Current guidance during a prostate biopsy a problematic since 3D MRI images are transformed into a 2D image. This makes the biopsy less accurate and flexible. Therefore, a research team led by Dr. Ming Li from the US National Institutes of Health propose using a HoloLens AR system to project the 3D images on the body. Research by this team pointed out that using AR for a biopsy is much more accurate and flexible.
The US Centers for Disease Control and Prevention say that prostate cancer is the second leading cause of cancer death among men. The catch the disease on time, one of the standard ways to diagnose involves a transperineal (TP) biopsy. This involves inserting a needle through the perineum wall to collect tissue samples. For this method the patient undergoes an MRI scan and gets an ultrasound of the area.
Challenges with a biopsy
However, currently these 3D images are translated in 2D visualization. Therefore, the guidance of the needle in this situation is less than desirable. According to Dr. Ming Li: “The current methods have certain limitations to them. Robot-assisted guidance is costly and adds procedural time, while other methods require a certain path for the needle that leaves out the outer reaches of the prostate.”
To solve these problems, the research team under guidance of Dr. Ming Li, experimented with the HoloLens AR system, using the reference data of the patient, to project the 3D images on the body of the patient. Li: “[It] provides the doctor with the ability to use a free-hand approach.” The urologist wears the HoloLens AR-glasses which allows him to see the patient and the needed MRI data. Also, they see the preplanned needle path on the patient.
AR for a biopsy much more flexible
The researchers tested the image overlay accuracy and needle targeting accuracy for the AR for a biopsy system on a dummy. The researchers recorded the placement errors for both free-hand and planned-path guidance methods. Additionally, they also used the system to deliver soft tissue markers onto the tumors of a human pelvis phantom.
“The HoloLens has the potential to provide more flexibility than the current grid-based TP methods and can do so accurately,” highlights Li. “By providing a 3D immersive experience, the HoloLens AR system makes free-hand lesion targeting feasible. AR for a biopsy could provide great clinical value to doctors and patients by solving the problems associated with prostate intervention procedures,” she concludes.
Read the complete article here: https://www.spiedigitallibrary.org/journals/journal-of-medical-imaging/volume-10/issue-2/025001/HoloLens-augmented-reality-system-for-transperineal-free-hand-prostate-procedures/10.1117/1.JMI.10.2.025001.full
