Towards a Mixed-Reality First Person Point of View Needle Navigation System

  • Leah GrovesEmail author
  • Natalie Li
  • Terry M. Peters
  • Elvis C. S. Chen
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 11768)


Ultrasound-guidance has reduced complications, such as carotid artery punctures, during central venous catherization (CVC). The continued prevalence of these complications has promoted the use of mixed-reality systems for surgical needle navigation. We have developed a surgical navigation system that renders the calibrated ultrasound (US) image and tracked models of the probe, needle and needle-trajectory. We compared the effectiveness of this guidance system on a desktop monitor or within a head-mounted display (HMD) to the US-only approach in a phantom-based user study with 33 expert clinical practitioners. These users performed one needle insertion on each of the two vessel sets within the phantom, where the first insertion was used as training and the second was used for analysis. The guidance system rendered within the HMD significantly improved the safety margin, defined as number of successful needle insertions, where the final needle position was within the lumen of the vessel, as 31 users performed successful insertions with the HMD system compared to 21 successful insertions under US-only guidance. Furthermore, the HMD system significantly improved the distance from the final needle tip to the vessel wall, as clinicians more consistently position the needle such that it was within the vessel lumen but far from the vessel wall when using the HMD system. The clinicians’ performance using the monitor system was comparable to the US-only guidance. Therefore, using a HMD to align the visual and motor fields of the clinician is imperative to successful needle guidance, promoting the continued pursuit of HMD guidance research.


Surgical navigation Mixed reality Needle guidance Tracking Calibration Perception User performance 


  1. 1.
    Ameri, G., Baxter, J.S.H., Bainbridge, D., Peters, T.M., Chen, E.C.S.: Mixed reality ultrasound guidance system: a case study in system development and a cautionary tale. Int. J. Comput. Assist. Radiol. Surg. 13(4), 495–505 (2018)CrossRefGoogle Scholar
  2. 2.
    Chao, A., et al.: Performance of central venous catheterization by medical students: a retrospective study of students’ logbooks. BMC Med. Educ. 14(1), 168 (2014)CrossRefGoogle Scholar
  3. 3.
    Chen, E.C.S., Peters, T.M., Ma, B.: Which point-line registration? In: Webster, R.J., Fei, B. (eds.) Proceedings of the SPIE 10135, Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling, p. 1013509 (2017)Google Scholar
  4. 4.
    Groves, L.A., et al.: Accuracy assessment for the co-registration between optical and VIVE head-mounted display tracking. Int. J. Comput. Assist. Radiol. Surg. 14(7), 1207–1215 (2019)CrossRefGoogle Scholar
  5. 5.
    Hameeteman, M., Bode, A.S., Peppelenbosch, A.G., der Sande, F.M.V., Tordoir, D.J.H.: Ultrasound-guided central venous catheter placement by surgical trainees: a safe procedure? J. Vasc. Access 11(4), 288–292 (2010)CrossRefGoogle Scholar
  6. 6.
    Raad, I.: Intravascular-catheter-related infections. Lancet (Lond. Engl.) 351(9106), 893–898 (1998)CrossRefGoogle Scholar
  7. 7.
    Saugel, B., Scheeren, T.W.L., Teboul, J.L.: Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice. Crit. Care 21(1), 225 (2017)CrossRefGoogle Scholar
  8. 8.
    Soni, N.J., et al.: Use of ultrasound guidance for central venous catheterization: a national survey of intensivists and hospitalists. J. Crit. Care 36, 277–283 (2016)CrossRefGoogle Scholar
  9. 9.
    Surry, K.J.M., Austin, H.J.B., Fenster, A., Peters, T.M.: Poly(vinyl alcohol) cryogel phantoms for use in ultrasound and MR imaging. Phys. Med. Biol. 49(24), 5529–5546 (2004)CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.School of Biomedical EngineeringWestern UniversityLondonCanada
  2. 2.Medical BiophysicsWestern UniversityLondonCanada
  3. 3.Robarts Research InstituteLondonCanada

Personalised recommendations