Three-Dimensional Augmented Reality Visualization Informs Locoregional Therapy in a Translational Model of Hepatocellular Carcinoma |
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Affiliation: | 1. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 646 BRB II/III, 421 Curie Blvd., Philadelphia, PA 19104;2. Medivis, Brooklyn, New York;1. Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Dr B1D502, Ann Arbor, MI 48109-5030;2. Division of Vascular and Interventional Radiology, Department of Radiology, Stanford University Medical Center, Stanford, California;3. Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio;1. Department of Vascular Surgery, Beijing Chaoyang Hospital, Capital Medical University, Gongren Tiyuchang Nanlu, Beijing 100020, China;2. Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China;1. Department of Radiology, Penn Image-Guided Interventions Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;2. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;3. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;4. Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;1. Department of Radiology, Ronald Reagan-University of California Los Angeles Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California;2. Department of Urology, Ronald Reagan-University of California Los Angeles Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California;3. Department of Bioinformatics, University of California Los Angeles Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California |
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Abstract: | PurposeTo evaluate the utility of visualizing preprocedural MR images in 3-dimensional (3D) space using augmented reality (AR) before transarterial embolization of hepatocellular carcinoma (HCC) in a preclinical model.Materials and MethodsA total of 28 rats with diethylnitrosamine-induced HCCs > 5 mm treated with embolization were included in a prospective study. In 12 rats, 3D AR visualization of preprocedural MR images was performed before embolization. Procedural metrics including catheterization time and radiation exposure were compared vs a prospective cohort of 16 rats in which embolization was performed without AR. An additional cohort of 15 retrospective cases was identified and combined with the prospective control cohort (n = 31) to improve statistical power.ResultsA 37% reduction in fluoroscopy time, from 11.7 min to 7.4 minutes, was observed with AR when compared prospectively, which did not reach statistical significance (P = .12); however, when compared with combined prospective and retrospective controls, the reduction in fluoroscopy time from 14.1 min to 7.4 minutes (48%) was significant (P = .01). A 27% reduction in total catheterization time, from 42.7 minutes to 31.0 minutes, was also observed with AR when compared prospectively, which did not reach statistical significance (P = .11). No significant differences were seen in dose–area product or air kerma prospectively.ConclusionsThree-dimensional AR visualization of preprocedural imaging may aid in the reduction of procedural metrics in a preclinical model of transarterial embolization. These data support the need for further studies to evaluate the potential of AR in endovascular oncologic interventions. |
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