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Out-of-Plane Needle Placements Using 3D Augmented Reality Protractor on Smartphone: An Experimental Phantom Study

  • Technical Note
  • Non-Vascular Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the accuracy of needle placement using a three-dimensional (3D) augmented reality (AR) protractor on smartphones (AR Puncture).

Materials and Methods

An AR protractor that can be rotated in three directions against the CT plane with angle guidance lines for smartphones was developed. The protractor center can be adjusted to an entry point by manually moving the smartphone with the protractor center fixed at the center of the screen (Fix-On-Screen) or by image tracking with a printed QR code placed at an entry point (QR-Tracking). Needle placement was performed by viewing a target line in the tangent direction with the Bull’s eye method. The needle placement errors placed by four operators in six out-of-plane directions in a phantom using a smartphone (iPhone XR, Apple, Cupertino, CA, USA) were compared with two registration methods.

Results

No significant difference in the average needle placement error was observed between the Fix-On-Screen and QR-Tracking methods (5.6 ± 1.7 mm vs. 6.1 ± 2.9 mm, p = 0.475). The average procedural time of the Fix-On-Screen method was shorter than that of the QR-Tracking method (71.0 ± 23.9 s vs. 98.4 ± 59.5 s, p = 0.042).

Conclusion

The accuracies of out-of-plane needle placements using the 3D AR protractor with the two registration methods were equally high, with short procedure times. In clinical use, the Fix-On-Screen registration method would be more convenient because no additional markers are required.

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Acknowledgements

The authors thank Ryuhei Maruyama, Shuhei Fujii, Kayo Ito, Haruya Tanaka, Shinichi Tanaka, and Jun Ohya of Department of Modern Mechanical Engineering, Waseda University, and Ken Masamune of Institute of Advanced BioMedical Engineering and Science, Tokyo Women's Medical University for technical advice and assistance.

Funding

This work was supported by JSPS KAKENHI Grant No. JP 18K07648, which is a Japanese national funding.

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Authors and Affiliations

  1. Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan

    Satoru Morita, Kazufumi Suzuki, Takahiro Yamamoto, Sota Endo, Hiroshi Yamazaki & Shuji Sakai

Authors
  1. Satoru Morita
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  2. Kazufumi Suzuki
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  3. Takahiro Yamamoto
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  4. Sota Endo
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  5. Hiroshi Yamazaki
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  6. Shuji Sakai
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Corresponding author

Correspondence to Satoru Morita.

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Conflict of interest

Otherwise, we have no financial relationships to disclose. The authors declare that they have no conflict of interest.

Ethical Approval

This study was exempted from approval by the Institutional Review Board of our institution as no actual patient or healthy volunteer data were obtained or analyzed.

Informed Consent

Does not apply as no actual patient or healthy volunteer data are obtained or analyzed.

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Supplementary Information

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Video1 Demonstration of out-of-plane needle placement in a phantom using the AR protractor with the Fix-On-Screen method at the original speed and without editing (MP4 24080 KB)

Video2 Demonstration of out-of-plane needle placement in a phantom using the AR protractor with the QR-Tracking method at original speed and without editing (MP4 26664 KB)

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Morita, S., Suzuki, K., Yamamoto, T. et al. Out-of-Plane Needle Placements Using 3D Augmented Reality Protractor on Smartphone: An Experimental Phantom Study. Cardiovasc Intervent Radiol 46, 675–679 (2023). https://doi.org/10.1007/s00270-023-03357-6

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