Evaluation of the accuracy of an augmented reality-based tumor-targeting guide for breast-conserving surgery

Junhyeok Ock; Sojin Moon; MinKyeong Kim; Beom Seok Ko; Namkug Kim

doi:10.1016/j.cmpb.2023.108002

Evaluation of the accuracy of an augmented reality-based tumor-targeting guide for breast-conserving surgery

Comput Methods Programs Biomed. 2024 Mar:245:108002. doi: 10.1016/j.cmpb.2023.108002. Epub 2023 Dec 29.

Authors

Junhyeok Ock¹, Sojin Moon¹, MinKyeong Kim¹, Beom Seok Ko², Namkug Kim³

Affiliations

¹ Department of Convergence Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap2-dong, Songpa-gu, Seoul, South Korea.
² Department of Breast Surgery, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap2-dong, Songpa-gu, Seoul, South Korea.
³ Department of Convergence Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap2-dong, Songpa-gu, Seoul, South Korea; Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap2-dong, Songpa-gu, Seoul, South Korea. Electronic address: namkugkim@gmail.com.

PMID: 38215659
DOI: 10.1016/j.cmpb.2023.108002

Abstract

Background and objectives: Although magnetic resonance imaging (MRI) is commonly used for breast tumor detection, significant challenges remain in determining and presenting the three-dimensional (3D) morphology of tumors to guide breast-conserving surgery. To address this challenge, we have developed the augmented reality-breast surgery guide (AR-BSG) and compared its performance with that of a traditional 3D-printed breast surgical guide (3DP-BSG).

Methods: Based on the MRI results of a breast cancer patient, a breast phantom made of skin, body, and tumor was fabricated through 3D printing and silicone-casting. AR-BSG and 3DP-BSG were executed using surgical plans based on the breast phantom's computed tomography scan images. Three operators independently inserted a catheter into the phantom using each guide. Their targeting accuracy was then evaluated using Bland-Altman analysis with limits of agreement (LoA). Differences between the users of each guide were evaluated using the intraclass correlation coefficient (ICC).

Results: The entry and end point errors associated with AR-BSG were -0.34±0.68 mm (LoA: -1.71-1.01 mm) and 0.81±1.88 mm (LoA: -4.60-3.00 mm), respectively, whereas 3DP-BSG was associated with entry and end point errors of -0.28±0.70 mm (LoA: -1.69-1.11 mm) and -0.62±1.24 mm (LoA: -3.00-1.80 mm), respectively. The AR-BSG's entry and end point ICC values were 0.99 and 0.97, respectively, whereas 3DP-BSG was associated with entry and end point ICC values of 0.99 and 0.99, respectively.

Conclusions: AR-BSG can consistently and accurately localize tumor margins for surgeons without inferior guiding accuracy AR-BSG can consistently and accurately localize tumor margins for surgeons without inferior guiding accuracy compared to 3DP-BSG. Additionally, when compared with 3DP-BSG, AR-BSG can offer better spatial perception and visualization, lower costs, and a shorter setup time.

Keywords: 3D printing guide; Augmented reality guide; Breast cancer; Breast conservation surgery; Phantom study; Surgical planning.

MeSH terms

Augmented Reality*
Breast Neoplasms* / diagnostic imaging
Breast Neoplasms* / surgery
Female
Humans
Imaging, Three-Dimensional / methods
Mastectomy, Segmental
Phantoms, Imaging
Printing, Three-Dimensional
Surgery, Computer-Assisted* / methods
Tomography, X-Ray Computed / methods