Elsevier

World Neurosurgery

Volume 87, March 2016, Pages 399-405
World Neurosurgery

Original Article
The Trans-Visible Navigator: A See-Through Neuronavigation System Using Augmented Reality

https://doi.org/10.1016/j.wneu.2015.11.084Get rights and content
Under a Creative Commons license
open access

Introduction

The neuronavigator has become indispensable for brain surgery and works in the manner of point-to-point navigation. Because the positional information is indicated on a personal computer (PC) monitor, surgeons are required to rotate the dimension of the magnetic resonance imaging/computed tomography scans to match the surgical field. In addition, they must frequently alternate their gaze between the surgical field and the PC monitor.

Objective

To overcome these difficulties, we developed an augmented reality-based navigation system with whole-operation-room tracking.

Methods

A tablet PC is used for visualization. The patient's head is captured by the back-face camera of the tablet. Three-dimensional images of intracranial structures are extracted from magnetic resonance imaging/computed tomography and are superimposed on the video image of the head. When viewed from various directions around the head, intracranial structures are displayed with corresponding angles as viewed from the camera direction, thus giving the surgeon the sensation of seeing through the head. Whole-operation-room tracking is realized using a VICON tracking system with 6 cameras.

Results

A phantom study showed a spatial resolution of about 1 mm. The present system was evaluated in 6 patients who underwent tumor resection surgery, and we showed that the system is useful for planning skin incisions as well as craniotomy and the localization of superficial tumors.

Conclusions

The main advantage of the present system is that it achieves volumetric navigation in contrast to conventional point-to-point navigation. It extends augmented reality images directly onto real surgical images, thus helping the surgeon to integrate these 2 dimensions intuitively.

Key words

Augmented reality
Motion capture
Navigator
Tablet PC

Abbreviations and Acronyms

3D
Three-dimensional
AR
Augmented reality
CT
Computed tomography
HMD
Head-mounted display
MRI
Magnetic resonance imaging
PC
Personal computer
SD
Standard deviation
TVN
Trans-Visible Navigation

Cited by (0)

Conflict of interest statement: The present device was manufactured by the authors without financial support by any industry.

Supplementary digital content available online.