Abstract
Purpose
The aim of this report is to present a prototype augmented reality (AR) intra-operative brain imaging system. We present our experience of using this new neuronavigation system in neurovascular surgery and discuss the feasibility of this technology for aneurysms, arteriovenous malformations (AVMs), and arteriovenous fistulae (AVFs).
Methods
We developed an augmented reality system that uses an external camera to capture the live view of the patient on the operating room table and to merge this view with pre-operative volume-rendered vessels. We have extensively tested the system in the laboratory and have used the system in four surgical cases: one aneurysm, two AVMs and one AVF case.
Results
The developed AR neuronavigation system allows for precise patient-to-image registration and calibration of the camera, resulting in a well-aligned augmented reality view. Initial results suggest that augmented reality is useful for tailoring craniotomies, localizing vessels of interest, and planning resection corridors.
Conclusion
Augmented reality is a promising technology for neurovascular surgery. However, for more complex anomalies such as AVMs and AVFs, better visualization techniques that allow one to distinguish between arteries and veins and determine the absolute depth of a vessel of interest are needed.










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Conflict of interest
Marta Kersten-Oertel, Ian Gerard, Simon Drouin, Kelvin Mok, Denis Sirhan, David Sinclair, and D. Louis Collins declare that they have no conflict of interest.
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Kersten-Oertel, M., Gerard, I., Drouin, S. et al. Augmented reality in neurovascular surgery: feasibility and first uses in the operating room. Int J CARS 10, 1823–1836 (2015). https://doi.org/10.1007/s11548-015-1163-8
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DOI: https://doi.org/10.1007/s11548-015-1163-8