Applications of Mixed Reality Technology in Orthopedics Surgery: A Pilot Study.
Applications of Mixed Reality Technology in Orthopedics Surgery: A Pilot Study.
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DOI：
10.3389/fbioe.2022.740507
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发表时间：
2022
影响因子：
5.7
通讯作者：
Ye Z
中科院分区：
文献类型：
--
作者：
Lu L;Wang H;Liu P;Liu R;Zhang J;Xie Y;Liu S;Huo T;Xie M;Wu X;Ye Z
目的：本研究的目的是探索混合现实（MR）技术在骨科手术可视化中的潜力。 方法：采用MR技术的可视化系统在骨科手术中得到广泛应用。该系统由3D成像工作站、云平台和MR空间站组成。 3D成像工作站采用智能分割算法，创建具有缩放和旋转效果的3D解剖模型。然后利用该模型对计算机断层扫描 (CT) 和磁共振成像 (MRI) 的数据进行高效的 3D 重建。此外，模型还可以上传到云平台进行物理参数调整、模型定位、渲染和高维显示。使用微软的 HoloLens 眼镜与 MR 系统相结合，我们可以在不同的临床场景下实时投影和查看 3D 全息图。每次手术后，九名外科医生完成了一份李克特量表调查问卷，内容涉及沟通和理解、空间意识以及 MR 技术使用的有效性。除此之外，美国航空航天局任务负荷指数（NASA-TLX）也用于评估MR全息图支持的工作量。 结果：1）MR全息图可以清晰地显示骨折的3D结构，有助于提高对不同骨折类型的理解和治疗方案的设计； 2）三维逼真动态特征的全息图为医生之间、医患之间提供了直观的沟通工具； 3）在手术过程中，可以获得完整的病灶全息图，并将其与患者的虚拟3D数字模型实时混合，以便通过手术区域的新颖高维“视角”为外科医生提供卓越的视觉引导； 4）基于全息图的磁导航提高了骨科手术螺钉置入的准确性和安全性； 5）混合现实云平台与基于5G的远程医疗系统的结合，为远程手术协作提供了全新的技术平台。定性研究的结果鼓励了 MR 技术在骨科手术中的应用。对李克特量表问卷的分析表明，MR 对理解和沟通、空间意识、学习和有效性具有显着的价值。根据 NASA TLX 规模的问卷调查结果，与通常的 2D 相比，混合现实在“心理”、“时间”、“表现”和“挫败感”类别下的得分明显较低。 结论：MR技术在骨科手术中的融合减少了对外科医生经验的依赖，为骨科异常的准确诊断和治疗提供了个性化的3D可视化模型。这种整合显然是医疗外科未来的突出发展方向之一。
Objective: The aim of this study is to explore the potential of mixed reality (MR) technology in the visualization of orthopedic surgery. Methods: The visualization system with MR technology is widely used in orthopedic surgery. The system is composed of a 3D imaging workstation, a cloud platform, and an MR space station. An intelligent segmentation algorithm is adopted on the 3D imaging workstation to create a 3D anatomical model with zooming and rotation effects. This model is then exploited for efficient 3D reconstruction of data for computerized tomography (CT) and magnetic resonance imaging (MRI). Additionally, the model can be uploaded to the cloud platform for physical parameter tuning, model positioning, rendering and high-dimensional display. Using Microsoft’s HoloLens glasses in combination with the MR system, we project and view 3D holograms in real time under different clinical scenarios. After each procedure, nine surgeons completed a Likert-scale questionnaire on communication and understanding, spatial awareness and effectiveness of MR technology use. In addition to that, the National Aeronautics and Space Administration Task Load Index (NASA-TLX) is also used to evaluate the workload of MR hologram support. Results: 1) MR holograms can clearly show the 3D structures of bone fractures, which improves the understanding of different fracture types and the design of treatment plans; 2) Holograms with three-dimensional lifelike dynamic features provide an intuitive communication tool among doctors and also between doctors and patients; 3) During surgeries, a full lesion hologram can be obtained and blended in real time with a patient’s virtual 3D digital model in order to give surgeons superior visual guidance through novel high-dimensional “perspectives” of the surgical area; 4) Hologram-based magnetic navigation improves the accuracy and safety of the screw placement in orthopaedics surgeries; 5) The combination of mixed reality cloud platform and telemedicine system based on 5G provides a new technology platform for telesurgery collaboration. Results of qualitative study encourage the usage of MR technology for orthopaedics surgery. Analysis of the Likert-scale questionnaire shows that MR adds significant value to understanding and communication, spatial awareness, learning and effectiveness. Based on the NASA TLX-scale questionnaire results, mixed reality scored significantly lower under the “mental,” “temporal,” “performance,” and “frustration” categories compared to usual 2D. Conclusion: The integration of MR technology in orthopaedic surgery reduces the dependence on surgeons’ experience and provides personalized 3D visualization models for accurate diagnosis and treatment of orthopaedic abnormalities. This integration is clearly one of the prominent future development directions in medical surgery.