Goal


Combine the capabilities of advanced anatomical lung segmentation with 3D virtual reality visualization to enable thoracic surgeons conducting precisely targeted interventions, sparing the healthy lung tissue and patient’s breathing capacity.

Medical Application

Pre-operative planning and patient selection for pulmonary interventions, including: segmentectomy for lung cancer and lung volume reduction surgery for COPD.

Timeline

Collaborating Partners

Contribution by Thirona

Thirona's chest CT analysis is at the core of the application, using artificial intelligence to distinguish anatomical structures and to provide detailed segmentation of the lungs into sub-lobar segments. When loaded onto the PulmoVR platform the segmentations are instantly translated into 3D visualization of the patient’s lung anatomy.

Background

Together with MedicalVR, the cardio-thoracic surgery department of the Erasmus Medical Center started a pilot in 2020, using virtual reality in preparation for complex lung surgeries. What makes the 3D virtual reality model so special, is that it lets surgeons see the location of tumors and other abnormalities in the lungs with much greater precision than on regular CT images. Precise identification of segmental borders and segmental branches of arteries, veins, and bronchi, allows for surgery accurately targeted at a certain part of the lung. As the result: more healthy lung tissue and breathing capacity is spared.

This is the first study that demonstrates the potential of artificial intelligence and immersive VR-based visualization method for personalized surgical planning for pulmonary segmentectomies.

The software can be installed on every computer or laptop with sufficient graphical and processing power and works with the off-the-shelf VR head mounted displays, with no need for additional 3D equipment.

Results


In the first phase an observational pilot study to asses and demonstrate the technical feasibility and clinical applicability of the VR platform was conducted. Cardiothoracic surgeons of Erasmus MC used our lung segmentations to assess 10 patients before surgery. In 40% of the surgeries, they decided upon a different strategy for the surgery after reviewing the lung anatomy in virtual reality. Moreover, all oncological resection procedures were performed successfully and adequately using the PulmoVR solution. Surgeons reported that, while easy to use, the tool provides a more accurate understanding of the patient’s segmental and subsegmental anatomy and helps better prepare for surgery.

PulmoVR, a novel and immersive virtual reality-based application, is a feasible and clinically applicable method for accurate and patient-tailored surgical planning of pulmonary segmentectomy. Read the full publication.

The next step is a larger multi-site study (across 8 clinical sites) to assess the scalability of the solution.

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