Extended reality in the changing landscape of cranial neurosurgery: Role of image fusions and connectomics in precision and safety

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-09-30 DOI:10.1016/j.jocn.2025.111652

Gagandeep Singh , Annie Singh , Tejasvi Kainth , Sidharth Sunil Menon , Shubham Jain , Vadim Spektor , Prateek Prasanna , Sunil Manjila

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引用次数: 0

Abstract

Recently, augmented reality (AR), virtual reality (VR) and mixed reality (MR) technologies, collectively termed Extended Reality (XR), have been adopted to support enhanced visualizations for neurosurgeons by augmenting the clinical environment with relevant digital content. These groundbreaking technologies, including connectomics, have been successfully integrated into neurosurgery as tools for preoperative rehearsals, surgical simulation, and intraoperative augmentation. Adaptation of XR within the surgical field has assisted neurosurgeons with preoperative planning using connectomics and anticipation of potential complications. XR enables neurosurgeons to explore operative fields from various angles and visualize hidden neurovascular anatomy, enhancing precision in keyhole approaches. It also addresses resident work hour restrictions and challenges like COVID-19, offering advanced training tools for novices and experts alike. Additionally, XR facilitates telecasting, patient education, remote telecollaboration, and helps bridge global educational gaps in neurosurgery, including credentialing and recertification. This paper outlays the conceptual differences between AR, VR, and MR, emphasizing the benefits and limitations of XR, along with the growing role of connectomics in micro-neurosurgery and endoscopic neurosurgery. The role of 2D versus 3D imaging, merger of preoperative versus real-time imaging, fusion of additional imaging data such as ICG, 5-ALA, or fluorescein angiography, and utilization of emerging technologies like Surgical Theater, QuickTome, etc. are highlighted. We also bring forth the pivotal role of visuo-spatial orientation of co-participants, apart from shared intentions and varied competence during the use of MR in neurosurgery. We explore the latest XR applications in neurosurgery and discuss exciting future directions, limitations, and ethical implications for the trailblazing technology.

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扩展现实在颅神经外科不断变化的景观：图像融合和连接组学在精度和安全性中的作用。

最近，增强现实（AR）、虚拟现实（VR）和混合现实（MR）技术，统称为扩展现实（XR），已被采用，通过用相关的数字内容增强临床环境来支持神经外科医生的增强可视化。这些突破性的技术，包括连接组学，已经成功地整合到神经外科中，作为术前排练、手术模拟和术中增强的工具。利用连接组学和对潜在并发症的预测，在手术领域内适应XR有助于神经外科医生进行术前计划。XR使神经外科医生能够从不同角度探索手术领域，并可视化隐藏的神经血管解剖，提高锁眼入路的精度。它还解决了居民工作时间的限制和COVID-19等挑战，为新手和专家提供了先进的培训工具。此外，XR促进了电视广播、患者教育、远程远程协作，并帮助弥合神经外科方面的全球教育差距，包括认证和重新认证。本文阐述了AR、VR和MR之间的概念差异，强调了XR的优点和局限性，以及连接组学在微神经外科和内窥镜神经外科中日益重要的作用。强调了2D与3D成像的作用、术前与实时成像的融合、ICG、5-ALA或荧光素血管造影等附加成像数据的融合以及Surgical Theater、QuickTome等新兴技术的应用。我们还提出了共同参与者的视觉空间取向的关键作用，除了共同的意图和不同的能力在神经外科中使用MR。我们将探索最新的XR在神经外科中的应用，并讨论令人兴奋的未来方向、限制和开创性技术的伦理影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.