Research On Pulmonary Nodule Localization Based On Mixed Reality Guidance

【Object】With the popularity of low-dose high-resolution CT,more and more pulmonary nodules are being detected,and minimally invasive thoracoscopic surgery is the main means of diagnosis and treatment of pulmonary nodules,and how to localize pulmonary nodules has been a challenge for thoracic surgeons.The most commonly used method is CT-guided localization of pulmonary nodules,but it has problems such as long localization time,high CT dependence,high radiation dose,and limited operation time and localization location.Mixed reality is a new digital imaging technology that emerged after virtual reality and augmented reality,which can accomplish real-time interaction from real space to virtual environment based on the precise matching of virtual environment and real space.Based on this,we intend to use mixed reality technology to explore a new method of lung nodule localization,in order to ensure the accuracy of lung nodule localization on the basis of the above problems can be avoided.【Methods】1.Development of mixed reality-guided pulmonary nodule localization device: Using the characteristics of mixed reality that can match the real space and virtual environment,improve the existing single-use biopsy puncture needle and disposable guide based on the motion capture system localization ball,and develop a pulmonary nodule localization device suitable for mixed reality guidance;2.Virtual environment for lung nodule localization under mixed reality guidance and establishment of lung nodule localization model: using 3D reconstruction technology,combined with the construction needs of virtual environment for lung nodule localization under mixed reality guidance,explore and establish a simple and practical 3D model required for lung nodule localization under mixed reality guidance;3.Animal experiments of mixed reality-guided lung nodule localization: 60 experimental animals(Beagle dogs)were divided into two groups,and on the basis of the successful development of the mixed reality-guided lung nodule localization device,the construction of the virtual environment and the establishment of the animal model,the advantages and disadvantages of mixed reality-guided pulmonary nodule localization and CT-guided pulmonary nodule localization in terms of puncture localization accuracy,puncture localization time,number of puncture localizations,and puncture localizationrelated complications were compared to explore the feasibility and rationality of mixed reality-guided pulmonary nodule localization.【Results】1.Based on the motion capture system positioning ball,we successfully developed mixed reality-guided single-use biopsy puncture positioning needle and mixed realityguided disposable guide;2.Using 3D reconstruction technology,combined with the requirements of lung nodule localization under mixed reality guidance,successfully explored the most brief and practical reconstruction steps and reconstruction models required for lung nodule localization under mixed reality guidance;3.This animal study showed that the difference in puncture accuracy between mixed reality-guided and CT-guided lung nodule localization was not statistically significant(5.71±2.59 vs.5.57±5.02 mm,p=0.895).Mixed reality-guided pulmonary nodule localization was significantly shorter than the CT-guided pulmonary nodule localization group in terms of puncture localization time(8.07±1.44 vs.10.23±2.65 p<0.001)and significantly less frequent than the CT-guided pulmonary nodule localization group in terms of the number of punctures localized(p<0.001).The difference in the incidence of complications related to puncture localization(pneumothorax,hemorrhage,decortication,etc.)between the two groups was not statistically significant(p=0.286).【Conclusion】The mixed reality-guided lung nodule localization is not limited by the operation time and localization location,which reduces the time and number of punctures required for localization on the basis of ensuring the accuracy of puncture localization,thus reducing the number of CT scans required for localization and the radiation dose received,as well as reducing the occurrence of complications related to puncture localization to a certain extent,providing a new idea and method for clinical lung nodule localization.However,the next step is to further reduce the factors affecting the localization accuracy by improving the method of localization of pulmonary nodules under mixed reality guidance,so as to improve the localization accuracy,and to further verify its clinical safety and feasibility by conducting multicenter clinical trials.