Neurology and Neurosurgery News

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Educating Families with 3D Clarity

At first glance, the goggles and handheld controllers look like the latest in gaming technology. But in fact, this Mixed Reality Viewer, recently introduced at Cincinnati Children’s, is helping parents understand their child’s brain anatomy and upcoming surgical plan with 3D clarity.

Cincinnati Children’s is the first pediatric hospital in the United States to use the viewer, available from Brainlab as an accessory to the company’s image-guided surgery platform. The technology uses computed tomography (CT) and magnetic resonance (MR) slices from a patient’s scans to create a 3D reconstruction of the patient’s brain. The reconstruction can include the bony structures, blood vessels, fiber tracts, optic tracts, cerebrum, ventricles and brainstem for example, as well as the pathology of interest.

The neurosurgeon can generate the reconstruction on any computer or on one of Brainlab’s image-guided surgery platforms. After pairing the system’s 3D goggles with the computer, the session can begin. As the brain reconstruction seemingly floats in the air, viewers can use a handheld controller to zoom in and out and rotate the image. They can view the brain from any angle and lean into the image face-first to see cutaway views of specific anatomical structures. The surgeon can deselect anatomical structures to provide a simplified view and use a laser pointer to demonstrate the trajectory of a planned surgical resection or show where depth electrodes will be placed.

Pediatric neurosurgeon Francesco Mangano, DO, FACS, and his neurosurgery colleagues primarily use the Mixed Reality Viewer as a patient and family education tool.

“This technology makes it easier for families or patients without a medical background to better understand the complex pathology and the surgical plan,” says Mangano, division chief of Pediatric Neurosurgery at Cincinnati Children’s. “For example, instead of just explaining that the surgery carries a risk of vision loss, we can show where a specific lesion interacts anatomically with the visual system. After surgery, we can use the viewer to demonstrate what was resected or ablated successfully, which is reassuring for families.”

A Resource for Trainees

Mangano says the faculty is using the viewer to train the next generation of pediatric neurosurgeons at Cincinnati Children’s as well.

“Conceptualizing brain anatomy and pathology in three dimensions is probably one of the most challenging aspects of neurosurgery training,” he says. “When we have an elective case, we can preload the MR scans and view the brain from all angles to help residents and fellows understand approaches and prepare for surgery.”

Experienced neurosurgeons also could use the Mixed Reality Viewer to fine-tune their surgical approach and collaborate with other specialists working together on a complex case.

To learn more, contact Francesco.Mangano@cchmc.org.