Shared visualizations and guided procedure simulation in augmented reality with Microsoft HoloLens.

2019 
Background: Current display technologies can be suboptimal, even inadequate, when conveying spatially-complex healthcare concepts to patients and providers. This can lead to difficulties in sharing medical information, with potentially deleterious effects on patient outcomes, research, and trainee education. Methods: Investigators used off-the-shelf augmented reality (AR) technologies to facilitate visual communication for healthcare. Using untethered headset devices (Microsoft HoloLens), proof-of-concept work was completed for two use-cases: 1.) multi-user shared AR visualizations and 2.) AR-guided invasive procedural performance. The research team collaborated to create: 1.) a shared AR environment that enabled multiple users to independently visualize and manipulate 3D patient anatomic models with position, rotation, and scale synchronized across users; and 2.) a hybrid [AR-physical] covered box configuration containing CT-scanned targets and custom trajectory guidance system for simulated needle aspiration. As a pilot study exploring technical feasibility and experimental viability of the selected approach, measurements of 1.) size, displacement, angular rotation, and 2.) expert aspiration success were used as primary metrics. Results: The mean difference between AR models and physical objects was 2.0±0.4% and 1.7±0.4% of all dimensions on two HoloLens devices. One shared model configuration exhibited deviations of 7.8±2.8mm in location and 0.5±0.9° in angular orientation, and another showed differences of 6.5±2.1mm and 0.1±0.7° . For AR-guided procedure simulations, two expert surgeons required 3 attempts in 10 minutes and 1 attempt in 3 minutes to successfully aspirate the hybrid targets. Conclusion: AR technologies were used to enable core elements of an interactive shared medical visualization environment and a guided procedure simulation.
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