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01-07-2020 | Artificial Intelligence | Original Article

Augmented reality and artificial intelligence-based navigation during percutaneous vertebroplasty: a pilot randomised clinical trial

Authors: Pierre Auloge, Roberto Luigi Cazzato, Nitin Ramamurthy, Pierre de Marini, Chloé Rousseau, Julien Garnon, Yan Philippe Charles, Jean-Paul Steib, Afshin Gangi

Published in: European Spine Journal | Issue 7/2020

Abstract

Purpose

To assess technical feasibility, accuracy, safety and patient radiation exposure of a novel navigational tool integrating augmented reality (AR) and artificial intelligence (AI), during percutaneous vertebroplasty of patients with vertebral compression fractures (VCFs).

Material and methods

This prospective parallel randomised open trial compared the trans-pedicular access phase of percutaneous vertebroplasty across two groups of 10 patients, electronically randomised, with symptomatic single-level VCFs. Trocar insertion was performed using AR/AI-guidance with motion compensation in Group A, and standard fluoroscopy in Group B. The primary endpoint was technical feasibility in Group A. Secondary outcomes included the comparison of Groups A and B in terms of accuracy of trocar placement (distance between planned/actual trajectory on sagittal/coronal fluoroscopic images); complications; time for trocar deployment; and radiation dose/fluoroscopy time.

Results

Technical feasibility in Group A was 100%. Accuracy in Group A was 1.68 ± 0.25 mm (skin entry point), and 1.02 ± 0.26 mm (trocar tip) in the sagittal plane, and 1.88 ± 0.28 mm (skin entry point) and 0.86 ± 0.17 mm (trocar tip) in the coronal plane, without any significant difference compared to Group B (p > 0.05). No complications were observed in the entire population. Time for trocar deployment was significantly longer in Group A (642 ± 210 s) than in Group B (336 ± 60 s; p = 0.001). Dose–area product and fluoroscopy time were significantly lower in Group A (182.6 ± 106.7 mGy cm² and 5.2 ± 2.6 s) than in Group B (367.8 ± 184.7 mGy cm² and 10.4 ± 4.1 s; p = 0.025 and 0.005), respectively.

Conclusion

AR/AI-guided percutaneous vertebroplasty appears feasible, accurate and safe, and facilitates lower patient radiation exposure compared to standard fluoroscopic guidance.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

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Title: Augmented reality and artificial intelligence-based navigation during percutaneous vertebroplasty: a pilot randomised clinical trial
Authors: Pierre Auloge
Roberto Luigi Cazzato
Nitin Ramamurthy
Pierre de Marini
Chloé Rousseau
Julien Garnon
Yan Philippe Charles
Jean-Paul Steib
Afshin Gangi
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keyword: Artificial Intelligence
Published in: European Spine Journal / Issue 7/2020
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-019-06054-6

At a glance: The STEP trials

Springer Medicine

Augmented reality and artificial intelligence-based navigation during percutaneous vertebroplasty: a pilot randomised clinical trial

Abstract

Purpose

Material and methods

Results

Conclusion

Graphic abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Material and methods

Results

Conclusion

Graphic abstract

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