Augmented Reality Guided Respiratory Liver Tumors Punctures: A Preliminary Feasibility Study

CT-guided radiofrequency ablation (RFA) has evolved rapidly over the past decade and become a widely accepted treatment option for patients with liver tumors. However, it is hard for doctors to locate tumors precisely while avoid damaging the surrounding risk structures with 2D CT images, which only provides limited static information, especially in case of respiratory motion. This paper presents a novel augmented reality guidance modality for improving the precision of liver tumors punctures by providing visual cue of 3D personalized anatomy with respiratory motion. Optical see-through display devices Epson MoveRio BT300 and Microsoft HoloLens are used to mix pre-operative 3D personalized data and intra-operative physical scene. Here an augmented reality based surgical navigation pipeline is proposed to achieve the transformation from raw medical data to virtual guidance information and precisely superimpose this information onto real experimental animal. In addition, to alleviate the difficulty during needle placement induced by respiratory motion, we proposed a correlation model to real-timely predict the tumor position via regression based respiration state estimation and the statistical tumor motion model. We experimentally validated the proposed system on in vivo beagle dogs with artificial lesion, which can effectively improve the puncture efficiency and precision. The proposed augmented reality modality is a general strategy to guide the doctors perform precise percutaneous puncture under respiration conditions and has the potential to be used for other surgical navigation tasks.