VR simulated training for less invasive vascular intervention
Introduction
As an emerging technology, virtual reality (VR) is getting increasingly popular in both academia and industries. It is evolving from VR to augmented reality (AR) and merging into mixed reality (MR) [1]. While fundamental VR research such as new algorithms and new methodologies [2], [3], [4] are rapidly emerging, VR has found great applications [5] in science, medicine, architecture, manufacturing, design, education, entertainment, etc. We are interested in applying VR technology for the training of less invasive vascular intervention.
Interventional radiological procedures are often used in place of surgery to minimize the invasiveness, patient discomfort, and general anesthesia associated with surgery and to reduce the cost and length of hospitalization.
In performing such procedures, interventionists must be very careful to avoid injury to the patient when manipulating of interventional devices within the blood vessels. Examples of injuries include rupturing or dissecting the wall of the vessels. To reduce these complications, medical students or junior interventionists require long and intensive training which usually starts from watching and assisting the experienced and certified interventionists in performing actual clinical cases. There is a need to provide additional means to train students or junior interventionists in order to improve their necessary skill levels. A realistic and computerized simulation system [6] could complement and enhance the traditional type of training with real patients. Several interventional radiology simulation systems have been reported in the literature. Anderson et al [7] presented their catheterization simulator called daVinci at the 21st SCVIR annual meeting in 1996. Dawson and Kaufman with HT Medical, Inc. [8], [9], [10], developed their interventional radiology simulator for angioplasty and other techniques. Wang et al [11] developed a simulator for training of percutaneous coronary revascularization procedures. Other researches on simulation of interventional catheterization or less invasive therapy have also been published in [12], [13], [14].
This paper discusses the development of a VR-enhanced simulator for vascular interventional training. In the following sections, a virtual and variational patient is first presented. This virtual patient is characterized by its capability of the variational change of the typical vascular diseases. A novel approach to modeling the human vascular networks is then described. The approach offers improved efficiency for vascular model display and interventional device manipulation. This is followed by the discussion of an efficient potential field method for the physically based modeling of the interaction between interventional devices and vascular walls. Finally, a haptic device to facilitate tactile sensations in the manipulations of catheterization devices is presented.
Section snippets
Virtual and variational vascular patient
In order to build a high fidelity simulator for training of vascular interventions, a computerized virtual patient model is necessary. Individual patients may demonstrate different vascular diseases, different diseased sites, different levels of diseased lesions and so on. Virtually, every vascular patient can be a training case and the vascular patient database, therefore, should include a large pool of real patient records covering enough diseased cases. This, however, may potentially lead to
Localized vascular modeling
Interventional radiology deals mainly with human vascular systems. Modeling of the vascular network is therefore a critical step in developing interventional simulators. In [7], the iso-surfacing technique was applied to generate the vascular surfaces. With such vascular wall surface model, simulated passage within the blood vessels becomes feasible. Typically, the extracted vascular iso-surface model is made of tessellated triangular meshes. Neighboring or adjacent relationship among triangles
Physical modeling for catheter navigation
In catheterization procedures, interventional devices will interact with the vascular walls when the devices are manipulated with movements of forward, backward, twisting, inflation, deflation, etc. Realistic simulation of catheter intervention must properly address these phenomena. Our simulation involves in the physical behaviors of both interventional devices and vascular walls. As described in [17], a potential field method was developed to support the physically based modeling for
Haptic VR-enhanced training
VR technology is applied in this project to develop an interventional simulation environment. For less invasive vascular interventional training, hand–eye coordination is utmost important in order for trainees to gain a realistic experience in catheterization procedures. For this purpose, a haptic interface is designed. The prototype of the haptic interface consists of an electro-mechanical unit, a digital balloon inflation unit and several others.
