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Tannoury T, Seo HH, Saade A, Chahine MN, Atallah B, Tannoury C. Evaluating the safe zone for lumbar pedicle screws: are midline crossing screws indicative of pedicle breach? Spine J 2024; 24:617-624. [PMID: 37939920 DOI: 10.1016/j.spinee.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/02/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND CONTEXT Pedicle screw breach (PSB) is not uncommon following lumbar instrumentation, and in some instances, it may lead to vascular and/or neurologic complications. Previous literature suggested that screws crossing the vertebral midline on an anterior-posterior (AP) radiograph (or midsagittal on CT) are concerning for medial pedicle breach. OBJECTIVE Our primary aim was to map out the safe zones (SZ) of bilateral pedicle instrumentation and their relationship at each lumbar vertebral level. Our secondary aim was to evaluate the presence of SZs' intersection at each lumbar level, denoting safe midline pedicle screw crossing not otherwise associated with medial pedicle breach. STUDY DESIGN/SETTING Retrospective Anatomical Study. PATIENT SAMPLE Adult patients in the from "The Cancer Imaging Archive" (TCIA) database who have not had thoraco-lumbo-sacral fusion. OUTCOME MEASURES Physiologic measures obtained through 3D analysis of CT images and virtual pedicle screws. METHOD CT scans of 51 patients were randomly selected from "The Cancer Imaging Archive" (TCIA) online database for analysis. The Sectra 3D Spine software was used to create 3D renderings, place virtual screws, and make measurements. At each lumbar vertebra, the right and left pedicle corridors were mapped. At each pedicle, two screw positions were templated, the "medial limit screw" (MLS) and the "lateral limit screw" (LLS). Each limit screw was the most extreme position that the screw could exist in without causing a medial or lateral breach. The safe zone was defined as the zone between MLS and LLS. Measurements were taken for each level (between L1 and L5) and side (Left, Right). RESULTS A total of 253 lumbar vertebrae from 51 patients (mean age 53.1, 56.9% male) were included. Two vertebrae from two patients were removed for poor image quality. Out of the 506 screw positions analyzed in our study, 97.4% had overlapping SZ and crossed the midplane without medial pedicle breach. The significant factors (p<.01) for safe midplane-crossing screws included: the screw length (L1-L5); the laterality of the screw entry point (L1-L4); and the pedicle diameter (L2 and L5). CONCLUSIONS A midline crossing pedicle screw on a lumbar AP radiograph is not necessarily indicative of a medial pedicle screw breach. Anatomical (ie, larger pedicle diameter) and technical (ie, longer screws, and lateral entry points) factors allow for safety zone intersections and indicate safe midline crossing by pedicle screws.
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Affiliation(s)
- Tony Tannoury
- Boston Medical Center, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA
| | | | | | - Mirna N Chahine
- The Lebanese University Faculty of Medicine, Beirut, Lebanon
| | - Bachir Atallah
- The Lebanese University Faculty of Medicine, Beirut, Lebanon
| | - Chadi Tannoury
- Boston Medical Center, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA.
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Andersen SAW, Hittle B, Värendh M, Lee J, Varadarajan V, Powell KA, Wiet GJ. Further Validity Evidence for Patient-Specific Virtual Reality Temporal Bone Surgical Simulation. Laryngoscope 2024; 134:1403-1409. [PMID: 37650640 DOI: 10.1002/lary.31016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/21/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Patient-specific virtual reality (VR) simulation of cochlear implant (CI) surgery potentially enables preoperative rehearsal and planning. We aim to gather supporting validity evidence for patient-specific simulation through the analysis of virtual performance and comparison with postoperative imaging. METHODS Prospective, multi-institutional study. Pre- and postoperative cone-beam CT scans of CI surgical patients were obtained and processed for patient-specific VR simulation. The virtual performances of five trainees and four attendings were recorded and (1) compared with volumes removed during actual surgery as determined in postoperative imaging, and (2) assessed using the Copenhagen Cochlear Implant Surgery Assessment Tool (CISAT) by two blinded raters. The volumes compared were cortical mastoidectomy, facial recess, and round window (RW) cochleostomy as well as violation of the facial nerve and chorda. RESULTS Trainees drilled more volume in the cortical mastoidectomy and facial recess, whereas attendings drilled more volume for the RW cochleostomy and made more violations. Except for the cochleostomy, attendings removed volumes closer to that determined in postoperative imaging. Trainees achieved a higher CISAT performance score compared with attendings (22.0 vs. 18.4 points) most likely due to lack of certain visual cues. CONCLUSION We found that there were differences in performance of trainees and attendings in patient-specific VR simulation of CI surgery as assessed by raters and in comparison with actual drilled volumes. The presented approach of volume comparison is novel and might be used for further validation of patient-specific VR simulation before clinical implementation for preoperative rehearsal in temporal bone surgery. LEVEL OF EVIDENCE n/a Laryngoscope, 134:1403-1409, 2024.
