivo experiments were conducted to test the AR system.
  • A multi-pinhole gamma detector reconstructed the 3D position of radioactive sources from gamma-images.
  • Microsoft HoloLens was used to visualize the reconstructed source positions in AR.

Main Results:

  • The AR system demonstrated good correlation between the single radioactive source and its visualization, with a maximum error of 4.47 mm.
  • The SLNF algorithm achieved a maximum error of 7.77 mm for single-source reconstruction.
  • Reconstructing two sources presented challenges, with errors ranging from 2.23 mm to 75.92 mm.

Conclusions:

  • The AR system shows promise for single radioactive source visualization in SLNB.
  • Simultaneous reconstruction and visualization of multiple sources require further algorithmic refinement.
  • This technology has the potential to enhance SLNB accuracy and efficiency in oral cancer surgery.