Modern medical imaging provides surgeons with valuable information about patients’ hearts, but its implementation is often somewhat basic in comparison. The conventional method is to look at “slices” in different orientations, before mentally reconstructing them into a 3D image.
That may soon change, however, thanks to a system developed at King’s College London (KCL) and Evelina London Children’s Hospital. The technology combines multiple scans into a beating three-dimensional “digital double” that can be viewed and manipulated in virtual reality (VR).
“Virtual reality really gives you this intuitive ability to ‘sense’ and move the heart, they can position it in whatever orientation they want,” said Dr Natasha Stephenson, clinical researcher at the KCL School of Biomedical Engineering. and Imaging Sciences. “It’s really about having that immersion and intuition and understanding of 3D relationships.” The team, which has received funding from the British Heart Foundation, hopes the system could improve outcomes for the thousands of patients who undergo surgery or keyhole procedures for congenital heart disease each year.
The program integrates echocardiograms – ultrasounds of the heart – with computed tomography (CT) and magnetic resonance imaging (MRI), which are usually viewed on a flat screen. 3D models of actual medical devices are also added to the system, so surgeons can try different approaches.
Against the watch
In the UK, an average of 13 babies are diagnosed with congenital heart disease every day. Depending on the severity of their condition, they might need one or more procedures to help their heart function normally. No two hearts are the same, but the KCL system shows surgeons exactly what they’re going to find, helping them plan ahead and take the right course of action. The heart is normally stopped during procedures, which means time is running out.
“In the group of patients we focused on, all of their hearts and heart defects were slightly different. You don’t find two people the same,” said lead researcher Professor John Simpson. the machines are taking over the work of the heart.But, essentially, time is running out…surgeons want to know exactly what they are going to find and exactly what they are going to do about it.
The program integrates echocardiograms with CT scans and MRIs
The approach aims to avoid surprises, minimize uptime and make it more predictable. It can also ensure that the correct size of medical devices are used, thus avoiding complications. Overall, this could reduce the need for multiple surgeries, leading to better outcomes and experiences for patients and families.
The system is designed to be as convenient and useful as possible. Training takes only minutes and built-in rendering capabilities eliminate time-consuming segmentation of initial scans.
Surgeons who tested a version using only echocardiograms preferred it for understanding patients’ heart anatomy, KCL said, while also reporting increased confidence and better decision-making.
Other procedures that could benefit from a similar approach include orthopedic surgery, bone and face reconstruction, and abdominal surgery, the researchers said. They hope to have the system in regular use within two years and are working with KCL’s quality management team to help it meet national regulatory standards.
Despite the exciting promise of the project, it cannot be “VR for virtual reality” in such a security-critical sector. “We have no interest in introducing virtual reality just to produce another image,” Simpson said. “He’s just not stealing – he’s got to give people something more than what they’re getting right now.”
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