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Affiliation(s)
- Steven Arild Wuyts Andersen
- Copenhagen Hearing and Balance Center, Department of Otorhinolaryngology, Rigshospitalet, Copenhagen, Denmark
| | - Brad Hittle
- Department of Biomedical Informatics, Ohio State University, Columbus, Ohio, U.S.A
| | - Maria Värendh
- Department of Otorhinolaryngology, Örebro University Hospital, Örebro University, Örebro, Sweden
- Department of Otorhinolaryngology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Julian Lee
- Department of Otorhinolaryngology, The Ohio State University, Columbus, Ohio, U.S.A
- Department of Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, U.S.A
| | | | - Kimerly A Powell
- Department of Biomedical Informatics, Ohio State University, Columbus, Ohio, U.S.A
| | - Gregory J Wiet
- Department of Otorhinolaryngology, The Ohio State University, Columbus, Ohio, U.S.A
- Department of Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, U.S.A
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3
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Tapiala J, Iso-Mustajärvi M, Timonen T, Vrzáková H, Dietz A. Impact of virtual reality training on mastoidectomy performance: a prospective randomised study. Eur Arch Otorhinolaryngol 2024; 281:701-710. [PMID: 37505263 PMCID: PMC10796652 DOI: 10.1007/s00405-023-08143-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE The opportunities for surgical training and practice in the operating room are in decline due to limited resources, increased efficiency demands, growing complexity of the cases, and concerns for patient safety. Virtual reality (VR) offers a novel opportunity to enhance surgical training and provide complementary three-dimensional experience that has been usually available in the operating room. Since VR allows viewing and manipulation of realistic 3D models, the VR environment could enhance anatomical and topographical knowledge, in particular. In this study, we explored whether incorporating VR anatomy training improves novices' performance during mastoidectomy over traditional methods. METHODS Thirty medical students were randomized into two groups and taught mastoidectomy in a structured manner. One group utilized a VR temporal bone model during the training while the other group used more traditional materials such as anatomy books. After the training, all participants completed a mastoidectomy on a 3D-printed temporal bone model under expert supervision. Performance during the mastoidectomy was evaluated with multiple metrics and feedback regarding the two training methods was gathered from the participants. RESULTS The VR training method was rated better by the participants, and they also needed less guidance during the mastoidectomy. There were no significant differences in operational time, the occurrence of injuries, self-assessment scores, and the surgical outcome between the two groups. CONCLUSION Our results support the utilization of VR training in complete novices as it has higher trainee satisfaction and leads to at least as good results as the more traditional methods.
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Affiliation(s)
- Jesse Tapiala
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
- Department of Otorhinolaryngology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, PL 100, 70029, Kuopio, Finland.
