Over the last few years the technology has been undergoing rapid development; from AR glasses from google to the AR games such as Pokémon GO. The technology has started to enter the medical technology field.

Augmented reality concept designs

Augmented reality (AR) is a technology that superimposes a computer-generated image on a user's view of the real world, therefore providing an enhanced interactive view of reality was showcased at RSNA 2019. Over the last few years the technology has been undergoing rapid development; from AR glasses from google to the AR games such as Pokémon GO. The technology has started to enter the medical technology field. Leading manufacturers such as GE Healthcare and Philips Healthcare are leading the race to explore the clinical benefits of the technology within surgical theatres.

In order to develop AR systems, the manufacturers have partnered with software technology companies to develop prototypes. Current concept designs showcase a similar-looking are augmented reality headset; the display of the superimposed images however varies amongst the manufacturers. The current two systems under development are:

·       Virtual interface AR headset – Philips Healthcare has partnered with Microsoft in order to combine its Azurion system and HoloLens 2 holographic computing platform to develop an AR system which uses live imaging and other sources of vital data to display a large 2D screen into a 3D holographic augmented reality environment of the systems interface. This can be easily and intuitively controlled by the physician using voice recognition, eye tracking and advanced gestures. The physician is therefore able to tailor the environment to focus solely on the optimal patient outcome.

·       Virtual navigation AR headset – GE Healthcare has invested in Decisio Health; a software company that specializes in clinical surveillance in order to develop its conceptual design of a virtual navigation AR headset. Decisio’s visualization software combines a consolidated view of patients across multiple systems with GE Healthcare’s digital clinical platforms in order to merge real-time patient data (e.g. blood pressure and lactic levels). The system is then able to display the patient specific data, such as anatomy and vascular pathways, whilst the physician is performing minimally invasive surgeries to help improve clinical decision-making and positively impact patient care.

 Integration into clinical practices

Clinical Benefits

AR systems have the potential to revolutionize the medical field by:

1. Improving pre-surgical planning – The AR systems will enable surgeons to carry out pre-operative planning by making it possible to highlight relevant anatomy and critical structures to avoid thereby having a better understanding of anatomical relationships.

2. Increasing patient outcomes – AR system’s virtual tools and guidance systems can be positioned so that surgery can be planned with precision thereby increasing accuracy of clinical decisions while performing surgeries.  

3. Educating medical professionals – AR technology can allow doctors to examine previous scans and could allow experts from remote sites to gain guidance on complex procedures via the technology. The technology also has the potential to be used as a training tool for new medical professionals to increase their confidence and experience performing complex surgeries.

Clinical integration

The clinical benefits of the technology are clear, however there are major hurdles manufacturers and clinical practices must overcome for the technology to be seemingly integrated within surgical theatres. The challenges that must be overcome are:

1. Use of software and hardware – There will be an initial learning barrier as surgeons become accustomed on how to use the software in order to manipulate imagines. It is therefore essential the system is easy to use. Training must be provided by developers in order to ease integrating.

2. Headset battery life – Minimally invasive surgeries are often time-consuming procedures and therefore the battery life of the headset is crucial for return on investment. Headset systems will need to have rapid charging and a long battery life for 6-8 hours.

3. Data storage – AR systems will require additional data management systems or servers to be installed and the speed at which the data can be manipulated and rendered in real-time will be an important deciding factor when purchasers are allocating budgets.

4. Data protection – As patient sensitive data is likely to be transmitted using cloud storage system technologies it will be important to ensure patient data is secure from cyber threats.

5. The long-term risks of continues use of the technology will need to be determined, long-term engagement with AR technology can lead to healthcare issues such as eye problems.

6. Start-up cost – Hospitals and imaging centers will be required to make a significant initial capital start-up cost which may deter some purchasers.

 Looking forward

Augmented reality systems continue to be developed rapidly, it is likely the upcoming years will showcase the next generation of image guided therapy systems as leading manufacturers will continue to partner with innovative technology firms to overcome the major hurdles highlighted above.

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High-end hospitals in developed markets, such as the United States will be early adopters of the technology as they integrate the systems into practice thereby leading the way in a positive feedback loop mechanism to further improve development efforts. It is expected the systems will be first used in training at university hospitals whilst manufacturers attempt to gain FDA approval. The figure above explores an implementation road map. It remains to be seen which manufacturer will win the race to showcase an approved and regulated AR system.

IHS Markit will continue to follow the developments of AR systems and other major trends in the interventional X-ray market as part of the as part of our coverage of the X-ray Intelligence service. For more information, please contact Sharjeel Ahmad at sharjeel.ahmad@ihsmarkit.com.