Mixed Reality Surgical Navigation System for Liver Interventions with Comprehensive Validation using Subsurface...

Mixed reality (MR) surgical navigation systems have achieved notable success in procedures involving rigid anatomical structures but face substantial challenges in soft tissue interventions due to intraoperative deformation. Current literature reveals a significant gap in MR-based navigation systems that provide quantitative validation through subsurface targeting experiments representative of clinical workflow.

This study presents a comprehensive MR surgical navigation platform for liver interventions enhanced with new features including soft-tissue deformation correction, real-time microwave (MW) probe trajectory visualization, and distance-to-target measurement capabilities. In addition to novel platform design, the first standardized experimental protocol specifically designed for validating subsurface targeting accuracy in the context of MR surgical navigation systems has been established. The validation methodology provides a quantitative targeting evaluation that can be universally adopted for comparative analysis with other MR approaches.

Using the MW probe navigation capabilities, surgical workflow maintained clinically viable efficiency with a navigation-to-target time of 5.5 ± 1.3 minutes per targeting session that spanned 13 subsurface targets per session. With respect to the correction for soft-tissue deformations, our non-rigid registration method (NRM) demonstrated superior performance compared to rigid registration method (RRM), achieving 41.3% reduction in user-navigated targeting error (from 10.4 ± 3.9 mm to 6.1 ± 2.8 mm) and 42.3% reduction in ground-truth measured targeting error (from 13.0 ± 5.5 mm to 7.5 ± 3.3 mm). Other novelties to the platform design are an integrated real-time ablation zone prediction and visualization tool as a potential direction for clinical application.

The advancement positions the technology as a powerful surgical guidance approach for hepatic interventions.

This research is the first to establish a validation framework standard for MR surgical navigation system which successfully compensates for soft tissue deformation.