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Augmented and Virtual Reality for Preprocedural Planning in Hepatic Transarterial Interventional Oncology: A Pilot
Saad Abu Zahra1, Matthew Antalek1, Ashima Kundu1
1Department of Radiology, Northwestern University, Chicago IL.
Purpose:
To evaluate the feasibility, usability, and perceived impact of augmented and virtual reality (AR/VR) for preprocedural planning in transarterial interventional oncology procedures, as assessed through structured operator surveys.
Materials And Methods:
This IRB-approved, single-center pilot study was conducted over 1 year (September 2024-September 2025). Interventional radiologists used an AR/VR headset (Apple Vision Pro; Apple Inc., Cupertino, CA) with Visage Ease VP software (Visage Imaging, San Diego, CA) to review patient-specific volume renderings of cone-beam CT and cross-sectional imaging before complex oncologic procedures. Cases included hepatic angiography prior to Y90 radioembolization (n=42), percutaneous hepatic perfusion (n=7), and transarterial chemoembolization (n=1). Operators completed structured surveys assessing workflow integration, anatomic visualization, confidence, usability, and comfort using 5-point Likert scales (1=worst, 5=best).
Results:
Fifty cases were analyzed, with a median case time of 81.0 minutes (IQR, 62.0-102.0). The median AR/VR planning time was 5 min [IQR 3.0-6.0], corresponding to a median of 6% of total case duration. AR/VR planning changed the procedural approach in 23 of 50 cases (46%). Likert score for procedural change had an overall mean of 3.3±1.3, with mean scores of 2.4±0.7 in cases where AR/VR did not influence the operator's intraprocedural approach and 4.4±0.8 in cases where AR/VR did influence the approach. Anatomic visualization scored 4.7±0.8, anatomic understanding 4.7±0.9, and procedural confidence 4.6±1.0. Workflow integration scored 4.8±0.5, system usability 4.5±0.9, and headset comfort 1.9±1.1. Specific use cases are described.
Conclusion:
AR/VR-based preprocedural planning was feasible, efficient, and enhanced perceived anatomic understanding, procedural confidence, and planning in transarterial interventional oncology cases. Headset comfort remains a limitation.