| | - Matti Iso-Mustajärvi
- Department of Otorhinolaryngology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, PL 100, 70029, Kuopio, Finland
| | - Tomi Timonen
- Department of Otorhinolaryngology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, PL 100, 70029, Kuopio, Finland
| | - Hana Vrzáková
- School of Computing, University of Eastern Finland, Joensuu, Finland
| | - Aarno Dietz
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Otorhinolaryngology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, PL 100, 70029, Kuopio, Finland
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Ding AS, Lu A, Li Z, Sahu M, Galaiya D, Siewerdsen JH, Unberath M, Taylor RH, Creighton FX. A Self-Configuring Deep Learning Network for Segmentation of Temporal Bone Anatomy in Cone-Beam CT Imaging. Otolaryngol Head Neck Surg 2023; 169:988-998. [PMID: 36883992 PMCID: PMC11060418 DOI: 10.1002/ohn.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/19/2023] [Accepted: 02/19/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE Preoperative planning for otologic or neurotologic procedures often requires manual segmentation of relevant structures, which can be tedious and time-consuming. Automated methods for segmenting multiple geometrically complex structures can not only streamline preoperative planning but also augment minimally invasive and/or robot-assisted procedures in this space. This study evaluates a state-of-the-art deep learning pipeline for semantic segmentation of temporal bone anatomy. STUDY DESIGN A descriptive study of a segmentation network. SETTING Academic institution. METHODS A total of 15 high-resolution cone-beam temporal bone computed tomography (CT) data sets were included in this study. All images were co-registered, with relevant anatomical structures (eg, ossicles, inner ear, facial nerve, chorda tympani, bony labyrinth) manually segmented. Predicted segmentations from no new U-Net (nnU-Net), an open-source 3-dimensional semantic segmentation neural network, were compared against ground-truth segmentations using modified Hausdorff distances (mHD) and Dice scores. RESULTS Fivefold cross-validation with nnU-Net between predicted and ground-truth labels were as follows: malleus (mHD: 0.044 ± 0.024 mm, dice: 0.914 ± 0.035), incus (mHD: 0.051 ± 0.027 mm, dice: 0.916 ± 0.034), stapes (mHD: 0.147 ± 0.113 mm, dice: 0.560 ± 0.106), bony labyrinth (mHD: 0.038 ± 0.031 mm, dice: 0.952 ± 0.017), and facial nerve (mHD: 0.139 ± 0.072 mm, dice: 0.862 ± 0.039). Comparison against atlas-based segmentation propagation showed significantly higher Dice scores for all structures (p < .05). CONCLUSION Using an open-source deep learning pipeline, we demonstrate consistently submillimeter accuracy for semantic CT segmentation of temporal bone anatomy compared to hand-segmented labels. This pipeline has the potential to greatly improve preoperative planning workflows for a variety of otologic and neurotologic procedures and augment existing image guidance and robot-assisted systems for the temporal bone.
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Affiliation(s)
- Andy S. Ding
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alexander Lu
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zhaoshuo Li
- Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Manish Sahu
- Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Deepa Galaiya
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeffrey H. Siewerdsen
- Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mathias Unberath
- Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Russell H. Taylor
- Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Francis X. Creighton
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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5
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Lan L, Mao RQ, Qiu RY, Kay J, de Sa D. Immersive Virtual Reality for Patient-Specific Preoperative Planning: A Systematic Review. Surg Innov 2023; 30:109-122. [PMID: 36448920 PMCID: PMC9925905 DOI: 10.1177/15533506221143235] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background. Immersive virtual reality (iVR) facilitates surgical decision-making by enabling surgeons to interact with complex anatomic structures in realistic 3-dimensional environments. With emerging interest in its applications, its effects on patients and providers should be clarified. This systematic review examines the current literature on iVR for patient-specific preoperative planning. Materials and Methods. A literature search was performed on five databases for publications from January 1, 2000 through March 21, 2021. Primary studies on the use of iVR simulators by surgeons at any level of training for patient-specific preoperative planning were eligible. Two reviewers independently screened titles, abstracts, and full texts, extracted data, and assessed quality using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Results were qualitatively synthesized, and descriptive statistics were calculated. Results. The systematic search yielded 2,555 studies in total, with 24 full-texts subsequently included for qualitative synthesis, representing 264 medical personnel and 460 patients. Neurosurgery was the most frequently represented discipline (10/24; 42%). Preoperative iVR did not significantly improve patient-specific outcomes of operative time, blood loss, complications, and length of stay, but may decrease fluoroscopy time. In contrast, iVR improved surgeon-specific outcomes of surgical strategy, anatomy visualization, and confidence. Validity, reliability, and feasibility of patient-specific iVR models were assessed. The mean QATSDD score of included studies was 32.9%. Conclusions. Immersive VR improves surgeon experiences of preoperative planning, with minimal evidence for impact on short-term patient outcomes. Future work should focus on high-quality studies investigating long-term patient outcomes, and utility of preoperative iVR for trainees.
