Skip to main content
Top
Published in: Acta Neurochirurgica 4/2021

Open Access 01-04-2021 | Glioma | Original Article - Neurosurgery Training

Augmented reality for the virtual dissection of white matter pathways

Authors: Sebastian Ille, Ann-Katrin Ohlerth, David Colle, Henry Colle, Olga Dragoy, John Goodden, Pierre Robe, Adrià Rofes, Emmanuel Mandonnet, Erik Robert, Djaina Satoer, Catarina Pessanha Viegas, Evy Visch-Brink, Martine van Zandvoort, Sandro M. Krieg

Published in: Acta Neurochirurgica | Issue 4/2021

Login to get access

Abstract

Background

The human white matter pathway network is complex and of critical importance for functionality. Thus, learning and understanding white matter tract anatomy is important for the training of neuroscientists and neurosurgeons. The study aims to test and evaluate a new method for fiber dissection using augmented reality (AR) in a group which is experienced in cadaver white matter dissection courses and in vivo tractography.

Methods

Fifteen neurosurgeons, neurolinguists, and neuroscientists participated in this questionnaire-based study. We presented five cases of patients with left-sided perisylvian gliomas who underwent awake craniotomy. Diffusion tensor imaging fiber tracking (DTI FT) was performed and the language-related networks were visualized separated in different tracts by color. Participants were able to virtually dissect the prepared DTI FTs using a spatial computer and AR goggles. The application was evaluated through a questionnaire with answers from 0 (minimum) to 10 (maximum).

Results

Participants rated the overall experience of AR fiber dissection with a median of 8 points (mean ± standard deviation 8.5 ± 1.4). Usefulness for fiber dissection courses and education in general was rated with 8 (8.3 ± 1.4) and 8 (8.1 ± 1.5) points, respectively. Educational value was expected to be high for several target audiences (student: median 9, 8.6 ± 1.4; resident: 9, 8.5 ± 1.8; surgeon: 9, 8.2 ± 2.4; scientist: 8.5, 8.0 ± 2.4). Even clinical application of AR fiber dissection was expected to be of value with a median of 7 points (7.0 ± 2.5).