Conclusion
This work presents a computerized simulator for less invasive vascular interventional procedures using VR technology. A virtual simulation environment is developed incorporating major components of virtual and variational patient, physically based and geometrically based vascular modeling, and haptic interventional interfaces. With the virtual haptic training environment, hand–eye coordination, necessary for interventional radiology can be enhanced. The work is targeting at low-cost PC desktop
Acknowledgements
The authors would like to thank Mr Zhong Fan and Mr Xin Ma for their helps. This project (012-101-0025) is supported by A*Star, previously known as Singapore's National Science & Technology Board. The third author would like to express his thanks to Zhejiang University's Cheung Kong Scholar's Program Fund, and the China National Science Foundation, under grant #60273060.
References (17)
- et al.
Mixed realitybeyond conventions
Computers and Graphics
(2001) - et al.
Distributed graphics support for virtual environment
Computers and Graphics
(1996) - et al.
Constructive modeling of G1 bifurcation
Computer Aided Geometric Design
(2002) - et al.
Filling polygonal holes with bi-cubic patches
Computer Aided Geometric Design
(1994) - Shi JY, Pan ZG. virtual reality: fundamental and practical algorithms. Scientific Publisher,...
- et al.
Scientific visualizationtheory and algorithm
(1996) - et al.
Virtual reality and its application in industry
(2002) Computerized patient simulation to train the next generation of interventional cardiologistscan virtual reality take the place of real life?
Catheterization and Cardiovascular Intervention
(2000)
Cited by (33)
Development and assessment of an educational application for the proper use of ceiling-suspended radiation shielding screens in angiography rooms using augmented reality technology
2021, European Journal of RadiologyCitation Excerpt :We think these failures to understand the protection means correctly is one of the reasons why the ceiling-suspended radiation protection screen has not been used properly. In recent years, virtual reality (VR) and augmented reality (AR) technology have been used in the field of medicine for training healthcare staff [16–18] and assisting physician's procedures [19–26]. The possibility has also been reported that visualization of the distribution of scattered radiation using VR [27], AR [28,29], and projection mapping [30] technology will lead to increased exposure awareness in medical staff and an efficient tool in their formative education and continuing development for radiation protection.
A virtual reality based surgical skills training simulator for catheter ablation with real-time and robust interaction
2021, Virtual Reality and Intelligent HardwareVR and AR in human performance research―An NUS experience
2020, Virtual Reality and Intelligent HardwareAn adaptive deviation-feedback approach for simulating multiple devices interaction in virtual interventional radiology
2019, CAD Computer Aided DesignCitation Excerpt :Nowinski et al. [10] modeled the guidewire as smoothly linked curves, and simulated its behavior with the finite element method (FEM). Cai et al. [11] used a potential field method to accelerate the FEM-based numerical calculation in their simulator. Duriez et al. [12] proposed an incremental FEM model to simulate the catheter navigation.
A geometric approach to the modeling of the catheterheart interaction for VR simulation of intra-cardiac intervention
2011, Computers and Graphics (Pergamon)Citation Excerpt :Virtual reality (VR) simulators for cardiology and vascular surgery are increasingly being used in surgical education [1]. For practical and ethical reasons, realistic VR simulators provide a good starting point compared to animal and patient trials [2–4]. VR simulators allow the surgeon to master complex techniques using VR devices in vascular and intra-cardiac intervention procedures.
A meshless rheological model for blood-vessel interaction in endovascular simulation
2010, Progress in Biophysics and Molecular BiologyCitation Excerpt :Nowinski et al. (Nowinski and Chui, 2001) proposed a virtual environment for simulating vascular modeling, where by assuming a static external vessel wall structure, interactive performance can be achieved. Cai et al. (2003) reported a computerized simulation system of less invasive vascular interventions using a virtual human patient based on the visible human data (from National Library of Medicine, US); their system is also integrated with a haptic interface for training interventional vascular procedures. Robert et al. (Robert and Peter, 2001) reported the development of a virtual reality environment which integrates interactive visualization of patient specific vascular data with flow simulation; it provides an interactive exploration of vascular reconstruction procedures where a mesoscopic lattice Boltzmann technique is used.