AR-assisted surgery: Precision placement of patient specific hip implants based on 3D printed PSIs.

Patient-specific implant placement in the case of pelvic tumour resection is usually a complex procedure, where the planned optimal position of the prosthesis may differ from the final location. This discrepancy arises from incorrect or differently executed bone resection and improper final positioning of the prosthesis. In order to overcome such mismatch, a navigation solution is presented based on an augmented reality application for HoloLens 2 to assist the entire procedure.

Tablet-based Augmented reality and 3D printed templates in fully guided Microtia Reconstruction: a clinical workflow.

Background: Microtia is a congenital malformation of the auricle that affects approximately 4 of every 10,000 live newborns. Radiographic film paper is traditionally employed to bidimensionally trace the structures of the contralateral healthy ear in a quasi-artistic manner. Anatomical points provide linear and angular measurements.

Selective sparing of bladder and rectum sub-regions in radiotherapy of prostate cancer combining knowledge-based automatic planning and multicriteria optimization.

Background And Purpose: The association between dose to selected bladder and rectum symptom-related sub-regions (SRS) and late toxicity after prostate cancer radiotherapy has been evidenced by voxel-wise analyses. The aim of the current study was to explore the feasibility of combining knowledge-based (KB) and multi-criteria optimization (MCO) to spare SRSs without compromising planning target volume (PTV) dose delivery, including pelvic-node irradiation.

Materials And Methods: Forty-five previously treated patients (74.

Real-time integration between Microsoft HoloLens 2 and 3D Slicer with demonstration in pedicle screw placement planning.

Purpose: Up to date, there has been a lack of software infrastructure to connect 3D Slicer to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting.

Deep learning-based segmentation of prostatic urethra on computed tomography scans for treatment planning.

Background And Purpose: The intraprostatic urethra is an organ at risk in prostate cancer radiotherapy, but its segmentation in computed tomography (CT) is challenging. This work sought to: i) propose an automatic pipeline for intraprostatic urethra segmentation in CT, ii) analyze the dose to the urethra, iii) compare the predictions to magnetic resonance (MR) contours.

Materials And Methods: First, we trained Deep Learning networks to segment the rectum, bladder, prostate, and seminal vesicles.

ABANICCO: A New Color Space for Multi-Label Pixel Classification and Color Analysis.

Classifying pixels according to color, and segmenting the respective areas, are necessary steps in any computer vision task that involves color images. The gap between human color perception, linguistic color terminology, and digital representation are the main challenges for developing methods that properly classify pixels based on color. To address these challenges, we propose a novel method combining geometric analysis, color theory, fuzzy color theory, and multi-label systems for the automatic classification of pixels into 12 conventional color categories, and the subsequent accurate description of each of the detected colors.

Corrigendum: Practice-oriented solutions integrating intraoperative electron irradiation and personalized proton therapy for recurrent or unresectable cancers: Proof of concept and potential for dual FLASH effect.

[This corrects the article DOI: 10.3389/fonc.2022.

Practice-oriented solutions integrating intraoperative electron irradiation and personalized proton therapy for recurrent or unresectable cancers: Proof of concept and potential for dual FLASH effect.

Background: Oligo-recurrent disease has a consolidated evidence of long-term surviving patients due to the use of intense local cancer therapy. The latter combines real-time surgical exploration/resection with high-energy electron beam single dose of irradiation. This results in a very precise radiation dose deposit, which is an essential element of contemporary multidisciplinary individualized oncology.

Deep Learning-Based Segmentation of Head and Neck Organs-at-Risk with Clinical Partially Labeled Data.

Radiotherapy is one of the main treatments for localized head and neck (HN) cancer. To design a personalized treatment with reduced radio-induced toxicity, accurate delineation of organs at risk (OAR) is a crucial step. Manual delineation is time- and labor-consuming, as well as observer-dependent.

Clinical feasibility of combining intraoperative electron radiation therapy with minimally invasive surgery: a potential for electron-FLASH clinical development.

Background: Local cancer therapy by combining real-time surgical exploration and resection with delivery of a single dose of high-energy electron irradiation entails a very precise and effective local therapeutic approach. Integrating the benefits from minimally invasive surgical techniques with the very precise delivery of intraoperative electron irradiation results in an efficient combined modality therapy.

Methods: Patients with locally advanced disease, who are candidates for laparoscopic and/or thoracoscopic surgery, received an integrated multimodal management.

Intra-Operative Electron Radiation Therapy: An Update of the Evidence Collected in 40 Years to Search for Models for Electron-FLASH Studies.

Introduction: The clinical practice and outcome results of intraoperative electron radiation therapy (IOeRT) in cancer patients have been extensively reported over 4 decades. Electron beams can be delivered in the promising FLASH dose rate.

Methods And Materials: Several cancer models were approached by two alternative radiobiological strategies to optimize local cancer control: boost versus exclusive IOeRT.

Evaluation of optical tracking and augmented reality for needle navigation in sacral nerve stimulation.

