P04.17 Novel augmented reality-based neuronavigation using smart glasses and clinical application to brain tumor surgery
K. Maruyama, Eiju Watanabe, K. Saito, K. Sato, H. Yoshida, S. Kume, Akio Noguchi, Yoshiaki Shiokawa, Motoo Nagane · Neuro-Oncology · 2017
Introduction: Smart glasses became commercially available recently, and can overlay data onto the sight through the lenses. Its clinical application for surgical navigation has never been reported so far. Materials and Methods: Smart glasses Epson Moverio BT-200 were applied for newly developed augmented reality-based neuronavigation, which overlays 3D images onto the video image of patient’s head, in two phantom heads and four patients with brain tumors (2 gliomas, 1 meningioma, 1 hemangioblastoma). Two phantom heads were created from a 3D printer XYZ printer. Three-dimensional computer graphics of the scalp, the brain, the brain tumors, and surrounding vascular structures were created from preoperative imaging studies by using the visualization software Amira. They were visualized through the glasses after registration based on a set of four markers. After measurement of accuracy, this technique was applied to four patients. Results: Image overlay through the smart glasses was successful in all the two phantom heads and four patients. By using 100 target points from phantoms (5 targets in 5 measurements for 4 sides), a mean preparatory targeting error was 1.9 mm with a standard deviation of 1.1 mm. A targeting error during the intraoperative visualization was 3 to 7 mm. All the tumors were totally removed successively, and the patients suffered no postoperative complications. Conclusions: Overlay of the three-dimensional computer graphics through the smart glasses provided clear and accurate localization of the targeted brain tumors by relatively simple procedure during the operation. Further improvement of accuracy is also underway.