Targeting accuracy of neuronavigation: a comparative evaluation of an innovative wearable AR platform vs. traditional EM navigation

Wearable augmented reality in neurosurgery offers significant advantages by enabling the visualization of navigation information directly on the patient, seamlessly integrating virtual data with the real surgical field. This ergonomic approach can facilitate a more intuitive understanding of spatial...

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Main Authors: Marina Carbone, Nicola Montemurro, Nadia Cattari, Martina Autelitano, Fabrizio Cutolo, Vincenzo Ferrari, Emanuele Cigna, Sara Condino
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Digital Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fdgth.2024.1500677/full
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author Marina Carbone
Marina Carbone
Nicola Montemurro
Nicola Montemurro
Nadia Cattari
Nadia Cattari
Martina Autelitano
Martina Autelitano
Fabrizio Cutolo
Fabrizio Cutolo
Vincenzo Ferrari
Vincenzo Ferrari
Emanuele Cigna
Emanuele Cigna
Sara Condino
Sara Condino
author_facet Marina Carbone
Marina Carbone
Nicola Montemurro
Nicola Montemurro
Nadia Cattari
Nadia Cattari
Martina Autelitano
Martina Autelitano
Fabrizio Cutolo
Fabrizio Cutolo
Vincenzo Ferrari
Vincenzo Ferrari
Emanuele Cigna
Emanuele Cigna
Sara Condino
Sara Condino
author_sort Marina Carbone
collection DOAJ
description Wearable augmented reality in neurosurgery offers significant advantages by enabling the visualization of navigation information directly on the patient, seamlessly integrating virtual data with the real surgical field. This ergonomic approach can facilitate a more intuitive understanding of spatial relationships and guidance cues, potentially reducing cognitive load and enhancing the accuracy of surgical gestures by aligning critical information with the actual anatomy in real-time. This study evaluates the benefits of a novel AR platform, VOSTARS, by comparing its targeting accuracy to that of the gold-standard electromagnetic (EM) navigation system, Medtronic StealthStation® S7®. Both systems were evaluated in phantom and human studies. In the phantom study, participants targeted 13 predefined landmarks using identical pointers to isolate system performance. In the human study, three facial landmarks were targeted in nine volunteers post-brain tumor surgery. The performance of the VOSTARS system was superior to that of the standard neuronavigator in both the phantom and human studies. In the phantom study, users achieved a median accuracy of 1.4 mm (IQR: 1.2 mm) with VOSTARS compared to 2.9 mm (IQR: 1.4 mm) with the standard neuronavigator. In the human study, the median targeting accuracy with VOSTARS was significantly better for selected landmarks in the outer eyebrow (3.7 mm vs. 6.6 mm, p = 0.05) and forehead (4.5 mm vs. 6.3 mm, p = 0.021). Although the difference for the pronasal point was not statistically significant (2.7 mm vs. 3.5 mm, p = 0.123), the trend towards improved accuracy with VOSTARS is clear. These findings suggest that the proposed AR technology has the potential to significantly improve surgical outcomes in neurosurgery.
