Clinical and Pre-operative Assessment of Lower Limb Rotational Profiles in Virtual and Augmented Reality

虚拟和增强现实中下肢旋转轮廓的临床和术前评估

• 批准号: 2456825
• 金额: --
• 依托单位: Durham University
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2456825
• 关键词: Clinical; Pre; operative; Assessment; Lower

Context and Research GoalRotational abnormalities of the lower extremities are common medical conditions, mostly seen in young adolescent population. These conditions manifest with gait disorders and knee symptoms. In extreme cases, rotational abnormalities can cause repetitive patellar dislocation from the trochlear groove, the notch within the distal femur, which articulates with the patella. Functionally, patients experience chronic symptoms, and in severe cases this can cause abstinence from sports and any strenuous physical activities. Rotational mal-alignment of the lower limb can also cause secondary complications and symptoms following knee arthroplasty. Computed Tomography (CT) is the imaging modality of choice, although interpretation of imaging can be challenging even to the most experienced radiologists and orthopaedic surgeons, given the complex anatomical considerations associated with these conditions. Often, due to the complexity of the condition, visualisation of multi-planar CT imaging on conventional medical 2D picture archiving and communication systems (PACS), can lead to poor understanding of the anatomy and lower limb rotational profile.Emerging Virtual Reality (VR) and Augmented Reality (AR) technologies have been pivotal in modern medical technological innovations. We suggest the use of VR and AR technologies for an immersive 3D visualisation of CT rotational profile imaging, to aid understanding of complex anatomical abnormalities. This can aid diagnosis and management, including pre-operative planning, for those requiring surgical correction and de-rotational osteotomies.Project AimsWe will develop a VR platform to enable 3D visualisation of CT imaging data in patients with suspected rotational abnormalities of the lower limbs. During pre-operative planning we aim to employ AR technologies to overlay the imaging data on the patient to (i) re-align osseous structures and (ii) obtain angles and measurements, for a complete and comprehensive understanding of the rotational alignment anatomy.MethodologyThe simulation software will be tested with respect to various clinical aspects. These include, but are not limited to, (i) the capability to render complex 3D anatomy in immersive VR environments, (ii) ability to obtain accurate key angles and measurements which will be further evaluated against state-of-the-art conventional techniques on PACS, and (iii), the functionality to enable real time manipulation of imaging data on a VR and AR platform to improve the assessment of structural abnormalities and aid pre-surgical planning.We also aim to obtain feedback from orthopaedic surgeons, regarding the experience and impact of using the sof tware in understanding the anatomical abnormalities, clinical decision-making and pre-operative planning in relevant cases.SummaryInterpretation of medical imaging in rotational abnormalities of lower limbs can be challenging, given that complex 3D anatomy is evaluated on 2D screens, and there exists significant inter-observer variability. The use of VR and AR software could enhance the image viewing experience of clinicians in simulated, real-life like, immersive 3D format, to better understand the complex anatomical abnormalities. We envisage that the use of the proposed technologies in such complex medical conditions can improve clinicians' understanding of structural abnormalities and aid patients' management, for improved clinical outcomes.

背景和研究目标下肢旋转异常是常见的医疗条件，主要见于年轻的青少年人群。这些病症表现为步态障碍和膝关节症状。在极端情况下，旋转异常可导致重复性髌骨脱位，从股骨远端与髌骨连接的股骨髁间沟。在功能上，患者会出现慢性症状，在严重的情况下，这可能会导致运动和任何剧烈的体力活动的禁欲。下肢的旋转对线不良也可能导致膝关节置换术后的继发性并发症和症状。计算机断层扫描（CT）是首选的成像方式，尽管考虑到与这些疾病相关的复杂解剖学因素，即使是最有经验的放射科医生和骨科医生也难以解释成像。由于疾病的复杂性，传统的医学2D图像存档和通信系统（PACS）上的多平面CT成像往往会导致对解剖结构和下肢旋转轮廓的理解不足。新兴的虚拟现实（VR）和增强现实（AR）技术已经成为现代医学技术创新的关键。我们建议使用VR和AR技术对CT旋转轮廓成像进行沉浸式3D可视化，以帮助理解复杂的解剖异常。这可以帮助诊断和管理，包括术前规划，对于那些需要手术矫正和去旋转截骨术。项目目标我们将开发一个VR平台，使三维可视化的CT成像数据的患者怀疑下肢旋转异常。在术前计划期间，我们的目标是采用AR技术来覆盖患者的成像数据，以（i）重新对齐骨性结构，（ii）获得角度和测量值，以便完整全面地了解旋转对齐解剖结构。这些包括但不限于：（i）在沉浸式VR环境中渲染复杂3D解剖结构的能力，（ii）获得准确关键角度和测量值的能力，这些角度和测量值将根据PACS上最先进的传统技术进行进一步评估，以及（iii），能够在VR和AR平台上对成像数据进行真实的实时操作的功能，以改善对结构异常的评估，我们还旨在从整形外科医生那里获得反馈，关于使用软件理解解剖异常、临床决策和相关病例中的术前计划的经验和影响。总结下肢旋转异常中的医学成像的解释可能具有挑战性，因为复杂的3D解剖结构是在2D屏幕上评估的，并且存在显著的观察者间变化。VR和AR软件的使用可以增强临床医生在模拟、真实、沉浸式3D格式下的图像查看体验，以更好地了解复杂的解剖异常。我们设想，在这种复杂的医疗条件下使用所提出的技术可以提高临床医生对结构异常的理解，并帮助患者管理，以改善临床结果。