Augmented reality for epilepsy surgery: Examining usability and efficacy in presurgical planning

Area of Science:

• Neurosurgery
• Medical Imaging
• Augmented Reality

Background:

• Epilepsy surgery planning involves complex 3-D data from various imaging modalities (EEG, MRI, PET, SPECT, fMRI) and electrode placement.
• Conventional 2-D visualization limits the understanding of intricate brain anatomy and electrode trajectories.
• Augmented reality (AR) offers a novel approach to visualize and interact with complex surgical data.

Purpose of the Study:

• To visualize 3-dimensional (3-D) brain and electrode placement data for epilepsy surgery in an augmented reality (AR) environment.
• To enhance presurgical planning for epilepsy surgery and assess the utility of AR in a clinical setting.
• To evaluate the efficiency and user-friendliness of an AR application for epilepsy surgery planning.

Main Methods:

• Generated 3-D AR representations from presurgical MRI, SEEG electrode, and CT scans of epilepsy patients.
• Utilized the Duke Augmented Reality Epilepsy Planner (AREP) application on Microsoft HoloLens 2 for visualization.
• Administered a survey to faculty members to assess the usability and effectiveness of the AR application.

Main Results:

• AR visualizations allowed interactive manipulation (resizing, movement, rotation) of 3-D brain and electrode models.
• Distinct colors differentiated brain tissue and electrodes for improved clarity.
• Survey results from 18 faculty members indicated AREP is user-friendly and effective for presurgical planning.

Conclusions:

• AR integration in epilepsy surgery planning enhances the representation of surgical anatomy.
• AR serves as a valuable tool for improving communication among clinicians.
• AR visualization of complex surgical data offers significant advantages over traditional 2-D methods.