Clinical Application Of 3D Slicer Assisted Augmented Reality In Preoperative Localization Of Superficial Intracranial Lesion

Objective To explore the clinical effect of 3D Slicer assisted augmented reality technology in preoperative localization of superficial intracranial lesions.Methods Twenty-eight patients who were diagnosed preoperatively with superficial intracranial lesions and planned to undergo surgical treatment from September 2017 to December 2019 were prospectively included in the study.Based on the preoperative imaging data of the patient,the approximate location of the intracranial lesion was preliminarily evaluated and 5 electrodes were placed around the lesion as scalp surface location markers.Thin-layer CT scan of the brain was performed,and the plain scan data was imported to the local computer via disk.3D Slicer software was used to conduct 3D reconstruction of intracranial lesions and scalp surface location markers.The reconstructed 3d model is imported into the iPad wirelessly connected to the a video projector to realize the augmented reality technology.Registration was performed by the help of fiducial markers.The optimal incision was designed according to the projection of intracranial lesion on the scalp surface.Intraoperatively,the lesion location and size were evaluated for consistency with preoperative localization.Results All the 28 cases were successfully completed without any residual lesions,and the clinical effect was satisfactory.According to the surgical incision and bone flap planned before the operation,the lesions were fully exposed after the opening of the dura in 27 cases,almost all of which were located in the center of the preoperative planned field.There was some deviation in the surgical location in 1 case,and the lesion was located at the edge of the planned operative field after the opening of the dura.The lesions were fully exposed after the removal of about 2mm of bone during the operation,and the clinical effect was satisfactory.Conclusion The new augmented reality technology offers a new way of thinking about image-guided neurosurgery.This technique has the advantages of accuracy,simplicity and practicality in the preoperative localization of superficial intracranial lesions.This technique can help surgeons to make individual and precise localization of superficial intracranial lesions,narrow surgical incision and achieve precise operation,especially in the absence of neural navigation system.