First use of computer-generated holography in neuroendovascular simulation and intraoperative assistance: A preliminary study

Satoshi Kiyofuji ¹, Kyoji Matsushima ², Taichi Kin ^1,3

⁰Department of Neurosurgery, The University of Tokyo, Tokyo, Japan.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences +

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November 20, 2025

View abstract on PubMed

Summary

Computer-generated holograms (CGHs) offer advanced 3D visualization for neurosurgery. This study shows CGHs improve anatomical understanding and assist in complex procedures like aneurysm treatment.

Area Of Science

Neurosurgery
Medical Imaging
Holography

Background

Computer-generated holograms (CGHs) provide advanced, glassless, three-dimensional (3D) visualizations.
This study marks the first surgical application of CGH for both preoperative and intraoperative neurosurgical assistance.

Purpose Of The Study

To evaluate the effectiveness and safety of CGH technology in neurosurgical procedures.
To compare the accuracy of 3D anatomical understanding using CGH versus conventional imaging methods.
To assess the utility of CGH for intraoperative guidance in complex cases.

Main Methods

A single-center case series and observational survey involving three patients with intracranial aneurysms undergoing endovascular treatment.
Twelve neurosurgical residents assessed CGHs and conventional 3D rotational angiograms, completing questionnaires on anatomical understanding and simulator sickness.
Comparison of correct answer rates for 3D anatomical identification and analysis of Simulator Sickness Questionnaire (SSQ) scores.

Main Results

CGH use resulted in significantly higher correct answer rates for 3D anatomical understanding compared to 2D images (75% vs. 60%, p < .01).
Mean SSQ scores indicated a favorable safety profile (nausea: 0.80, oculomotor: 13.9, disorientation: 12.8, total severity: 10.6).
Intraoperative CGH visualization notably aided guidewire navigation during flow-diverter placement for a giant internal carotid artery aneurysm.

Conclusions

The 3D visualization capabilities of CGH were quantitatively validated for anatomical structures.
CGH comprehension requires no specialized training and demonstrates a good safety profile.
CGH presents a promising tool for enhancing surgical assistance and education, especially in complex neuroanatomical cases.

Keywords:

Aneurysm angiography computer-generated holography endovascular treatment flow diverter