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Affiliation(s)
- Lucy Lan
- Michael G. DeGroote School of
Medicine, McMaster University, Hamilton, ON, Canada,Lucy Lan, Michael G. DeGroote School of
Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8N 3Z5,
Canada.
| | - Randi Q. Mao
- Michael G. DeGroote School of
Medicine, McMaster University, Hamilton, ON, Canada
| | - Reva Y. Qiu
- Michael G. DeGroote School of
Medicine, McMaster University, Hamilton, ON, Canada
| | - Jeffrey Kay
- Division of Orthopaedic Surgery,
Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Darren de Sa
- Division of Orthopaedic Surgery,
Department of Surgery, McMaster University, Hamilton, ON, Canada
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Timonen T, Dietz A, Linder P, Lehtimäki A, Löppönen H, Elomaa AP, Iso-Mustajärvi M. The effect of virtual reality on temporal bone anatomy evaluation and performance. Eur Arch Otorhinolaryngol 2022; 279:4303-4312. [PMID: 34837519 PMCID: PMC9363303 DOI: 10.1007/s00405-021-07183-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/15/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE There is only limited data on the application of virtual reality (VR) for the evaluation of temporal bone anatomy. The aim of the present study was to compare the VR environment to traditional cross-sectional viewing of computed tomography images in a simulated preoperative planning setting in novice and expert surgeons. METHODS A novice (n = 5) and an expert group (n = 5), based on their otosurgery experience, were created. The participants were asked to identify 24 anatomical landmarks, perform 11 distance measurements between surgically relevant anatomical structures and 10 fiducial markers on five cadaver temporal bones in both VR environment and cross-sectional viewings in PACS interface. The data on performance time and user-experience (i.e., subjective validation) were collected. RESULTS The novice group made significantly more errors (p < 0.001) and with significantly longer performance time (p = 0.001) in cross-sectional viewing than the expert group. In the VR environment, there was no significant differences (errors and time) between the groups. The performance of novices improved faster in the VR. The novices showed significantly faster task performance (p = 0.003) and a trend towards fewer errors (p = 0.054) in VR compared to cross-sectional viewing. No such difference between the methods were observed in the expert group. The mean overall scores of user-experience were significantly higher for VR than cross-sectional viewing in both groups (p < 0.001). CONCLUSION In the VR environment, novices performed the anatomical evaluation of temporal bone faster and with fewer errors than in the traditional cross-sectional viewing, which supports its efficiency for the evaluation of complex anatomy.
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Affiliation(s)
- Tomi Timonen
- Department of Otorhinolaryngology, Kuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, PL 100, 70029, Kuopio, Finland.
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
| | - Aarno Dietz
- Department of Otorhinolaryngology, Kuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, PL 100, 70029, Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Pia Linder
- Department of Otorhinolaryngology, Kuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, PL 100, 70029, Kuopio, Finland
| | - Antti Lehtimäki
- Department of Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Heikki Löppönen
- Department of Otorhinolaryngology, Kuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, PL 100, 70029, Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Antti-Pekka Elomaa
- Microsurgery Centre of Eastern Finland, Kuopio, Finland
- Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland
| | - Matti Iso-Mustajärvi
- Department of Otorhinolaryngology, Kuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, PL 100, 70029, Kuopio, Finland
- Microsurgery Centre of Eastern Finland, Kuopio, Finland
