Cargando…

Cinematic Rendering in Mixed-Reality Holograms: A New 3D Preoperative Planning Tool in Pediatric Heart Surgery

Cinematic rendering (CR) is based on a new algorithm that creates a photo-realistic three-dimensional (3D) picture from cross-sectional images. Previous studies have shown its positive impact on preoperative planning. To date, CR presentation has only been possible on 2D screens which limited natura...

Descripción completa

Detalles Bibliográficos
Autores principales: Gehrsitz, Pia, Rompel, Oliver, Schöber, Martin, Cesnjevar, Robert, Purbojo, Ariawan, Uder, Michael, Dittrich, Sven, Alkassar, Muhannad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900175/
https://www.ncbi.nlm.nih.gov/pubmed/33634174
http://dx.doi.org/10.3389/fcvm.2021.633611
_version_ 1783654168560402432
author Gehrsitz, Pia
Rompel, Oliver
Schöber, Martin
Cesnjevar, Robert
Purbojo, Ariawan
Uder, Michael
Dittrich, Sven
Alkassar, Muhannad
author_facet Gehrsitz, Pia
Rompel, Oliver
Schöber, Martin
Cesnjevar, Robert
Purbojo, Ariawan
Uder, Michael
Dittrich, Sven
Alkassar, Muhannad
author_sort Gehrsitz, Pia
collection PubMed
description Cinematic rendering (CR) is based on a new algorithm that creates a photo-realistic three-dimensional (3D) picture from cross-sectional images. Previous studies have shown its positive impact on preoperative planning. To date, CR presentation has only been possible on 2D screens which limited natural 3D perception. To depict CR-hearts spatially, we used mixed-reality technology and mapped corresponding hearts as holograms in 3D space. Our aim was to assess the benefits of CR-holograms in the preoperative planning of cardiac surgery. Including 3D prints allowed a direct comparison of two spatially resolved display methods. Twenty-six patients were recruited between February and September 2019. CT or MRI was used to visualize the patient's heart preoperatively. The surgeon was shown the anatomy in cross-sections on a 2D screen, followed by spatial representations as a 3D print and as a high-resolution hologram. The holographic representation was carried out using mixed-reality glasses (HoloLens®). To create the 3D prints, corresponding structures were segmented to create STL files which were printed out of resin. In 22 questions, divided in 5 categories (3D-imaging effect, representation of pathology, structure resolution, cost/benefit ratio, influence on surgery), the surgeons compared each spatial representation with the 2D method, using a five-level Likert scale. The surgical preparation time was assessed by comparing retrospectively matched patient pairs, using a paired t-test. CR-holograms surpassed 2D-monitor imaging in all categories. CR-holograms were superior to 3D prints in all categories (mean Likert scale 4.4 ± 1.0 vs. 3.7 ± 1.3, P < 0.05). Compared to 3D prints it especially improved the depth perception (4.7 ± 0.7 vs. 3.7 ± 1.2) and the representation of the pathology (4.4 ± 0.9 vs. 3.6 ± 1.2). 3D imaging reduced the intraoperative preparation time (n = 24, 59 ± 23 min vs. 73 ± 43 min, P < 0.05). In conclusion, the combination of an extremely photo-realistic presentation via cinematic rendering and the spatial presentation in 3D space via mixed-reality technology allows a previously unattained level of comprehension of anatomy and pathology in preoperative planning.
format Online
Article
Text
id pubmed-7900175
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-79001752021-02-24 Cinematic Rendering in Mixed-Reality Holograms: A New 3D Preoperative Planning Tool in Pediatric Heart Surgery Gehrsitz, Pia Rompel, Oliver Schöber, Martin Cesnjevar, Robert Purbojo, Ariawan Uder, Michael Dittrich, Sven Alkassar, Muhannad Front Cardiovasc Med Cardiovascular Medicine Cinematic rendering (CR) is based on a new algorithm that creates a photo-realistic three-dimensional (3D) picture from cross-sectional images. Previous studies have shown its positive impact on preoperative planning. To date, CR presentation has only been possible on 2D screens which limited natural 3D perception. To depict CR-hearts spatially, we used mixed-reality technology and