Elsevier

Computers & Graphics

Volume 27, Issue 2, April 2003, Pages 215-221
Computers & Graphics

VR simulated training for less invasive vascular intervention

https://doi.org/10.1016/S0097-8493(02)00278-9Get rights and content

Abstract

This paper describes a computerized simulation system for less invasive vascular interventions using virtual-reality (VR)-based technology. A virtual human patient is constructed on top of the visible human data (VHD) incorporating in various vascular disease cases. Specially, the human vascular network is modeled for the use of catheterization simulation. Physical modeling technique is applied to model the interaction between the blood vessels and vascular catheterization devices. A haptic interface is integrated with the computer simulation system to provide tactile sensations to the user during the simulated catheterization procedures. The system can be used for training and pre-treatment planning of interventional vascular procedures.

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)

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