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Sureshkumar H, Xu R, Erukulla N, Wadhwa A, Zhao L. "Snap on" or Not? A Validation on the Measurement Tool in a Virtual Reality Application. J Digit Imaging 2022; 35:692-703. [PMID: 35088186 PMCID: PMC9156653 DOI: 10.1007/s10278-022-00582-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/04/2021] [Accepted: 01/03/2022] [Indexed: 12/15/2022] Open
Abstract
This multi-rater comparison study aims to validate the measurement tool with a "snap" feature option (SNAP ON vs. SNAP OFF), in a virtual reality (VR) application, ImmersiveView v. 2.1, against a conventional software Mimics Innovation Suite v.22 (MIS). It is hypothesized that these measurement tools are equivalent between SNAP ON, and SNAP OFF, and when compared to MIS, in terms of basic linear and angular measurements. Six (6) raters conducted a set of 40 linear and 15 angular measurements using CT scan data of three objects (L-block, hand model, and dry skull) with fiducial markers. Inter-rater repeatability and intra-rater reproducibility were assessed via inter-class coefficient (ICC). Equivalency between each pair of modules (SNAP ON, SNAP OFF, and MIS) was analyzed via Bland-Altman plots and two one-sided t-tests (TOST) procedure. The ICC for intra-rater repeatability yielded 0.999 to 1.000, and inter-rater reproducibility yielded 0.998 to 1.000, which suggests high degree of intra- and inter-rater reliability. The Bland-Altman plots demonstrated that measurements acquired from SNAP ON, SNAP OFF, and MIS were equivalent. The TOST procedure yielded that the measurements through all three modules are equivalent within ± 0.2 mm interval for distance, and ± 0.3° interval for angular measurements. The measurement tool with the "snap" feature in a newly developed VR application (ImmersiveView v.2.1) has been validated through a multi-rater comparison study. In terms of linear and angular measurements, this VR application, whether the "snap" feature was on or off, was equivalent to each other and to the control software (MIS) under the condition of this study. A strong reliability, both intra-rater repeatability and inter-rater reproducibility, has been found.
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Affiliation(s)
- Haarisudhan Sureshkumar
- Department of Biomedical Engineering, University of Illinois at Chicago, 851 S Morgan St, Chicago, IL, 60607, USA
| | - Ruidi Xu
- Department of Biomedical Engineering, University of Illinois at Chicago, 851 S Morgan St, Chicago, IL, 60607, USA
| | - Nikith Erukulla
- Department of Biomedical Engineering, University of Illinois at Chicago, 851 S Morgan St, Chicago, IL, 60607, USA
| | - Aditi Wadhwa
- Department of Biomedical Engineering, University of Illinois at Chicago, 851 S Morgan St, Chicago, IL, 60607, USA
| | - Linping Zhao
- Virtual Surgical Simulation Laboratory, Division of Plastic, Reconstructive and Cosmetic Surgery, University of Illinois at Chicago, 811 S. Paulina St, Chicago, IL, 60612, USA.
- Shriners Hospitals for Children at Chicago, 2211 N. Oak Park Ave, Chicago, IL, 60707, USA.
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Taylor S, Soneji S. Bioinformatics and the Metaverse: Are We Ready? FRONTIERS IN BIOINFORMATICS 2022; 2:863676. [PMID: 36304263 PMCID: PMC9580841 DOI: 10.3389/fbinf.2022.863676] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/20/2022] [Indexed: 02/01/2023] Open
Abstract
COVID-19 forced humanity to think about new ways of working globally without physically being present with other people, and eXtended Reality (XR) systems (defined as Virtual Reality, Augmented Reality and Mixed Reality) offer a potentially elegant solution. Previously seen as mainly for gaming, commercial and research institutions are investigating XR solutions to solve real world problems from training, simulation, mental health, data analysis, and studying disease progression. More recently large corporations such as Microsoft and Meta have announced they are developing the Metaverse as a new paradigm to interact with the digital world. This article will look at how visualization can leverage the Metaverse in bioinformatics research, the pros and cons of this technology, and what the future may hold.