mapped corresponding hearts as holograms in 3D space. Our aim was to assess the benefits of CR-holograms in the preoperative planning of cardiac surgery. Including 3D prints allowed a direct comparison of two spatially resolved display methods. Twenty-six patients were recruited between February and September 2019. CT or MRI was used to visualize the patient's heart preoperatively. The surgeon was shown the anatomy in cross-sections on a 2D screen, followed by spatial representations as a 3D print and as a high-resolution hologram. The holographic representation was carried out using mixed-reality glasses (HoloLens®). To create the 3D prints, corresponding structures were segmented to create STL files which were printed out of resin. In 22 questions, divided in 5 categories (3D-imaging effect, representation of pathology, structure resolution, cost/benefit ratio, influence on surgery), the surgeons compared each spatial representation with the 2D method, using a five-level Likert scale. The surgical preparation time was assessed by comparing retrospectively matched patient pairs, using a paired t-test. CR-holograms surpassed 2D-monitor imaging in all categories. CR-holograms were superior to 3D prints in all categories (mean Likert scale 4.4 ± 1.0 vs. 3.7 ± 1.3, P < 0.05). Compared to 3D prints it especially improved the depth perception (4.7 ± 0.7 vs. 3.7 ± 1.2) and the representation of the pathology (4.4 ± 0.9 vs. 3.6 ± 1.2). 3D imaging reduced the intraoperative preparation time (n = 24, 59 ± 23 min vs. 73 ± 43 min, P < 0.05). In conclusion, the combination of an extremely photo-realistic presentation via cinematic rendering and the spatial presentation in 3D space via mixed-reality technology allows a previously unattained level of comprehension of anatomy and pathology in preoperative planning. Frontiers Media S.A. 2021-02-09 /pmc/articles/PMC7900175/ /pubmed/33634174 http://dx.doi.org/10.3389/fcvm.2021.633611 Text en Copyright © 2021 Gehrsitz, Rompel, Schöber, Cesnjevar, Purbojo, Uder, Dittrich and Alkassar. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Gehrsitz, Pia
Rompel, Oliver
Schöber, Martin
Cesnjevar, Robert
Purbojo, Ariawan
Uder, Michael
Dittrich, Sven
Alkassar, Muhannad
Cinematic Rendering in Mixed-Reality Holograms: A New 3D Preoperative Planning Tool in Pediatric Heart Surgery
title Cinematic Rendering in Mixed-Reality Holograms: A New 3D Preoperative Planning Tool in Pediatric Heart Surgery
title_full Cinematic Rendering in Mixed-Reality Holograms: A New 3D Preoperative Planning Tool in Pediatric Heart Surgery
title_fullStr Cinematic Rendering in Mixed-Reality Holograms: A New 3D Preoperative Planning Tool in Pediatric Heart Surgery
title_full_unstemmed Cinematic Rendering in Mixed-Reality Holograms: A New 3D Preoperative Planning Tool in Pediatric Heart Surgery
title_short Cinematic Rendering in Mixed-Reality Holograms: A New 3D Preoperative Planning Tool in Pediatric Heart Surgery
title_sort cinematic rendering in mixed-reality holograms: a new 3d preoperative planning tool in pediatric heart surgery
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900175/
https://www.ncbi.nlm.nih.gov/pubmed/33634174
http://dx.doi.org/10.3389/fcvm.2021.633611
work_keys_str_mv AT gehrsitzpia cinematicrenderinginmixedrealityhologramsanew3dpreoperativeplanningtoolinpediatricheartsurgery
AT rompeloliver cinematicrenderinginmixedrealityhologramsanew3dpreoperativeplanningtoolinpediatricheartsurgery
AT schobermartin cinematicrenderinginmixedrealityhologramsanew3dpreoperativeplanningtoolinpediatricheartsurgery
AT cesnjevarrobert cinematicrenderinginmixedrealityhologramsanew3dpreoperativeplanningtoolinpediatricheartsurgery
AT purbojoariawan cinematicrenderinginmixedrealityhologramsanew3dpreoperativeplanningtoolinpediatricheartsurgery
AT udermichael cinematicrenderinginmixedrealityhologramsanew3dpreoperativeplanningtoolinpediatricheartsurgery
AT dittrichsven cinematicrenderinginmixedrealityhologramsanew3dpreoperativeplanningtoolinpediatricheartsurgery
AT alkassarmuhannad cinematicrenderinginmixedrealityhologramsanew3dpreoperativeplanningtoolinpediatricheartsurgery