Virtual embolization for treatment support of intracranial AVMs using an interactive desktop and VR application.

Sprengel, Ulrike; Saalfeld, Patrick; Stahl, Janneck; Mittenentzwei, Sarah; Drittel, Moritz; Behrendt, Benjamin; Kaneko, Naoki; Behme, Daniel; Berg, Philipp; Preim, Bernhard; Saalfeld, Sylvia

doi:10.1007/s11548-021-02532-9

by Ulrike Sprengel, Patrick Saalfeld, Janneck Stahl, Sarah Mittenentzwei, Moritz Drittel, Benjamin Behrendt, Naoki Kaneko, Daniel Behme, Philipp Berg, Bernhard Preim, Sylvia Saalfeld

Abstract:

PURPOSE: The treatment of intracranial arteriovenous malformations (AVM) is challenging due to their complex anatomy. For this vessel pathology, arteries are directly linked to veins without a capillary bed in between. For endovascular treatment, embolization is carried out, where the arteries that supply the AVM are consecutively blocked. A virtual embolization could support the medical expert in treatment planning. METHOD: We designed and implemented an immersive VR application that allows the visualization of the simulated blood flow by displaying millions of particles. Furthermore, the user can interactively block or unblock arteries that supply the AVM and analyze the altered blood flow based on pre-computed simulations. RESULTS: In a pilot study, the application was successfully adapted to three patient-specific cases. We performed a qualitative evaluation with two experienced neuroradiologist who regularly conduct AVM embolizations. The feature of virtually blocking or unblocking feeders was rated highly beneficial, and a desire for the inclusion of quantitative information was formulated. CONCLUSION: The presented application allows for virtual embolization and interactive blood flow visualization in an immersive virtual reality environment. It could serve as useful addition for treatment planning and education in clinical practice, supporting the understanding of AVM topology as well as understanding the influence of the AVM's feeding arteries.

Reference:

Virtual embolization for treatment support of intracranial AVMs using an interactive desktop and VR application. (Ulrike Sprengel, Patrick Saalfeld, Janneck Stahl, Sarah Mittenentzwei, Moritz Drittel, Benjamin Behrendt, Naoki Kaneko, Daniel Behme, Philipp Berg, Bernhard Preim, Sylvia Saalfeld), In International journal of computer assisted radiology and surgery, volume 16, 2021.

Bibtex Entry:

@article{sprengel_virtual_2021,
	title = {Virtual embolization for treatment support of intracranial {AVMs} using an  interactive desktop and {VR} application.},
	volume = {16},
	copyright = {© 2021. The Author(s).},
	issn = {1861-6429 1861-6410 1861-6410},
	doi = {10.1007/s11548-021-02532-9},
	abstract = {PURPOSE: The treatment of intracranial arteriovenous malformations (AVM) is  challenging due to their complex anatomy. For this vessel pathology, arteries are  directly linked to veins without a capillary bed in between. For endovascular  treatment, embolization is carried out, where the arteries that supply the AVM  are consecutively blocked. A virtual embolization could support the medical  expert in treatment planning. METHOD: We designed and implemented an immersive VR  application that allows the visualization of the simulated blood flow by  displaying millions of particles. Furthermore, the user can interactively block  or unblock arteries that supply the AVM and analyze the altered blood flow based  on pre-computed simulations. RESULTS: In a pilot study, the application was  successfully adapted to three patient-specific cases. We performed a qualitative  evaluation with two experienced neuroradiologist who regularly conduct AVM  embolizations. The feature of virtually blocking or unblocking feeders was rated  highly beneficial, and a desire for the inclusion of quantitative information was  formulated. CONCLUSION: The presented application allows for virtual embolization  and interactive blood flow visualization in an immersive virtual reality  environment. It could serve as useful addition for treatment planning and  education in clinical practice, supporting the understanding of AVM topology as  well as understanding the influence of the AVM's feeding arteries.},
	language = {eng},
	number = {12},
	journal = {International journal of computer assisted radiology and surgery},
	author = {Sprengel, Ulrike and Saalfeld, Patrick and Stahl, Janneck and Mittenentzwei, Sarah and Drittel, Moritz and Behrendt, Benjamin and Kaneko, Naoki and Behme, Daniel and Berg, Philipp and Preim, Bernhard and Saalfeld, Sylvia},
	month = dec,
	year = {2021},
	pmid = {34806143},
	pmcid = {PMC8616893},
	keywords = {*Embolization, Therapeutic, *Intracranial Arteriovenous Malformations/diagnostic imaging/therapy, *Virtual Reality, AVM, embolization, hemodynamics, Humans, Pilot Projects, VR},
	pages = {2119--2127}
}