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Affiliation(s)
- Stephen Taylor
- Analysis, Visualization and Informatics Group, MRC Weatherall Institute of Computational Biology, MRC Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
- *Correspondence: Stephen Taylor,
| | - Shamit Soneji
- Division of Molecular Hematology, Department of Laboratory Medicine, Faculty of Medicine, BMC, Lund University, Lund, Sweden
- Lund Stem Cell Center, Faculty of Medicine, BMC, Lund University, Lund, Sweden
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Pelizzo G, Costanzo S, Roveri M, Lanfranchi G, Vertemati M, Milani P, Zuccotti G, Cassin S, Panfili S, Rizzetto F, Campari A, Camporesi A, Calcaterra V. Developing Virtual Reality Head Mounted Display (HMD) Set-Up for Thoracoscopic Surgery of Complex Congenital Lung MalFormations in Children. CHILDREN (BASEL, SWITZERLAND) 2022; 9:50. [PMID: 35053675 PMCID: PMC8774663 DOI: 10.3390/children9010050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/20/2021] [Accepted: 12/31/2021] [Indexed: 11/19/2022]
Abstract
Video assisted thoracoscopic surgery (VATS) has been adopted in pediatric age for the treatment of congenital lung malformations (CLM). The success of VATS in pediatrics largely depends on the surgeon's skill ability to understand the airways, vascular system and lung parenchyma anatomy in CLM. In the last years, virtual reality (VR) and 3-dimensional (3D) printing of organ models and VR head mounted display (HMD) technologies have been introduced for completion of preoperative planning in adult patients. To date no reports about the use of VR HMD technologies in a pediatric setting are available. The aim of this report is to introduce a VR HMD model in VATS procedure to improve the quality of care in children with CLM. VR HMD set-up for planning thoracoscopic surgery was performed in a series of pediatric patients with diagnosis of CLM. The preoperative VR HMD evaluation allowed a navigation into the malformation with the aim to explore, interact, and make the surgeon more confident and skilled to answer to the traps. A development of surgical simulations models and teaching program dedicated to education and training in pediatric VATS is suitable among the pediatric surgery community. Further studies should demonstrate all the benefits of such technology in pediatric patients submitted to VATS procedure.
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Affiliation(s)
- Gloria Pelizzo
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.C.); (M.R.); (G.L.)
- Department of Biomedical and Clinical Science “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (M.V.); (G.Z.); (S.C.); (S.P.)
| | - Sara Costanzo
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.C.); (M.R.); (G.L.)
| | - Margherita Roveri
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.C.); (M.R.); (G.L.)
| | - Giulia Lanfranchi
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.C.); (M.R.); (G.L.)
| | - Maurizio Vertemati
- Department of Biomedical and Clinical Science “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (M.V.); (G.Z.); (S.C.); (S.P.)
- CIMaINa (Interdisciplinary Centre for Nanostructured Materials and Interfaces), University of Milano, 20133 Milan, Italy;
| | - Paolo Milani
- CIMaINa (Interdisciplinary Centre for Nanostructured Materials and Interfaces), University of Milano, 20133 Milan, Italy;
- Department of Physics “Aldo Pontremoli”, University of Milano, 20157 Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Biomedical and Clinical Science “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (M.V.); (G.Z.); (S.C.); (S.P.)
- Pediatric Department, Children’s Hospital “Vittore Buzzi”, 20154 Milan, Italy;
| | - Simone Cassin
- Department of Biomedical and Clinical Science “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (M.V.); (G.Z.); (S.C.); (S.P.)
| | - Sebastiano Panfili
- Department of Biomedical and Clinical Science “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (M.V.); (G.Z.); (S.C.); (S.P.)
| | - Francesco Rizzetto
- Department of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy;
- Postgraduate School of Diagnostic and Interventional Radiology, University of Milano, 20157 Milan, Italy
| | - Alessandro Campari
- Pediatric Radiology and Neuroradiology Unit, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy;
| | - Anna Camporesi
- Division of Pediatric Anesthesia and Intensive Care Unit, Department of Pediatrics, Children’s Hospital Vittore Buzzi, 20154 Milan, Italy;
| | - Valeria Calcaterra
- Pediatric Department, Children’s Hospital “Vittore Buzzi”, 20154 Milan, Italy;
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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Virtual Reality (VR) Simulation and Augmented Reality (AR) Navigation in Orthognathic Surgery: A Case Report. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11125673] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
VR and AR technology have gradually developed to the extent that they could help operators in the surgical field. In this study, we present a case of VR simulation for preoperative planning and AR navigation applied to orthognathic surgery. The average difference between the preplanned data and the post-operative results was 3.00 mm, on average, and the standard deviation was 1.44 mm. VR simulation could provide great advantages for 3D medical simulations, with accurate manipulation and immersiveness. AR navigation has great potential in medical application; its advantages include displaying real time augmented 3D models of patients. Moreover, it is easily applied in the surgical field, without complicated 3D simulations or 3D-printed surgical guides.
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