Augmented Reality Image Guidance for Intracranial Catheter Placement

Sunday, May 5, 2024

2:23 PM – 2:25 PM CT

Location: S405a

Presenting Author(s)

Pranish A. Kantak, MD, MPH (he/him/his)

Resident, PGY3
Henry Ford Health System, Department of Neurological Surgery
Detroit, MI, US

Co-Author(s)

SB

Seamus Bartlett, MD

Resident, PGY1
Henry Ford Health System, Department of Neurological Surgery
Detroit, Michigan, United States
Anisse N. Chaker, MD

Resident, PGY3
Henry Ford Health System, Department of Neurological Surgery
Detroit, MI, US
SH

Samuel Harmon, n/a

Undergraduate Student
Michigan State University, United States
Tarek R. Mansour, MD (he/him/his)

Resident, PGY6
Henry Ford Health System, Department of Neurological Surgery
Detroit, MI, US
JP

Jacob Pawloski, MD

Resident, PGY5
Henry Ford Health System, Department of Neurological Surgery
Detroit, Michigan, United States
JR

Jack Rock, MD FACS

Professor
Henry Ford Health System, Department of Neurological Surgery
Detroit, Michigan, United States
LS

Lisa Scarpace, MS

Program Director Hermelin Brain Tumor Center
Henry Ford Health System, Department of Neurological Surgery
Detroit, Michigan, United States
Edvin Telemi, MD

Resident, PGY6
Henry Ford Health System, Department of Neurological Surgery
Detroit, MI, US
SW

Samantha Winslow, MSMS

Simulation Technical Specialist
Henry Ford Health System, Department of Medical Education, United States
HY

Heegook Yeo, MD

Resident, PGY4
Henry Ford Health System, Department of Neurological Surgery
Detroit, Michigan, United States

Disclosure(s):

Pranish A. Kantak, MD, MPH: No financial relationships to disclose

Introduction: Augmented Reality is rapidly emerging as a promising tool in the field of neurosurgery. The accuracy and usability of currently available systems has enabled this technology to serve as an image guidance alternative to traditional navigation.

Methods: A novel Augmented reality system that operates entirely out of the Microsoft Hololens 2 was used. The registration process is markerless (fiducial-less) and is capable of superimposing 3D reconstructed anatomy onto the head in approximately 12 seconds. A cadaver head was CT scanned and intracranial targets we annotated on the resulting CT scan. After registering a 3D model onto the cadaver head, the accuracy of four different targeting methods were evaluated for catheter placement: 1) Freehand, 2) Target points overlaid, 3) Target points + trajectory overlaid and 4) Instrument tracking. Participants used each method to target intracranial locations using a catheter and the targeting accuracy was evaluated based on a post-procedural scan.

Results: The average surface registration accuracy of the AR system was 1.15  0.9 mm and the average registration time was 13.4  1.4 seconds. Following registration participants inserted ventricular catheters towards intracranial targets using four different targeting methods. All AR-guided insertions were significantly more accurate as compared to freehand insertions. Displaying the target point + a trajectory lines yielded the highest accuracy of 3.14  1.65 mm. Finally, a comparison between junior and senior proceduralist demonstrated that while senior proceduralists were significantly more accurate during freehand placement, there was no difference in accuracy between senior and junior proceduralists when the AR system was used.

Conclusion : We evaluated a novel augmented reality system for intracranial catheter targeting. Despite ongoing work to improve the technology, the system demonstrated clinically acceptable registration and targeting accuracy . The accuracy of the system combined with its speed and small footprint make it a promising image guidance solution for procedures that are not typically performed with navigation.