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Augmented reality with Microsoft Hololens as a method for neurosurgical navigation
Author(s): ,
J. Duerinck
Affiliations:
UZ Brussel, Neurosurgery, Brussels, Belgium
,
T. Frantz
Affiliations:
VUB, ETRO, Brussels, Belgium
,
J. Vandemeulebroucke
Affiliations:
VUB, ETRO, Brussels, Belgium
,
B. Jansen
Affiliations:
VUB, ETRO, Brussels, Belgium
,
T. Scheerlinck
Affiliations:
Uz Brussel, Orthopedics, Brussels, Belgium
V. Van Velthoven
Affiliations:
Uz Brussel, Neurosurgery, Brussels, Belgium
EANS Academy. Duerinck J. Oct 21, 2018; 225747; EP12036
Johnny Duerinck
Johnny Duerinck
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Abstract
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Introduction
Neuronavigation has revolutionized the way neurosurgery is practiced, but it is not without its limitations. Augmented reality has the potential to solve many issues with current forms of neuronavigation by making the navigating procedure more visual and intuitive.

Materials and methods
As a combined effort between the informatics and engineering departments of the VUB and clinical departments of neurosurgery and orthopedic surgery of Uz Brussel, we have set up a project called SARA (Surgical Augmented Reality-Assistance). The goal is to develop software running on a head-mounted augmented reality display (Microsoft Hololens) providing the surgeon with anatomical information on the patient before him, as well as additional useful planning information such as angles, trajectories, etc. This software is now usable as a proof of concept. Accuracy testing is performed on a phantom, looking at accuracy of placement of 3d holographic objects (segmented from CT images) in 3d space using different settings of the device, different algorithms and registration methods.

Results
The current state of the software shows the significant potential of this application in the clinical setting will be demoed during the presentation. Accuracy testing shows that, using one-time manual registration and relying on spatial mapping for stability, discrepancy between the physical object and the hologram varies between 0 and 26mm (X,Y,Z measured as well as on-surface distances) and is maximal at a 90° angle compared to the registration position.

Conclusion
Augmented Reality will imply a radical change in the way neurosurgery is performed. Simple interventions that are often performed free-hand but have a significant chance of error (such as drain placement) but also more complex surgical procedures could be performed under direct visual control of all relevant anatomy. Further work is being performed in our lab, optimizing registration quality and algorithms, to obtain more accurate tracking of the subject.
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