MR in OR: First analysis of AR/VR visualization in 100 intra-operative Freehand SPECT acquisitions

For the past two decades, medical Augmented Reality visualization has been researched and prototype systems have been tested in laboratory setups and limited clinical trials. Up to our knowledge, until now, no commercial system incorporating Augmented Reality visualization has been developed and used routinely within the real-life surgical environment. In this paper, we are reporting on observations and analysis concerning the usage of a commercially developed and clinically approved Freehand SPECT system, which incorporates monitor-based Mixed Reality visualization, during real-life surgeries. The workflow-based analysis we present is focused on an atomic sub-task of sentinel lymph node biopsy. We analyzed the usage of the Augmented and Virtual Reality visualization modes by the surgical team, while leaving the staff completely uninfluenced and unbiased in order to capture the natural interaction with the system. We report on our observations in over 100 Freehand SPECT acquisitions within different phases of 52 surgeries.