OBJECTIVE To develop and assess the accuracy of an augmented reality (AR) needle guidance smartphone application. METHODS A needle guidance AR smartphone application was developed using Unity and Vuforia SDK platforms, enabling real-time displays of planned and actual needle trajectories. To assess the application's accuracy in a phantom, eleven operators (including interventional radiologists, non-interventional radiology physicians, and non-physicians) performed single-pass needle insertions using AR guidance (n = 8) and CT-guided freehand (n = 8). Placement errors were measured on post-placement CT scans. Two interventional radiologists then used AR guidance (n = 3) and CT-guided freehand (n = 3) to navigate needles to within 5 mm of targets with intermediate CT scans permitted to mimic clinical use. The total time and number of intermediate CT scans required for successful navigation were recorded. RESULTS In the first experiment, the average operator insertion error for AR-guided needles was 78% less than that for CT-guided freehand (2.69 ± 2.61 mm vs. 12.51 ± 8.39 mm, respectively, p < 0.001). In the task-based experiment, interventional radiologists achieved successful needle insertions on each first attempt when using AR guidance, thereby eliminating the need for intraoperative CT scans. This contrasted with 2 ± 0.9 intermediate CT scans when using CT-guided freehand. Additionally, average procedural times were reduced from 13.1 ± 6.6 min with CT-guided freehand to 4.5 ± 1.3 min with AR guidance, reflecting a 66% reduction. CONCLUSIONS All operators exhibited superior needle insertion accuracy when using the smartphone-based AR guidance application compared to CT-guided freehand. This AR platform can potentially facilitate percutaneous biopsies and ablations by improving needle insertion accuracy, expediting procedural times, and reducing radiation exposures.

中文翻译：

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基于智能手机增强现实 CT 的进针引导平台：一项幻象研究。

目标 开发和评估增强现实 (AR) 针引导智能手机应用程序的准确性。方法 使用 Unity 和 Vuforia SDK 平台开发针引导 AR 智能手机应用程序，实现计划和实际针轨迹的实时显示。为了评估应用在体模中的准确性，11 名操作员（包括介入放射科医师、非介入放射科医师和非医师）使用 AR 引导 (n = 8) 和 CT 引导徒手 (n = 8) 进行单次穿刺针插入）。在放置后的 CT 扫描中测量放置误差。然后，两名介入放射科医生使用 AR 引导 (n = 3) 和 CT 引导徒手 (n = 3) 将针头引导至目标 5 mm 范围内，并允许进行中间 CT 扫描以模拟临床使用。记录成功导航所需的中间 CT 扫描的总时间和次数。结果 在第一个实验中，AR 引导针的平均操作员插入误差比 CT 引导徒手针的平均插入误差小 78%（分别为 2.69 ± 2.61 mm 和 12.51 ± 8.39 mm，p < 0.001）。在基于任务的实验中，介入放射科医师在使用 AR 引导时每次首次尝试都成功插入针头，从而消除了术中 CT 扫描的需要。这与使用 CT 引导徒手进行 2 ± 0.9 次中间 CT 扫描形成对比。此外，平均手术时间从 CT 引导徒手的 13.1 ± 6.6 分钟减少到 AR 引导的 4.5 ± 1.3 分钟，减少了 66%。结论 与 CT 引导徒手相比，使用基于智能手机的 AR 引导应用程序时，所有操作员都表现出出色的进针精度。这个 AR 平台可以通过提高针插入精度、加快手术时间和减少辐射暴露来潜在地促进经皮活检和消融。