Comparing Computed Tomography-Derived Augmented Reality Holograms to a Standard Picture Archiving and Communication Systems Viewer for Presurgical Planning: Feasibility Study

David Dallas-Orr; Yordan Penev; Robert Schultz; Jesse Courtier

doi:10.2196/18367

Comparing Computed Tomography-Derived Augmented Reality Holograms to a Standard Picture Archiving and Communication Systems Viewer for Presurgical Planning: Feasibility Study

JMIR Perioper Med. 2020 Sep 24;3(2):e18367. doi: 10.2196/18367.

Authors

David Dallas-Orr^#^{1

2}, Yordan Penev^#^{1

2}, Robert Schultz^{1

2}, Jesse Courtier^{3

4}

Affiliations

¹ Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, United States.
² Department of Bioengineering, University of California, Berkeley, Berkeley, CA, United States.
³ Department of Radiology, Mission Bay Hospital, University of California, San Francisco, San Francisco, CA, United States.
⁴ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.

^# Contributed equally.

PMID: 33393933
PMCID: PMC7709855
DOI: 10.2196/18367

Abstract

Background: Picture archiving and communication systems (PACS) are ubiquitously used to store, share, and view radiological information for preoperative planning across surgical specialties. Although traditional PACS software has proven reliable in terms of display accuracy and ease of use, it remains limited by its inherent representation of medical imaging in 2 dimensions. Augmented reality (AR) systems present an exciting opportunity to complement traditional PACS capabilities.

Objective: This study aims to evaluate the technical feasibility of using a novel AR platform, with holograms derived from computed tomography (CT) imaging, as a supplement to traditional PACS for presurgical planning in complex surgical procedures.

Methods: Independent readers measured objects of predetermined, anthropomorphically correlated sizes using the circumference and angle tools of standard-of-care PACS software and a newly developed augmented reality presurgical planning system (ARPPS).

Results: Measurements taken with the standard PACS and the ARPPS showed no statistically significant differences. Bland-Altman analysis showed a mean difference of 0.08% (95% CI -4.20% to 4.36%) for measurements taken with PACS versus ARPPS' circumference tools and -1.84% (95% CI -6.17% to 2.14%) for measurements with the systems' angle tools. Lin's concordance correlation coefficients were 1.00 and 0.98 for the circumference and angle measurements, respectively, indicating almost perfect strength of agreement between ARPPS and PACS. Intraclass correlation showed no statistically significant difference between the readers for either measurement tool on each system.

Conclusions: ARPPS can be an effective, accurate, and precise means of 3D visualization and measurement of CT-derived holograms in the presurgical care timeline.

Keywords: augmented reality; medical imaging; mixed reality; new technology evaluation; picture archiving and communication system; presurgical planning; surgery.

©David Dallas-Orr, Yordan Penev, Robert Schultz, Jesse Courtier. Originally published in JMIR Perioperative Medicine (http://periop.jmir.org), 24.09.2020.