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IMHOTEP: virtual reality framework for surgical applications

Abstract

Purpose

The data which is available to surgeons before, during and after surgery is steadily increasing in quantity as well as diversity. When planning a patient’s treatment, this large amount of information can be difficult to interpret. To aid in processing the information, new methods need to be found to present multimodal patient data, ideally combining textual, imagery, temporal and 3D data in a holistic and context-aware system.

Methods

We present an open-source framework which allows handling of patient data in a virtual reality (VR) environment. By using VR technology, the workspace available to the surgeon is maximized and 3D patient data is rendered in stereo, which increases depth perception. The framework organizes the data into workspaces and contains tools which allow users to control, manipulate and enhance the data. Due to the framework’s modular design, it can easily be adapted and extended for various clinical applications.

Results

The framework was evaluated by clinical personnel (77 participants). The majority of the group stated that a complex surgical situation is easier to comprehend by using the framework, and that it is very well suited for education. Furthermore, the application to various clinical scenarios—including the simulation of excitation propagation in the human atrium—demonstrated the framework’s adaptability. As a feasibility study, the framework was used during the planning phase of the surgical removal of a large central carcinoma from a patient’s liver.

Conclusion

The clinical evaluation showed a large potential and high acceptance for the VR environment in a medical context. The various applications confirmed that the framework is easily extended and can be used in real-time simulation as well as for the manipulation of complex anatomical structures.

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Notes

  1. Immersive Medical Hands-On Operation Teaching and Planning System.

  2. https://github.com/IMHOTEP-Medical/imhotep.

  3. While older publications often use the term “Virtual Reality” to refer to a very wide range of methods, we use it only for those systems in which the user wears a head-mounted display, with stereo rendering and positional as well as orientational tracking.

  4. https://www.kineviz.com/.

  5. https://www.virtualitics.com/.

  6. http://dynamoid.com.

  7. Digital Imaging and Communications in Medicine.

  8. Insight Segmentation and Registration Toolkit.

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Acknowledgements

We thank the Medien- und Filmgesellschaft Baden-Württemberg for supporting early development of the framework through the Karl-Steinbuch scholarship.

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Correspondence to Micha Pfeiffer.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from the study participant.

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Pfeiffer, M., Kenngott, H., Preukschas, A. et al. IMHOTEP: virtual reality framework for surgical applications. Int J CARS 13, 741–748 (2018). https://doi.org/10.1007/s11548-018-1730-x

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  • DOI: https://doi.org/10.1007/s11548-018-1730-x

Keywords

  • Virtual reality
  • Surgical planning
  • Advanced medical visualization