Intra-operative applications of augmented reality in glioma surgery: a systematic review

Frontiers in Surgery

Surgery

Chao Li¹  Michail Mamalakis²  John Suckling²  Rafael Romero-Garcia³  Mackenzie H. Zimmerman⁴  Ahmet K. Uğuralp⁴  Zeliha Oğuz-Uğuralp⁴  Victoria N. Curry⁵  Layth Alkhani⁶  Noor Baig⁷  Willis Holle⁸  Anya Ragnhildstveit⁹ 

[1] Department of Clinical Neurosciences, University of Cambridge, Cambridge, England;Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge, England;Department of Psychiatry, University of Cambridge, Cambridge, England;Department of Psychiatry, University of Cambridge, Cambridge, England;Instituto de Biomedicina de Sevilla (IBiS) HUVR/CSIC/Universidad de Sevilla/CIBERSAM, ISCIII, Dpto. de Fisiología Médica y Biofísica;Integrated Research Literacy Group, Draper, UT, United States;Integrated Research Literacy Group, Draper, UT, United States;Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States;Integrated Research Literacy Group, Draper, UT, United States;Department of Biology, Stanford University, Stanford, CA, United States;Integrated Research Literacy Group, Draper, UT, United States;Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, United States;Integrated Research Literacy Group, Draper, UT, United States;Department of Physics and Astronomy, The University of Utah, Salt Lake City, UT, United States;Integrated Research Literacy Group, Draper, UT, United States;Department of Psychiatry, University of Cambridge, Cambridge, England;

关键词: augmented reality;    brain tumor;    glioma;    mixed reality;    neuronavigation;    neurosurgery;    systematic review;    virtual reality;   

DOI  :  10.3389/fsurg.2023.1245851

 received in 2023-06-23, accepted in 2023-08-04,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundAugmented reality (AR) is increasingly being explored in neurosurgical practice. By visualizing patient-specific, three-dimensional (3D) models in real time, surgeons can improve their spatial understanding of complex anatomy and pathology, thereby optimizing intra-operative navigation, localization, and resection. Here, we aimed to capture applications of AR in glioma surgery, their current status and future potential.MethodsA systematic review of the literature was conducted. This adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. PubMed, Embase, and Scopus electronic databases were queried from inception to October 10, 2022. Leveraging the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) framework, study eligibility was evaluated in the qualitative synthesis. Data regarding AR workflow, surgical application, and associated outcomes were then extracted. The quality of evidence was additionally examined, using hierarchical classes of evidence in neurosurgery.ResultsThe search returned 77 articles. Forty were subject to title and abstract screening, while 25 proceeded to full text screening. Of these, 22 articles met eligibility criteria and were included in the final review. During abstraction, studies were classified as “development” or “intervention” based on primary aims. Overall, AR was qualitatively advantageous, due to enhanced visualization of gliomas and critical structures, frequently aiding in maximal safe resection. Non-rigid applications were also useful in disclosing and compensating for intra-operative brain shift. Irrespective, there was high variance in registration methods and measurements, which considerably impacted projection accuracy. Most studies were of low-level evidence, yielding heterogeneous results.ConclusionsAR has increasing potential for glioma surgery, with capacity to positively influence the onco-functional balance. However, technical and design limitations are readily apparent. The field must consider the importance of consistency and replicability, as well as the level of evidence, to effectively converge on standard approaches that maximize patient benefit.

【 授权许可】

Unknown   
© 2023 Ragnhildstveit, Li, Zimmerman, Mamalakis, Curry, Holle, Baig, Uğuralp, Alkhani, Oğuz-Uğuralp, Romero-Garcia and Suckling.