scholarly journals A Novel Virtual Reality Medical Image Display System for Group Discussions of Congenital Heart Disease: Development and Usability Testing

JMIR Cardio ◽  
10.2196/20633 ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. e20633
Author(s):  
Byeol Kim ◽  
Yue-Hin Loke ◽  
Paige Mass ◽  
Matthew R Irwin ◽  
Conrad Capeland ◽  
...  

Background The complex 3-dimensional (3D) nature of anatomical abnormalities in congenital heart disease (CHD) necessitates multidisciplinary group discussions centered around the review of medical images such as magnetic resonance imaging. Currently, group viewings of medical images are constrained to 2-dimensional (2D) cross-sectional displays of 3D scans. However, 2D display methods could introduce additional challenges since they require physicians to accurately reconstruct the images mentally into 3D anatomies for diagnosis, staging, and planning of surgery or other therapies. Virtual reality (VR) software may enhance diagnosis and care of CHD via 3D visualization of medical images. Yet, present-day VR developments for medicine lack the emphasis on multiuser collaborative environments, and the effect of displays and level of immersion for diagnosing CHDs have not been studied. Objective The objective of the study was to evaluate and compare the diagnostic accuracies and preferences of various display systems, including the conventional 2D display and a novel group VR software, in group discussions of CHD. Methods A total of 22 medical trainees consisting of 1 first-year, 10 second-year, 4 third-year, and 1 fourth-year residents and 6 medical students, who volunteered for the study, were formed into groups of 4 to 5 participants. Each group discussed three diagnostic cases of CHD with varying structural complexity using conventional 2D display and group VR software. A group VR software, Cardiac Review 3D, was developed by our team using the Unity engine. By using different display hardware, VR was classified into nonimmersive and full-immersive settings. The discussion time, diagnostic accuracy score, and peer assessment were collected to capture the group and individual diagnostic performances. The diagnostic accuracies for each participant were scored by two experienced cardiologists following a predetermined answer rubric. At the end of the study, all participants were provided a survey to rank their preferences of the display systems for performing group medical discussions. Results Diagnostic accuracies were highest when groups used the full-immersive VR compared with the conventional and nonimmersive VR (χ22=9.0, P=.01) displays. Differences between the display systems were more prominent with increasing case complexity (χ22=14.1, P<.001) where full-immersive VR had accuracy scores that were 54.49% and 146.82% higher than conventional and nonimmersive VR, respectively. The diagnostic accuracies provided by the two cardiologists for each participant did not statistically differ from each other (t=–1.01, P=.31). The full-immersive VR was ranked as the most preferred display for performing group CHD discussions by 68% of the participants. Conclusions The most preferred display system among medical trainees for visualizing medical images during group diagnostic discussions is full-immersive VR, with a trend toward improved diagnostic accuracy in complex anatomical abnormalities. Immersion is a crucial feature of displays of medical images for diagnostic accuracy in collaborative discussions.

2020 ◽  
Author(s):  
Byeol Kim ◽  
Yue-Hin Loke ◽  
Paige Mass ◽  
Matthew R Irwin ◽  
Conrad Capeland ◽  
...  

BACKGROUND The complex 3-dimensional (3D) nature of anatomical abnormalities in congenital heart disease (CHD) necessitates multidisciplinary group discussions centered around the review of medical images such as magnetic resonance imaging. Currently, group viewings of medical images are constrained to 2-dimensional (2D) cross-sectional displays of 3D scans. However, 2D display methods could introduce additional challenges since they require physicians to accurately reconstruct the images mentally into 3D anatomies for diagnosis, staging, and planning of surgery or other therapies. Virtual reality (VR) software may enhance diagnosis and care of CHD via 3D visualization of medical images. Yet, present-day VR developments for medicine lack the emphasis on multiuser collaborative environments, and the effect of displays and level of immersion for diagnosing CHDs have not been studied. OBJECTIVE The objective of the study was to evaluate and compare the diagnostic accuracies and preferences of various display systems, including the conventional 2D display and a novel group VR software, in group discussions of CHD. METHODS A total of 22 medical trainees consisting of 1 first-year, 10 second-year, 4 third-year, and 1 fourth-year residents and 6 medical students, who volunteered for the study, were formed into groups of 4 to 5 participants. Each group discussed three diagnostic cases of CHD with varying structural complexity using conventional 2D display and group VR software. A group VR software, Cardiac Review 3D, was developed by our team using the Unity engine. By using different display hardware, VR was classified into nonimmersive and full-immersive settings. The discussion time, diagnostic accuracy score, and peer assessment were collected to capture the group and individual diagnostic performances. The diagnostic accuracies for each participant were scored by two experienced cardiologists following a predetermined answer rubric. At the end of the study, all participants were provided a survey to rank their preferences of the display systems for performing group medical discussions. RESULTS Diagnostic accuracies were highest when groups used the full-immersive VR compared with the conventional and nonimmersive VR (χ<sup>2</sup><sub>2</sub>=9.0, <i>P</i>=.01) displays. Differences between the display systems were more prominent with increasing case complexity (χ<sup>2</sup><sub>2</sub>=14.1, <i>P</i>&lt;.001) where full-immersive VR had accuracy scores that were 54.49% and 146.82% higher than conventional and nonimmersive VR, respectively. The diagnostic accuracies provided by the two cardiologists for each participant did not statistically differ from each other (<i>t</i>=–1.01, <i>P</i>=.31). The full-immersive VR was ranked as the most preferred display for performing group CHD discussions by 68% of the participants. CONCLUSIONS The most preferred display system among medical trainees for visualizing medical images during group diagnostic discussions is full-immersive VR, with a trend toward improved diagnostic accuracy in complex anatomical abnormalities. Immersion is a crucial feature of displays of medical images for diagnostic accuracy in collaborative discussions.


