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      Development of an augmented reality guidance system for head and neck cancer resection

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          Abstract

          The use of head‐mounted augmented reality (AR) for surgeries has grown rapidly in recent years. AR aids in intraoperative surgical navigation through overlaying three‐dimensional (3D) holographic reconstructions of medical data. However, performing AR surgeries on complex areas such as the head and neck region poses challenges in terms of accuracy and speed. This study explores the feasibility of an AR guidance system for resections of positive tumour margins in a cadaveric specimen. The authors present an intraoperative solution that enables surgeons to upload and visualize holographic reconstructions of resected cadaver tissues. The solution involves using a 3D scanner to capture detailed scans of the resected tissue, which are subsequently uploaded into our software. The software converts the scans of resected tissues into specimen holograms that are viewable through a head‐mounted AR display. By re‐aligning these holograms with cadavers with gestures or voice commands, surgeons can navigate the head and neck tumour site. This workflow can run concurrently with frozen section analysis. On average, the authors achieve an uploading time of 2.98 min, visualization time of 1.05 min, and re‐alignment time of 4.39 min, compared to the 20 to 30 min typical for frozen section analysis. The authors achieve a mean re‐alignment error of 3.1 mm. The authors’ software provides a foundation for new research and product development for using AR to navigate complex 3D anatomy in surgery.

          Abstract

          This study explores the feasibility of an augmented reality guidance system for resections of positive tumour margins in a cadaveric specimen. The authors present an intraoperative solution that enables surgeons to upload and visualize holographic reconstructions of resected cadaver tissues.

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          Most cited references30

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          Positive Surgical Margins in the 10 Most Common Solid Cancers

          A positive surgical margin (PSM) following cancer resection oftentimes necessitates adjuvant treatments and carries significant financial and prognostic implications. We sought to compare PSM rates for the ten most common solid cancers in the United States, and to assess trends over time. Over 10 million patients were identified in the National Cancer Data Base from 1998–2012, and 6.5 million had surgical margin data. PSM rates were compared between two time periods, 1998–2002 and 2008–2012. PSM was positively correlated with tumor category and grade. Ovarian and prostate cancers had the highest PSM prevalence in women and men, respectively. The highest PSM rates for cancers affecting both genders were seen for oral cavity tumors. PSM rates for breast cancer and lung and bronchus cancer in both men and women declined over the study period. PSM increases were seen for bladder, colon and rectum, and kidney and renal pelvis cancers. This large-scale analysis appraises the magnitude of PSM in the United States in order to focus future efforts on improving oncologic surgical care with the goal of optimizing value and improving patient outcomes.
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            Virtual, augmented, and mixed reality applications in orthopedic surgery

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              Augmented reality in neurosurgery

              Neurosurgery is a medical specialty that relies heavily on imaging. The use of computed tomography and magnetic resonance images during preoperative planning and intraoperative surgical navigation is vital to the success of the surgery and positive patient outcome. Augmented reality application in neurosurgery has the potential to revolutionize and change the way neurosurgeons plan and perform surgical procedures in the future. Augmented reality technology is currently commercially available for neurosurgery for simulation and training. However, the use of augmented reality in the clinical setting is still in its infancy. Researchers are now testing augmented reality system prototypes to determine and address the barriers and limitations of the technology before it can be widely accepted and used in the clinical setting.
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                Author and article information

                Contributors
                guansen.tong@vanderbilt.edu
                jiayi.xu.1@vanderbilt.edu
                Journal
                Healthc Technol Lett
                Healthc Technol Lett
                10.1049/(ISSN)2053-3713
                HTL2
                Healthcare Technology Letters
                John Wiley and Sons Inc. (Hoboken )
                2053-3713
                07 December 2023
                Apr-Jun 2024
                : 11
                : 2-3 , Special Issue: Papers from the 17th Joint Workshop on Augmented Environments for Computer Assisted Interventions at MICCAI 2023 ( doiID: 10.1049/htl2.v11.2-3 )
                : 93-100
                Affiliations
                [ 1 ] Computer Science Department Vanderbilt University Nashville Tennessee USA
                [ 2 ] Vanderbilt University Medical Center Nashville Tennessee USA
                Author notes
                [*] [* ] Correspondence

                Guansen Tong and Jiayi Xu, Computer Science Department, Vanderbilt University, Nashville, Tennessee, USA.

                Email: guansen.tong@ 123456vanderbilt.edu and jiayi.xu.1@ 123456vanderbilt.edu

                Author information
                https://orcid.org/0000-0002-5370-6192
                https://orcid.org/0009-0006-6108-1117
                Article
                HTL212062
                10.1049/htl2.12062
                11022213
                38638497
                82da964e-d5d1-47b6-b1d8-93485c325fc2
                © 2023 The Authors. Healthcare Technology Letters published by John Wiley & Sons Ltd on behalf of The Institution of Engineering and Technology.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 November 2023
                : 22 November 2023
                Page count
                Figures: 4, Tables: 3, Pages: 8, Words: 5656
                Funding
                Funded by: Vanderbilt Clinical Oncology Research Career Development Program
                Award ID: K12 NCI 2K12CA090625‐22A1
                Funded by: American Cancer Society Institutional Research Grant
                Award ID: #IRG‐19‐139‐60
                Categories
                Letter
                Letters
                Custom metadata
                2.0
                April-June 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.0 mode:remove_FC converted:17.04.2024

                augmented reality,surgery
                augmented reality, surgery

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