Augmented and Virtual Reality Radiology at the Center of Medical Technology – Diagnostic Imaging

Augmented and virtual reality are among some of the newest technologies to reach a sophistication viable for medical use. Augmented reality (AR) is the integration of virtual components onto the background of reality, while virtual reality (VR) is a complete and isolated virtual display.

The most popular utilization of AR and VR is in entertainment devices, such as video games, but the versatility and responsiveness of the technologies have allowed for exciting developments in healthcare, as well. In some ways, it can be said that interventional radiologists have been using these techniques for their entire existence. In essence, anytime a fluoroscopic projection is used during a procedure, that is technically an augmentation of reality used to help visualize internal structures in real time.

Utilizing recent AR and VR technological advances, radiographic data can now be used to create a display with more integration and interaction. In addition to its utility in image-guided procedures, AR and VR have also found niche roles in the education of trainees and for direct benefits to patients, as well, though the technology is not without its drawbacks.

One of the most promising uses of AR technology, specifically, is procedural planning and guidance. In the operating room, AR displays are generated using advanced algorithms that interpret CT data into a 3D map of structures delineated by density (Tang et al.). This map can, then, be displayed in several ways, such as on a screen nearby, through a headset, or projected onto the patient themselves depending on the needs of the procedure. Then, a plan can be drawn onto the augmented surgical field before the first cut.

Not only can structures, such as vessels and tumors, be overlaid onto a display of the surgical field, but organ movements and deformations can be accounted for in real time to update the display. This gives some compensation for the lack of tactile feedback during laparoscopic procedures and allows for a better real-time visualization of underlying structures. Tang and colleagues demonstrated the value of these displays for hepatobiliary surgery, but these techniques can be applied to just about any surgical procedure that can be planned far enough in advance.

AR projectors can already integrate navigation aids in MRI-guided procedures to assist in carrying out the procedure such as Mewes et al. describes. Wherever radiographic information exists before or during a procedure, AR stands to improve the integration of that information in the OR, and radiologists are the gatekeepers of this technology with their knowledge of medical informatics and mastery of radiologic anatomy.

With AR and VR already in the public consciousness as powerful tools of media consumption, it should come as no surprise that they have been quickly modified to work as compelling interactive forms of education. Progress has been made in developing AR tools for the advance of tele-mentoring, the use of displays to mentor trainees at long distance (Andersen et al.). AR allows for mentors to annotate directly on the students display so the trainee is no longer required to shift attention between a separate screen and their work and the training procedure can be done collaboratively. This system would also allow a more experienced interventional radiologist or surgeon to assist one doing an unfamiliar procedure without the need for transportation of the expert to the patient.

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Augmented and Virtual Reality Radiology at the Center of Medical Technology - Diagnostic Imaging