The Feasibility and Accuracy of Holographic Navigation with Laser Crosshair Simulator Registration on a Mixed-Reality Display.
Ziyu Qi, Haitao Jin, Qun Wang, Zhichao Gan, Ruochu Xiong, Shiyu Zhang, Minghang Liu, Jingyue Wang, Xinyu Ding, Xiaolei Chen, Jiashu Zhang, Christopher Nimsky, Miriam H A Bopp
Author Information
Ziyu Qi: Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany. ORCID
Haitao Jin: Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. ORCID
Qun Wang: Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. ORCID
Zhichao Gan: Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. ORCID
Ruochu Xiong: Department of Neurosurgery, Division of Medicine, Graduate School of Medical Sciences, Kanazawa University, Takara-machi 13-1, Kanazawa 920-8641, Japan. ORCID
Shiyu Zhang: Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. ORCID
Minghang Liu: Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. ORCID
Jingyue Wang: Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. ORCID
Xinyu Ding: Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. ORCID
Xiaolei Chen: Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. ORCID
Jiashu Zhang: Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. ORCID
Christopher Nimsky: Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany. ORCID
Miriam H A Bopp: Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany. ORCID
Addressing conventional neurosurgical navigation systems' high costs and complexity, this study explores the feasibility and accuracy of a simplified, cost-effective mixed reality navigation (MRN) system based on a laser crosshair simulator (LCS). A new automatic registration method was developed, featuring coplanar laser emitters and a recognizable target pattern. The workflow was integrated into Microsoft's HoloLens-2 for practical application. The study assessed the system's precision by utilizing life-sized 3D-printed head phantoms based on computed tomography (CT) or magnetic resonance imaging (MRI) data from 19 patients (female/male: 7/12, average age: 54.4 ± 18.5 years) with intracranial lesions. Six to seven CT/MRI-visible scalp markers were used as reference points per case. The LCS-MRN's accuracy was evaluated through landmark-based and lesion-based analyses, using metrics such as target registration error (TRE) and Dice similarity coefficient (DSC). The system demonstrated immersive capabilities for observing intracranial structures across all cases. Analysis of 124 landmarks showed a TRE of 3.0 ± 0.5 mm, consistent across various surgical positions. The DSC of 0.83 ± 0.12 correlated significantly with lesion volume (Spearman rho = 0.813, < 0.001). Therefore, the LCS-MRN system is a viable tool for neurosurgical planning, highlighting its low user dependency, cost-efficiency, and accuracy, with prospects for future clinical application enhancements.
