Navigate Biopsy with Ultrasound under Augmented Reality Device: Towards Higher System Performance

Purpose: Biopsies play a crucial role in determining the classification and staging of tumors. Ultrasound is frequently used in this procedure to provide real-time anatomical information. Using augmented reality (AR), surgeons can visualize ultrasound data and spatial navigation information seamlessly integrated with real tissues. This innovation facilitates faster and more precise biopsy operations. Methods: We developed an AR biopsy navigation system with low display latency and high accuracy. Ultrasound data is initially read by an image capture card and streamed to Unity via net communication. In Unity, navigation information is rendered and transmitted to the HoloLens 2 device using holographic remoting. Retro-reflective tool tracking is implemented on the HoloLens 2, enabling simultaneous tracking of the ultrasound probe and biopsy needle. Distinct navigation information is provided during in-plane and out-of-plane punctuation. To evaluate the effectiveness of our system, we conducted a study involving ten participants, for puncture accuracy and biopsy time, comparing to traditional methods. Results: Our proposed framework enables ultrasound visualization in AR with only $16.22\pm11.45ms$ additional latency. Navigation accuracy reached $1.23\pm 0.68mm$ in the image plane and $0.95\pm 0.70mm$ outside the image plane. Remarkably, the utilization of our system led to $98\%$ and $95\%$ success rate in out-of-plane and in-plane biopsy. Conclusion: To sum up, this paper introduces an AR-based ultrasound biopsy navigation system characterized by high navigation accuracy and minimal latency. The system provides distinct visualization contents during in-plane and out-of-plane operations according to their different characteristics. Use case study in this paper proved that our system can help young surgeons perform biopsy faster and more accurately.