University of Twente Student Theses
Feasibility of Infrared Reflective Marker Tracking for Nephron-Sparing Surgery Using Augmented Reality
Groot, N.T. de (2024) Feasibility of Infrared Reflective Marker Tracking for Nephron-Sparing Surgery Using Augmented Reality.
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| Full Text Status: | Access to this publication is restricted |
| Embargo date: | 1 September 2026 |
| Abstract: | Purpose: During Nephron-Sparing Surgery (NSS) for Wilms Tumors (WT), current clinical challenges involve preventing positive surgical margins and preserving as much healthy renal parenchyma as possible. Intraoperative Ultrasound (iUS) has multiple limitations, such as difficulties correlating two-dimensional (2D) images with 3D anatomy. Augmented Reality (AR) presents a potential solution by providing a 3D holographic model overlay to enhance intraoperative visualization and decision-making. This study tries to identify the clinical limitations of AR and propose a new AR system for surgical navigation during NSS for WTs. Methods: AR is introduced in the clinical setting to support surgical navigation during NSS. The preliminary evaluation of AR holographic visualization during total nephrectomies revealed specific challenges related to registration accuracy due to tumor size, Quick Response(QR)-code, and continuous tracking (Chapter 3). An application was developed to enable continuous tracking of the kidney using infrared (IR) reflective markers (Chapter 4). Static and dynamic accuracy assessments of different IR markers using the DINO-CLINIC systems identified optimal configurations for clinical use (Chapter 5). The clinical usability and accuracy of the DINO-CLINIC system were further evaluated through phantom experiments, focusing on IR-marker placement surgical feasibility (Chapter 6). Results: Successful AR registration was achieved in two out of six patients, with significant limitations related to QR-code registration and positional changes of the kidney affecting the holographic overlay (Chapter 3). The 6.4 mm and 12.7mm IR markers met technical accuracy requirements (<3.0 mm), with overall accuracies of -0.73 mm and -0.12, respectively, although an overestimation of distance was noted (Chapter 5). The DINO-CLINIC system exhibited a target registration error (TRE) of 11.82 mm and a positional localization error (PLE) of 8.74 mm, failing to meet clinical accuracy requirements (<5.0 mm). Surgeons rated the system's usability positively but identified significant tracking limitations (Chapter 6). Conclusion: Inside-out IR-tracking with the HoloLens 2 shows potential for enhancing intraoperative guidance during NSS by providing continuous 3D visualization of the tumor and resection boundaries. However, further research and development must address limitations regarding holographic stability and accuracy before further clinical implementation. |
| Item Type: | Essay (Master) |
| Clients: | Prinses Maxima Centrum, Utrecht, The Netherlands |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine, 50 technical science in general |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/103489 |
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