Augmented Reality Guidance for the Surgical Localisation of Paediatric Chest Wall Tumours

This thesis addresses the complexity of surgically managing paediatric chest wall tumours, which are often hard to locate due to prior chemotherapy-induced shrinkage. Surgeons rely on various imaging techniques to locate the affected ribs and tumours during surgery. Augmented Reality (AR) has potential to aid this process by projecting anatomical information onto the patient. A previous study introduced a HoloLens 2-based AR system using a landmark-based registration method for tumour localisation. This thesis explores the feasibility of improving this system using surface matching as a new registration method. Two surface acquisition methods were examined: a 3D printed pointer tracing the patient's thorax and the HoloLens 2's Time-of-Flight camera. A phantom study compared these methods to landmark-based registration, revealing accurate target localisation with sub-1 cm precision. A cadaver study demonstrated surgeons' ability to accurately locate ribs using both surface matching methods. The contour registration approach showed the most consistency and accuracy, allowing registration on exposed ribs after incision. In conclusion, this thesis proves the feasibility of surface matching for AR-assisted tumour localisation during paediatric chest wall resections. The contour registration method demonstrated the most potential, suggesting improved pre- and post-incision registration. Future research should focus on realistic testing, enhancing HoloLens application usability, and increasing surgeon acceptance. AR has the potential to facilitate tumour localisation and surgical decisions, reducing the need for additional imaging techniques during paediatric chest wall resections.