Virtual Simulation in Enhancing Procedural Training for Fluoroscopy- guided Lumbar Puncture: A Pilot Study
Virtual Simulation in Enhancing Procedural Training for Fluoroscopy- guided Lumbar Puncture: A Pilot Study
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DOI：
10.1016/j.acra.2017.08.002
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发表时间：
2018-02-01
影响因子：
4.8
通讯作者：
Yang, Carina W.
中科院分区：
文献类型：
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作者：
Ali, Saad;Qandeel, Monther;Yang, Carina W.
理由和目标：透视引导腰椎穿刺 (FGLP) 是放射科住院医师培训和神经放射科进修培训的基本程序组成部分。在经验有限的情况下执行手术会增加患者不适以及增加辐射剂量、穿刺尝试和并发症发生率。医疗保健模拟是一个发展中的领域，有潜力加强程序培训。我们演示了用于执行 FGLP 的虚拟现实模拟器的设计和实用性。材料和方法：FGLP 模块是在 ImmersiveTouch 平台上开发的，该模块通过类似全息图的投影以数字方式再现程序环境。根据健康成人脊柱的计算机断层扫描数据集，我们构建了腰椎和覆盖软组织的 3D 模型。我们为每种组织类型分配了不同的物理特征，用户在推进虚拟脊椎针时可以通过触觉反馈体验这些特征。可以获得虚拟透视以及 3D 图像以用于程序规划和指导。可以计算穿刺尝试的次数、到目标的距离、透视拍摄的次数以及近似的辐射剂量。参与模拟的用户的初步数据是在模拟后调查中获得的。结果：所有用户都发现模拟是解剖结构和手术的真实复制，并将推荐给同事。按照 1-5 分（从最低到最高）对虚拟模拟器训练进行总体评分，平均得分为 4.3（范围 3-5）。结论：我们描述了用于执行 FGLP 的虚拟现实模拟器的设计，并介绍了这项新技术的初步经验。
Rationale and Objectives: Fluoroscopy-guided lumbar puncture (FGLP) is a basic procedural component of radiology residency and neuroradiology fellowship training. Performance of the procedure with limited experience is associated with increased patient discomfort as well as increased radiation dose, puncture attempts, and complication rate. Simulation in health care is a developing field that has potential for enhancing procedural training. We demonstrate the design and utility of a virtual reality simulator for performing FGLP.Materials and Methods: An FGLP module was developed on an ImmersiveTouch platform, which digitally reproduces the procedural environment with a hologram-like projection. From computed tomography datasets of healthy adult spines, we constructed a 3-D model of the lumbar spine and overlying soft tissues. We assigned different physical characteristics to each tissue type, which the user can experience through haptic feedback while advancing a virtual spinal needle. Virtual fluoroscopy as well as 3-D images can be obtained for procedural planning and guidance. The number of puncture attempts, the distance to the target, the number of fluoroscopic shots, and the approximate radiation dose can be calculated. Preliminary data from users who participated in the simulation were obtained in a postsimulation survey.Results: All users found the simulation to be a realistic replication of the anatomy and procedure and would recommend to a colleague. On a scale of 1-5 (lowest to highest) rating the virtual simulator training overall, the mean score was 4.3 (range 3-5).Conclusions: We describe the design of a virtual reality simulator for performing FGLP and present the initial experience with this new technique.