Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study

Kwok Chuen Wong,1 Edgar Yan Sun,2 Irene Oi Ling Wong,3 Shekhar Madhukar Kumta4 1Orthopaedic Oncology, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong SAR, People’s Republic of China; 2Independent Contractor, Hong Kong SAR, People’...

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Main Authors: Wong KC, Sun EY, Wong IOL, Kumta SM
Format: Article
Language:English
Published: Dove Medical Press 2023-07-01
Series:Orthopedic Research and Reviews
Subjects:
Online Access:https://www.dovepress.com/mixed-reality-improves-3d-visualization-and-spatial-awareness-of-bone--peer-reviewed-fulltext-article-ORR
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author Wong KC
Sun EY
Wong IOL
Kumta SM
author_facet Wong KC
Sun EY
Wong IOL
Kumta SM
author_sort Wong KC
collection DOAJ
description Kwok Chuen Wong,1 Edgar Yan Sun,2 Irene Oi Ling Wong,3 Shekhar Madhukar Kumta4 1Orthopaedic Oncology, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong SAR, People’s Republic of China; 2Independent Contractor, Hong Kong SAR, People’s Republic of China; 3School of Public Health, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, People’s Republic of China; 4Northern Health Precinct and Department of Surgery, The University of Melbourne, The Northern Hospital, Melbourne, VIC, AustraliaCorrespondence: Kwok Chuen Wong, Orthopaedic Oncology, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, the Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR, People’s Republic of China, Email skcwong@cuhk.edu.hkIntroduction: In orthopedic oncology, computer navigation and 3D-printed guides facilitate precise osteotomies only after surgical exposure. Before surgeries start, it is challenging to mentally process and superimpose the virtual medical images onto patients’ anatomy for preoperative surgical planning. Mixed Reality (MR) is an immersive technology merging real and virtual worlds, and users can interact with digital objects in real time. Through Head-Mounted Displays, surgeons directly visualize holographic models that overlaid on tumor patients. The technology may facilitate surgical planning before skin incisions.Methods: Nine bone tumor patients were included (July 2021 – Dec 2022). There were six primary bone sarcomas, two benign bone tumors, and one revision pelvic prosthesis. MR applications were created using patients’ preoperative medical images. The surgeon examined each patient clinically using the conventional method of viewing 2D images and MR via HMD, Hololens 2. A Likert-Scale (LS) questionnaire and The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score were used to evaluate and compare the effectiveness of surgical planning and the surgeon’s clinical cognitive workload for the two methods.Results: The qualitative survey of the LS questionnaire suggested that the MR group had superior spatial awareness of tumors and was considered more effective as a preoperative planning tool than the conventional group. For NASA-TLX scores, the overall cognitive workload was lower in MR 3D hologram group than in the 2D Group for preoperative clinical assessment. When using MR technology with HMDs, the surgeon reported no discomfort.Conclusion: MR technology may improve 3D visualization and spatial awareness of bone tumors in patients’ anatomies and may facilitate surgical planning before skin incisions in orthopedic oncology surgery. With less cognitive load and better ergonomics, surgeons can focus on patients and surgical tasks with MR technology. Further studies must investigate whether MR technology improves clinical outcomes.Keywords: mixed reality, holograms, spatial awareness, computer navigation, 3D printing
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spelling doaj.art-747d14faaf294ec79993c460d13d0fcc2023-08-01T19:38:38ZengDove Medical PressOrthopedic Research and Reviews1179-14622023-07-01Volume 1513914985555Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept StudyWong KCSun EYWong IOLKumta SMKwok Chuen Wong,1 Edgar Yan Sun,2 Irene Oi Ling Wong,3 Shekhar Madhukar Kumta4 1Orthopaedic Oncology, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong SAR, People’s Republic of China; 2Independent Contractor, Hong Kong SAR, People’s Republic of China; 3School of Public Health, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, People’s Republic of China; 4Northern Health Precinct and Department of Surgery, The University of Melbourne, The Northern Hospital, Melbourne, VIC, AustraliaCorrespondence: Kwok Chuen Wong, Orthopaedic Oncology, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, the Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR, People’s Republic of China, Email skcwong@cuhk.edu.hkIntroduction: In orthopedic oncology, computer navigation and 3D-printed guides facilitate precise osteotomies only after surgical exposure. Before surgeries start, it is challenging to mentally process and superimpose the virtual medical images onto patients’ anatomy for preoperative surgical planning. Mixed Reality (MR) is an immersive technology merging real and virtual worlds, and users can interact with digital objects in real time. Through Head-Mounted Displays, surgeons directly visualize holographic models that overlaid on tumor patients. The technology may facilitate surgical planning before skin incisions.Methods: Nine bone tumor patients were included (July 2021 – Dec 2022). There were six primary bone sarcomas, two benign bone tumors, and one revision pelvic prosthesis. MR applications were created using patients’ preoperative medical images. The surgeon examined each patient clinically using the conventional method of viewing 2D images and MR via HMD, Hololens 2. A Likert-Scale (LS) questionnaire and The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score were used to evaluate and compare the effectiveness of surgical planning and the surgeon’s clinical cognitive workload for the two methods.Results: The qualitative survey of the LS questionnaire suggested that the MR group had superior spatial awareness of tumors and was considered more effective as a preoperative planning tool than the conventional group. For NASA-TLX scores, the overall cognitive workload was lower in MR 3D hologram group than in the 2D Group for preoperative clinical assessment. When using MR technology with HMDs, the surgeon reported no discomfort.Conclusion: MR technology may improve 3D visualization and spatial awareness of bone tumors in patients’ anatomies and may facilitate surgical planning before skin incisions in orthopedic oncology surgery. With less cognitive load and better ergonomics, surgeons can focus on patients and surgical tasks with MR technology. Further studies must investigate whether MR technology improves clinical outcomes.Keywords: mixed reality, holograms, spatial awareness, computer navigation, 3D printinghttps://www.dovepress.com/mixed-reality-improves-3d-visualization-and-spatial-awareness-of-bone--peer-reviewed-fulltext-article-ORRmixed realityhologramsspatial awarenesscomputer navigation3d printing
spellingShingle Wong KC
Sun EY
Wong IOL
Kumta SM
Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
Orthopedic Research and Reviews
mixed reality
holograms
spatial awareness
computer navigation
3d printing
title Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title_full Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title_fullStr Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title_full_unstemmed Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title_short Mixed Reality Improves 3D Visualization and Spatial Awareness of Bone Tumors for Surgical Planning in Orthopaedic Oncology: A Proof of Concept Study
title_sort mixed reality improves 3d visualization and spatial awareness of bone tumors for surgical planning in orthopaedic oncology a proof of concept study
topic mixed reality
holograms
spatial awareness
computer navigation
3d printing
url https://www.dovepress.com/mixed-reality-improves-3d-visualization-and-spatial-awareness-of-bone--peer-reviewed-fulltext-article-ORR
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