Multimodal mixed reality visualisation for intraoperative surgical guidance

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ORIGINAL ARTICLE

Multimodal mixed reality visualisation for intraoperative surgical guidance João Cartucho1 · David Shapira1,2 · Hutan Ashrafian1 · Stamatia Giannarou1 Received: 16 November 2019 / Accepted: 6 April 2020 © The Author(s) 2020

Abstract Purpose In the last decade, there has been a great effort to bring mixed reality (MR) into the operating room to assist surgeons intraoperatively. However, progress towards this goal is still at an early stage. The aim of this paper is to propose a MR visualisation platform which projects multiple imaging modalities to assist intraoperative surgical guidance. Methodology In this work, a MR visualisation platform has been developed for the Microsoft HoloLens. The platform contains three visualisation components, namely a 3D organ model, volumetric data, and tissue morphology captured with intraoperative imaging modalities. Furthermore, a set of novel interactive functionalities have been designed including scrolling through volumetric data and adjustment of the virtual objects’ transparency. A pilot user study has been conducted to evaluate the usability of the proposed platform in the operating room. The participants were allowed to interact with the visualisation components and test the different functionalities. Each surgeon answered a questionnaire on the usability of the platform and provided their feedback and suggestions. Results The analysis of the surgeons’ scores showed that the 3D model is the most popular MR visualisation component and neurosurgery is the most relevant speciality for this platform. The majority of the surgeons found the proposed visualisation platform intuitive and would use it in their operating rooms for intraoperative surgical guidance. Our platform has several promising potential clinical applications, including vascular neurosurgery. Conclusion The presented pilot study verified the potential of the proposed visualisation platform and its usability in the operating room. Our future work will focus on enhancing the platform by incorporating the surgeons’ suggestions and conducting extensive evaluation on a large group of surgeons. Keywords Image-guided surgery · HoloLens · Mixed reality · Augmented reality · Computer-assisted surgery · Head-mounted display

Introduction Mixed reality (MR) is emerging as a vital tool in surgery as it enables the surgeon to visualise subsurface anatomical structures in 3D. This is because MR “mixes” virtual and real objects, thus allowing, for example, a surgeon to see a João Cartucho and David Shapira have contributed equally to this work.

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João Cartucho [email protected] David Shapira [email protected]

1

The Hamlyn Centre for Robotic Surgery, Imperial College London, London SW7 2AZ, UK

2

Product Development Group Zurich, ETH Zürich, 8092 Zürich, Switzerland

virtual tumour inside a real patient’s body. Besides the virtual 3D objects, MR enables a surgeon to consult a patient’s data through virtual 2D screens. Those virtual screens can display data collected before surgery (preope