Augmented reality for the virtual dissection of white matter pathways

Ille, S., Ohlerth, A.-K., Colle, D., Colle, H., Dragoy, O., Goodden, J., Robe, P., Rofes, A., Mandonnet, E., Robert, E., Satoer, D., Viegas, C., Visch-Brink, E., van Zandvoort, M., & Krieg, S. (2021). Augmented reality for the virtual dissection of white matter pathways. Acta Neurochirurgica, (4), 895-903. doi:10.1007/s00701-019-04159-x.
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)
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