Background And Objective: Sacral nerve stimulation (SNS) is a minimally invasive procedure where an electrode lead is implanted through the sacral foramina to stimulate the nerve modulating colonic and urinary functions. One of the most crucial steps in SNS procedures is the placement of the tined lead close to the sacral nerve. However, needle insertion is very challenging for surgeons.

HoloLens 1 vs. HoloLens 2: Improvements in the New Model for Orthopedic Oncological Interventions.

This work analyzed the use of Microsoft HoloLens 2 in orthopedic oncological surgeries and compares it to its predecessor (Microsoft HoloLens 1). Specifically, we developed two equivalent applications, one for each device, and evaluated the augmented reality (AR) projection accuracy in an experimental scenario using phantoms based on two patients. We achieved automatic registration between virtual and real worlds using patient-specific surgical guides on each phantom.

UltrARsound: in situ visualization of live ultrasound images using HoloLens 2.

Purpose: Augmented Reality (AR) has the potential to simplify ultrasound (US) examinations which usually require a skilled and experienced sonographer to mentally align narrow 2D cross-sectional US images in the 3D anatomy of the patient. This work describes and evaluates a novel approach to track retroreflective spheres attached to the US probe using an inside-out technique with the AR glasses HoloLens 2. Finally, live US images are displayed in situ on the imaged anatomy.

Surgical Navigation, Augmented Reality, and 3D Printing for Hard Palate Adenoid Cystic Carcinoma En-Bloc Resection: Case Report and Literature Review.

Adenoid Cystic Carcinoma is a rare and aggressive tumor representing less than 1% of head and neck cancers. This malignancy often arises from the minor salivary glands, being the palate its most common location. Surgical en-bloc resection with clear margins is the primary treatment.

Augmented Reality as a Tool to Guide PSI Placement in Pelvic Tumor Resections.

Patient-specific instruments (PSIs) have become a valuable tool for osteotomy guidance in complex surgical scenarios such as pelvic tumor resection. They provide similar accuracy to surgical navigation systems but are generally more convenient and faster. However, their correct placement can become challenging in some anatomical regions, and it cannot be verified objectively during the intervention.

Effectiveness of Automatic Planning of Fronto-orbital Advancement for the Surgical Correction of Metopic Craniosynostosis.

Background: The surgical correction of metopic craniosynostosis usually relies on the subjective judgment of surgeons to determine the configuration of the cranial bone fragments and the degree of overcorrection. This study evaluates the effectiveness of a new approach for automatic planning of fronto-orbital advancement based on statistical shape models and including overcorrection.

Methods: This study presents a planning software to automatically estimate osteotomies in the fronto-orbital region and calculate the optimal configuration of the bone fragments required to achieve an optimal postoperative shape.

Real-Time Tool Detection for Workflow Identification in Open Cranial Vault Remodeling.

Deep learning is a recent technology that has shown excellent capabilities for recognition and identification tasks. This study applies these techniques in open cranial vault remodeling surgeries performed to correct craniosynostosis. The objective was to automatically recognize surgical tools in real-time and estimate the surgical phase based on those predictions.

Point-of-care manufacturing: a single university hospital's initial experience.

Background: The integration of 3D printing technology in hospitals is evolving toward production models such as point-of-care manufacturing. This study aims to present the results of the integration of 3D printing technology in a manufacturing university hospital.

Methods: Observational, descriptive, retrospective, and monocentric study of 907 instances of 3D printing from November 2015 to March 2020.

Conceptual evolution of 3D printing in orthopedic surgery and traumatology: from "do it yourself" to "point of care manufacturing".

Background: 3D printing technology in hospitals facilitates production models such as point-of-care manufacturing. Orthopedic Surgery and Traumatology is the specialty that can most benefit from the advantages of these tools. The purpose of this study is to present the results of the integration of 3D printing technology in a Department of Orthopedic Surgery and Traumatology and to identify the productive model of the point-of-care manufacturing as a paradigm of personalized medicine.

Combining Augmented Reality and 3D Printing to Improve Surgical Workflows in Orthopedic Oncology: Smartphone Application and Clinical Evaluation.

During the last decade, orthopedic oncology has experienced the benefits of computerized medical imaging to reduce human dependency, improving accuracy and clinical outcomes. However, traditional surgical navigation systems do not always adapt properly to this kind of interventions. Augmented reality (AR) and three-dimensional (3D) printing are technologies lately introduced in the surgical environment with promising results.

Patient-specific desktop 3D-printed guides for pelvic tumour resection surgery: a precision study on cadavers.

Purpose: 3D-printed patient-specific instruments have become a useful tool to improve accuracy in pelvic tumour resections. However, their correct placement can be challenging in some regions due to the morphology of the bone, so it is essential to be aware of the possible placement errors in each region. In this study, we characterize these errors in common pelvic osteotomies.

Three-dimensional photography for intraoperative morphometric analysis in metopic craniosynostosis surgery.

Purpose: Surgical correction of metopic craniosynostosis typically involves open cranial vault remodeling. Accurate translation of the virtual surgical plan into the operating room is challenging due to the lack of tools for intraoperative analysis of the surgical outcome. This study aimed to evaluate the feasibility of using a hand-held 3D photography device for intraoperative evaluation and guidance during cranial vault surgical reconstruction.