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Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study

INTRODUCTION: In orthopedic oncology, computer navigation and 3D-printed guides facilitate precise osteotomies only after surgical exposure. Before surgeries start, it is challenging to mentally process and superimpose the virtual medical images onto patients’ anatomy for preoperative surgical plann...

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Autores principales: Wong, Kwok Chuen, Sun, Edgar Yan, Wong, Irene Oi Ling, Kumta, Shekhar Madhukar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10402726/
https://www.ncbi.nlm.nih.gov/pubmed/37546697
http://dx.doi.org/10.2147/ORR.S421077
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author Wong, Kwok Chuen
Sun, Edgar Yan
Wong, Irene Oi Ling
Kumta, Shekhar Madhukar
author_facet Wong, Kwok Chuen
Sun, Edgar Yan
Wong, Irene Oi Ling
Kumta, Shekhar Madhukar
author_sort Wong, Kwok Chuen
collection PubMed
description INTRODUCTION: In orthopedic oncology, computer navigation and 3D-printed guides facilitate precise osteotomies only after surgical exposure. Before surgeries start, it is challenging to mentally process and superimpose the virtual medical images onto patients’ anatomy for preoperative surgical planning. Mixed Reality (MR) is an immersive technology merging real and virtual worlds, and users can interact with digital objects in real time. Through Head-Mounted Displays, surgeons directly visualize holographic models that overlaid on tumor patients. The technology may facilitate surgical planning before skin incisions. METHODS: Nine bone tumor patients were included (July 2021 – Dec 2022). There were six primary bone sarcomas, two benign bone tumors, and one revision pelvic prosthesis. MR applications were created using patients’ preoperative medical images. The surgeon examined each patient clinically using the conventional method of viewing 2D images and MR via HMD, Hololens 2. A Likert-Scale (LS) questionnaire and The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score were used to evaluate and compare the effectiveness of surgical planning and the surgeon’s clinical cognitive workload for the two methods. RESULTS: The qualitative survey of the LS questionnaire suggested that the MR group had superior spatial awareness of tumors and was considered more effective as a preoperative planning tool than the conventional group. For NASA-TLX scores, the overall cognitive workload was lower in MR 3D hologram group than in the 2D Group for preoperative clinical assessment. When using MR technology with HMDs, the surgeon reported no discomfort. CONCLUSION: MR technology may improve 3D visualization and spatial awareness of bone tumors in patients’ anatomies and may facilitate surgical planning before skin incisions in orthopedic oncology surgery. With less cognitive load and better ergonomics, surgeons can focus on patients and surgical tasks with MR technology. Further studies must investigate whether MR technology improves clinical outcomes.
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spelling pubmed-104027262023-08-05 Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study Wong, Kwok Chuen Sun, Edgar Yan Wong, Irene Oi Ling Kumta, Shekhar Madhukar Orthop Res Rev Original Research INTRODUCTION: In orthopedic oncology, computer navigation and 3D-printed guides facilitate precise osteotomies only after surgical exposure. Before surgeries start, it is challenging to mentally process and superimpose the virtual medical images onto patients’ anatomy for preoperative surgical planning. Mixed Reality (MR) is an immersive technology merging real and virtual worlds, and users can interact with digital objects in real time. Through Head-Mounted Displays, surgeons directly visualize holographic models that overlaid on tumor patients. The technology may facilitate surgical planning before skin incisions. METHODS: Nine bone tumor patients were included (July 2021 – Dec 2022). There were six primary bone sarcomas, two benign bone tumors, and one revision pelvic prosthesis. MR applications were created using patients’ preoperative medical images. The surgeon examined each patient clinically using the conventional method of viewing 2D images and MR via HMD, Hololens 2. A Likert-Scale (LS) questionnaire and The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score were used to evaluate and compare the effectiveness of surgical planning and the surgeon’s clinical cognitive workload for the two methods. RESULTS: The qualitative survey of the LS questionnaire suggested that the MR group had superior spatial awareness of tumors and was considered more effective as a preoperative planning tool than the conventional group. For NASA-TLX scores, the overall cognitive workload was lower in MR 3D hologram group than in the 2D Group for preoperative clinical assessment. When using MR technology with HMDs, the surgeon reported no discomfort. CONCLUSION: MR technology may improve 3D visualization and spatial awareness of bone tumors in patients’ anatomies and may facilitate surgical planning before skin incisions in orthopedic oncology surgery. With less cognitive load and better ergonomics, surgeons can focus on patients and surgical tasks with MR technology. Further studies must investigate whether MR technology improves clinical outcomes. Dove 2023-07-31 /pmc/articles/PMC10402726/ /pubmed/37546697 http://dx.doi.org/10.2147/ORR.S421077 Text en © 2023 Wong et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Wong, Kwok Chuen
Sun, Edgar Yan
Wong, Irene Oi Ling
Kumta, Shekhar Madhukar
Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title_full Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title_fullStr Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title_full_unstemmed Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title_short Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title_sort mixed reality improves 3d visualization and spatial awareness of bone tumors for surgical planning in orthopaedic oncology: a proof of concept study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10402726/
https://www.ncbi.nlm.nih.gov/pubmed/37546697
http://dx.doi.org/10.2147/ORR.S421077
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