Conclusion

The present evaluation of this first application of AR for fiber dissection shows a throughout positive evaluation for educational purposes.
Literature
1.
go back to reference Catani M, Thiebaut de Schotten M (2008) A diffusion tensor imaging tractography atlas for virtual in vivo dissections. Cortex 44:1105–1132CrossRef Catani M, Thiebaut de Schotten M (2008) A diffusion tensor imaging tractography atlas for virtual in vivo dissections. Cortex 44:1105–1132CrossRef
2.
go back to reference Contreras Lopez WO, Navarro PA, Crispin S (2019) Intraoperative clinical application of augmented reality in neurosurgery: a systematic review. Clin Neurol Neurosurg 177:6–11CrossRef Contreras Lopez WO, Navarro PA, Crispin S (2019) Intraoperative clinical application of augmented reality in neurosurgery: a systematic review. Clin Neurol Neurosurg 177:6–11CrossRef
3.
go back to reference De Witt Hamer PC, Hendriks EJ, Mandonnet E, Barkhof F, Zwinderman AH, Duffau H (2013) Resection probability maps for quality assessment of glioma surgery without brain location bias. PLoS One 8:e73353CrossRef De Witt Hamer PC, Hendriks EJ, Mandonnet E, Barkhof F, Zwinderman AH, Duffau H (2013) Resection probability maps for quality assessment of glioma surgery without brain location bias. PLoS One 8:e73353CrossRef
4.
go back to reference Duffau H, Gatignol P, Mandonnet E, Peruzzi P, Tzourio-Mazoyer N, Capelle L (2005) New insights into the anatomo-functional connectivity of the semantic system: a study using cortico-subcortical electrostimulations. Brain 128:797–810CrossRef Duffau H, Gatignol P, Mandonnet E, Peruzzi P, Tzourio-Mazoyer N, Capelle L (2005) New insights into the anatomo-functional connectivity of the semantic system: a study using cortico-subcortical electrostimulations. Brain 128:797–810CrossRef
5.
go back to reference Duffau H, Moritz-Gasser S, Mandonnet E (2014) A re-examination of neural basis of language processing: proposal of a dynamic hodotopical model from data provided by brain stimulation mapping during picture naming. Brain Lang 131:1–10CrossRef Duffau H, Moritz-Gasser S, Mandonnet E (2014) A re-examination of neural basis of language processing: proposal of a dynamic hodotopical model from data provided by brain stimulation mapping during picture naming. Brain Lang 131:1–10CrossRef
6.
go back to reference Fiani B, De Stefano F, Kondilis A, Covarrubias C, Reier L, Sarhadi K (2020) Virtual reality in neurosurgery: “can you see it?”-a review of the current applications and future potential. World Neurosurg 141:291–298CrossRef Fiani B, De Stefano F, Kondilis A, Covarrubias C, Reier L, Sarhadi K (2020) Virtual reality in neurosurgery: “can you see it?”-a review of the current applications and future potential. World Neurosurg 141:291–298CrossRef
7.
go back to reference Henry RG, Berman JI, Nagarajan SS, Mukherjee P, Berger MS (2004) Subcortical pathways serving cortical language sites: initial experience with diffusion tensor imaging fiber tracking combined with intraoperative language mapping. Neuroimage 21:616–622CrossRef Henry RG, Berman JI, Nagarajan SS, Mukherjee P, Berger MS (2004) Subcortical pathways serving cortical language sites: initial experience with diffusion tensor imaging fiber tracking combined with intraoperative language mapping. Neuroimage 21:616–622CrossRef
8.
go back to reference Incekara F, Smits M, Dirven C, Vincent A (2018) Clinical feasibility of a wearable mixed-reality device in neurosurgery. World Neurosurg 118:e422–e427CrossRef Incekara F, Smits M, Dirven C, Vincent A (2018) Clinical feasibility of a wearable mixed-reality device in neurosurgery. World Neurosurg 118:e422–e427CrossRef
9.
go back to reference Ius T, Angelini E, Thiebaut de Schotten M, Mandonnet E, Duffau H (2011) Evidence for potentials and limitations of brain plasticity using an atlas of functional resectability of WHO grade II gliomas: towards a “minimal common brain”. Neuroimage 56:992–1000CrossRef Ius T, Angelini E, Thiebaut de Schotten M, Mandonnet E, Duffau H (2011) Evidence for potentials and limitations of brain plasticity using an atlas of functional resectability of WHO grade II gliomas: towards a “minimal common brain”. Neuroimage 56:992–1000CrossRef
10.
go back to reference Jimenez de la Pena M, Gil Robles S, Recio Rodriguez M, Ruiz Ocana C, Martinez de Vega V (2013) Cortical and subcortical mapping of language areas: correlation of functional MRI and tractography in a 3T scanner with intraoperative cortical and subcortical stimulation in patients with brain tumors located in eloquent areas. Radiologia 55:505–513CrossRef Jimenez de la Pena M, Gil Robles S, Recio Rodriguez M, Ruiz Ocana C, Martinez de Vega V (2013) Cortical and subcortical mapping of language areas: correlation of functional MRI and tractography in a 3T scanner with intraoperative cortical and subcortical stimulation in patients with brain tumors located in eloquent areas. Radiologia 55:505–513CrossRef
11.
go back to reference Karmonik C, Boone TB, Khavari R (2018) Workflow for visualization of neuroimaging data with an augmented reality device. J Digit Imaging 31:26–31CrossRef Karmonik C, Boone TB, Khavari R (2018) Workflow for visualization of neuroimaging data with an augmented reality device. J Digit Imaging 31:26–31CrossRef
12.
go back to reference Krieg SM, Buchmann NH, Gempt J, Shiban E, Meyer B, Ringel F (2012) Diffusion tensor imaging fiber tracking using navigated brain stimulation--a feasibility study. Acta Neurochir 154:555–563CrossRef Krieg SM, Buchmann NH, Gempt J, Shiban E, Meyer B, Ringel F (2012) Diffusion tensor imaging fiber tracking using navigated brain stimulation--a feasibility study. Acta Neurochir 154:555–563CrossRef
13.
go back to reference Sanai N, Berger MS (2010) Intraoperative stimulation techniques for functional pathway preservation and glioma resection. Neurosurg Focus 28:E1CrossRef Sanai N, Berger MS (2010) Intraoperative stimulation techniques for functional pathway preservation and glioma resection. Neurosurg Focus 28:E1CrossRef
14.
go back to reference Sanai N, Mirzadeh Z, Berger MS (2008) Functional outcome after language mapping for glioma resection. N Engl J Med 358:18–27CrossRef Sanai N, Mirzadeh Z, Berger MS (2008) Functional outcome after language mapping for glioma resection. N Engl J Med 358:18–27CrossRef
15.
go back to reference Thiebaut de Schotten M, Ffytche DH, Bizzi A, Dell'Acqua F, Allin M, Walshe M, Murray R, Williams SC, Murphy DG, Catani M (2011) Atlasing location, asymmetry and inter-subject variability of white matter tracts in the human brain with MR diffusion tractography. Neuroimage 54:49–59CrossRef Thiebaut de Schotten M, Ffytche DH, Bizzi A, Dell'Acqua F, Allin M, Walshe M, Murray R, Williams SC, Murphy DG, Catani M (2011) Atlasing location, asymmetry and inter-subject variability of white matter tracts in the human brain with MR diffusion tractography. Neuroimage 54:49–59CrossRef
Metadata
Title
Augmented reality for the virtual dissection of white matter pathways
Authors
Sebastian Ille
Ann-Katrin Ohlerth
David Colle
Henry Colle
Olga Dragoy
John Goodden
Pierre Robe
Adrià Rofes
Emmanuel Mandonnet
Erik Robert
Djaina Satoer
Catarina Pessanha Viegas
Evy Visch-Brink
Martine van Zandvoort
Sandro M. Krieg
Publication date
01-04-2021
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 4/2021
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-020-04545-w

Other articles of this Issue 4/2021

Acta Neurochirurgica 4/2021 Go to the issue