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Portable mixed reality navigation system for neurosurgery: a clinical feasibility study
Zhongjie Shi1,2, Yilong Peng3, Xin Gao1
1Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China.
Scientific Reports
|November 4, 2025
Summary
A new portable mixed reality navigation (PMRN) system for neurosurgery demonstrated high accuracy and surgeon satisfaction in clinical feasibility testing. This system offers a viable solution for enhancing surgical navigation and improving patient outcomes.
Area of Science:
- Neurosurgery
- Medical Technology
- Mixed Reality Applications
Background:
- Traditional navigation systems in neurosurgery can be cumbersome and limit real-time visualization.
- Mixed Reality (MR) offers potential for enhanced surgical guidance by overlaying digital information onto the real world.
- Development of portable and user-friendly MR navigation systems is crucial for wider clinical adoption.
Purpose of the Study:
- To develop and assess the feasibility of a portable mixed reality navigation (PMRN) system for neurosurgical applications.
- To evaluate the accuracy and reliability of the PMRN system in both laboratory and clinical settings.
- To provide design insights for optimizing MR navigation systems for neurosurgery.
Main Methods:
- Developed a PMRN system integrating a head-mounted display (HMD), laptop, and infrared tracking for real-time probe localization.
- Conducted laboratory accuracy tests using simulation models with neurosurgeons performing localization tasks.
- Performed a prospective clinical study involving 42 patients with intracranial lesions, comparing PMRN with traditional optical navigation (TON) and assessing surgeon satisfaction with hologram-patient alignment.
Main Results:
- Laboratory testing showed efficient localization (under 5 min, stabilizing at ~3.5 min) with maximum errors of 2.5 mm (FRE) and 2.3 mm (TRE).
- Clinical study yielded mean localization times of 4.3 ± 1.0 min, with FRE of 2.2 ± 0.7 mm and TRE of 1.7 ± 0.5 mm.
- 95% of surgeons rated hologram-patient alignment as satisfactory, indicating high reliability and usability of the PMRN system.
Conclusions:
- The portable mixed reality navigation system is feasible, accurate (millimeter-level), easy to use, and highly satisfactory for routine neurosurgical procedures.
- The system meets the requirements for most standard operations, though further refinement is needed for submillimeter precision tasks.
- Results support the further development and clinical adoption of MR navigation in neurosurgery.