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spelling doaj-art-35069a7b0f384d4a80d109c01ff4ece92025-01-14T06:10:45ZengFrontiers Media S.A.Frontiers in Digital Health2673-253X2025-01-01610.3389/fdgth.2024.15006771500677Targeting accuracy of neuronavigation: a comparative evaluation of an innovative wearable AR platform vs. traditional EM navigationMarina Carbone0Marina Carbone1Nicola Montemurro2Nicola Montemurro3Nadia Cattari4Nadia Cattari5Martina Autelitano6Martina Autelitano7Fabrizio Cutolo8Fabrizio Cutolo9Vincenzo Ferrari10Vincenzo Ferrari11Emanuele Cigna12Emanuele Cigna13Sara Condino14Sara Condino15Department of Information Engineering, University of Pisa, Pisa, ItalyEndoCAS Interdipartimental Center, University of Pisa, Pisa, ItalyEndoCAS Interdipartimental Center, University of Pisa, Pisa, ItalyDepartment of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, ItalyDepartment of Information Engineering, University of Pisa, Pisa, ItalyEndoCAS Interdipartimental Center, University of Pisa, Pisa, ItalyEndoCAS Interdipartimental Center, University of Pisa, Pisa, ItalyDepartment of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, ItalyDepartment of Information Engineering, University of Pisa, Pisa, ItalyEndoCAS Interdipartimental Center, University of Pisa, Pisa, ItalyDepartment of Information Engineering, University of Pisa, Pisa, ItalyEndoCAS Interdipartimental Center, University of Pisa, Pisa, ItalyEndoCAS Interdipartimental Center, University of Pisa, Pisa, ItalyDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, ItalyDepartment of Information Engineering, University of Pisa, Pisa, ItalyEndoCAS Interdipartimental Center, University of Pisa, Pisa, ItalyWearable augmented reality in neurosurgery offers significant advantages by enabling the visualization of navigation information directly on the patient, seamlessly integrating virtual data with the real surgical field. This ergonomic approach can facilitate a more intuitive understanding of spatial relationships and guidance cues, potentially reducing cognitive load and enhancing the accuracy of surgical gestures by aligning critical information with the actual anatomy in real-time. This study evaluates the benefits of a novel AR platform, VOSTARS, by comparing its targeting accuracy to that of the gold-standard electromagnetic (EM) navigation system, Medtronic StealthStation® S7®. Both systems were evaluated in phantom and human studies. In the phantom study, participants targeted 13 predefined landmarks using identical pointers to isolate system performance. In the human study, three facial landmarks were targeted in nine volunteers post-brain tumor surgery. The performance of the VOSTARS system was superior to that of the standard neuronavigator in both the phantom and human studies. In the phantom study, users achieved a median accuracy of 1.4 mm (IQR: 1.2 mm) with VOSTARS compared to 2.9 mm (IQR: 1.4 mm) with the standard neuronavigator. In the human study, the median targeting accuracy with VOSTARS was significantly better for selected landmarks in the outer eyebrow (3.7 mm vs. 6.6 mm, p = 0.05) and forehead (4.5 mm vs. 6.3 mm, p = 0.021). Although the difference for the pronasal point was not statistically significant (2.7 mm vs. 3.5 mm, p = 0.123), the trend towards improved accuracy with VOSTARS is clear. These findings suggest that the proposed AR technology has the potential to significantly improve surgical outcomes in neurosurgery.https://www.frontiersin.org/articles/10.3389/fdgth.2024.1500677/fullneuronavigationaugmented reality navigationtargeting accuracyhead mounted displaysneurosurgerysurgical navigation
spellingShingle Marina Carbone
Marina Carbone
Nicola Montemurro
Nicola Montemurro
Nadia Cattari
Nadia Cattari
Martina Autelitano
Martina Autelitano
Fabrizio Cutolo
Fabrizio Cutolo
Vincenzo Ferrari
Vincenzo Ferrari
Emanuele Cigna
Emanuele Cigna
Sara Condino
Sara Condino
Targeting accuracy of neuronavigation: a comparative evaluation of an innovative wearable AR platform vs. traditional EM navigation
Frontiers in Digital Health
neuronavigation
augmented reality navigation
targeting accuracy
head mounted displays
neurosurgery
surgical navigation
title Targeting accuracy of neuronavigation: a comparative evaluation of an innovative wearable AR platform vs. traditional EM navigation
title_full Targeting accuracy of neuronavigation: a comparative evaluation of an innovative wearable AR platform vs. traditional EM navigation
title_fullStr Targeting accuracy of neuronavigation: a comparative evaluation of an innovative wearable AR platform vs. traditional EM navigation
title_full_unstemmed Targeting accuracy of neuronavigation: a comparative evaluation of an innovative wearable AR platform vs. traditional EM navigation
title_short Targeting accuracy of neuronavigation: a comparative evaluation of an innovative wearable AR platform vs. traditional EM navigation
title_sort targeting accuracy of neuronavigation a comparative evaluation of an innovative wearable ar platform vs traditional em navigation
topic neuronavigation
augmented reality navigation
targeting accuracy
head mounted displays
neurosurgery
surgical navigation
url https://www.frontiersin.org/articles/10.3389/fdgth.2024.1500677/full
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