Prostate cancer is a significant health concern and the second most common cause of cancer-related deaths among men in the United States. Conventional methods, such as transperineal (TP) biopsy, are used to collect tissue samples through a needle inserted through the perineum wall to diagnose and treat prostate cancer.
However, 2D visualization of a 3D region can make the needle’s guidance and visualization challenging. In response to this challenge, US National Institutes of Health (NIH) researchers have proposed a novel approach based on an augmented reality (AR) system called HoloLens. Â
In their recent study, published in the Journal of Medical Imaging and reported in Hospimedica, the researchers detailed their successful HoloLens AR system that accurately and effectively projects MRI and ultrasound images onto patients, helping to guide a needle to the target. The HoloLens AR system employs a volumetric 3D scan, like an MRI scan, to create an accurate view of the patient. Leveraging reference data from the patient, the MRI scan can be superimposed precisely onto the patient.
The superimposed image is fed into the HoloLens goggles worn by the urologist and enables viewing of the patient and the MRI of the patient in proper alignment. The HoloLens goggles enable the urologist to view the image at different angles by moving the head. HoloLens can also display the pre-planned needle path on the patient, the target tissue of the prostate, and the real-time needle position during the procedure. Â
To evaluate their AR system’s image overlay accuracy and needle targeting precision, the researchers utilized a 3D-printed phantom. They used the free-hand and planned-path guidance methods to guide needles into a gel phantom and recorded needle placement errors. The system was also used to deliver soft tissue markers onto tumors of a human pelvis phantom. The researchers found similar placement errors associated with free-hand and planned-path guidance methods. Moreover, all implanted soft tissue markers were inside or near the tumors. Â
“The current methods have certain limitations to them,” said Dr. Ming Li from the NIH, who led the research. “Robot-assisted guidance is costly and adds procedural time, while other methods require a certain path for the needle that leaves out the outer reaches of the prostate. These problems are solved using the HoloLens AR system, which allows the doctor to use a free-hand approach.” Â
The HoloLens AR system’s the potential to provide more flexibility than the current grid-based TP methods can do so accurately. “By providing a 3D immersive experience, the HoloLens AR system makes free-hand lesion targeting feasible. As needle procedures move from the rectum to the perineum, AR systems could provide great clinical value to doctors and patients by solving the problems associated with prostate intervention procedures,” highlighted Li. Â
The HoloLens AR system has a wide range of applications beyond the field of urology. It can assist surgeons in various medical procedures, such as laparoscopy, endoscopy, and neurosurgery. AR systems such as HoloLens have great potential to enable doctors to visualize and manipulate medical images in real-time.
With the potential to improve patient outcomes and reduce procedural time and cost, AR systems could become an essential tool in modern medical practices. The HoloLens AR system has demonstrated its potential to provide an accurate and effective solution to the challenges associated with TP biopsy.
Its ability to provide a free-hand approach and accurately guide needles to the target tissue of the prostate is expected to enhance the diagnostic and therapeutic outcomes of prostate cancer significantly. Â