2021 ◽  
Author(s):  
Developer Account

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2014 ◽  
Vol 2 (2) ◽  
pp. 68-70
Author(s):  
Sandeep Singh Rana ◽  
Balbir Kumar ◽  
Sethu Madhavan J

ABSTRACT Complex congenital heart diseases (CHD) often present as multiple cardiac lesions. The presence of one anomaly should stimulate the physician to perform a comprehensive assessment and look for other associated anomalies.1 Multimodal imaging may be necessary to diagnose such associated lesions as single imaging may occasionally miss them. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are complimentary to each other. Routine use of TEE during intraoperative period may help us to refine diagnosis, detect the missing components and guide effective surgical repair. We present one such case where diagnosis and management were optimized by multimodal imaging. How to cite this article Kumar B, Madhavan JS, Puri GD, Rana SS. Role of TEE in Improving Diagnostic Accuracy of Congenital Heart Disease. J Perioper Echocardiogr 2014;2(2):68-70.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
G Wheeler ◽  
S Deng ◽  
K Pushparajah ◽  
J A Schnabel ◽  
J M Simpson ◽  
...  

Abstract Funding Acknowledgements Work supported by the NIHR i4i funded 3D Heart project [II-LA-0716-20001] Background/Introduction Virtual Reality (VR) has recently gained great interest for examining 3D images from congenital heart disease (CHD) patients. Currently, 3D printed models of the heart may be used for particularly complex cases. These have been found to be intuitive and to positively impact clinical decision-making. Although positively received, such printed models must be segmented from the image data, generally only CT/MR may be used, the prints are static, and models do not allow for cropping / slicing or easy manipulation. Our VR system is designed to address these issues, as well as providing a simple interface compared to standard software. Building such a VR system, one with intuitive interaction which is clinically useful, requires studying user acceptance and requirements. Purpose: We evaluate the usability of our VR system can a prototype VR system be easily learned and used by clinicians unfamiliar with VR. Method We tested a VR system which can display 3D echo images and enables the user to interact with them, for instance by translating, rotating and cropping. Our system is tested on a transoesophageal echocardiogram from a patient with aortic valve disease. 13 clinicians evaluated the system including 5 imaging cardiologists, 5 physiologists, 2 surgeons and an interventionist, with their clinical experience ranging from trainee to more than 5 years’ of experience. None had used VR regularly in the past. After a brief training session, they were asked to place three anatomical landmarks and identify a particular cardiac view. They then completed a questionnaire on system ease of learning and image manipulation. Results: Results are shown in the figure below. Learning to use the system was perceived as easy for all but one participant, who rated it as ‘Somewhat difficult’. However, once trained, all users found the system easy to use. Participants found the interaction, where objects in the scene are picked up using the controller and then track the controller’s motion in a 1:1 way, to be particularly easy to learn and use. Conclusion Our VR system was accepted by the vast majority of clinicians, both for ease of learning and use. Intuitiveness and the ability to interact with images in a natural way were highlighted as most useful - suggesting that such a system could become accepted for routine clinical use in the future. Abstract P1417 Figure. VR system evaluation participant feedbac


Author(s):  
Shujie Deng ◽  
Gavin Wheeler ◽  
Nicolas Toussaint ◽  
Lindsay Munroe ◽  
Suryava Bhattacharya ◽  
...  

The intricate nature of congenital heart disease requires understanding of complex, patient-specific three-dimensional dynamic anatomy of the heart, from imaging data such as three-dimensional echocardiography for successful outcomes from surgical and interventional procedures. Conventional clinical systems use flat screens and therefore display remains two-dimensional, which undermines the full understanding of the three-dimensional dynamic data. Additionally, control of three-dimensional visualisation with two-dimensional tools is often difficult, so used only by imaging specialists. In this paper we describe a virtual reality system for immersive surgery planning using dynamic three-dimensional echocardiography, which enables fast prototyping for visualisation such as volume rendering, multi-planar reformatting, flow visualisation, and advanced interaction such as three-dimensional cropping, windowing, measurement, haptic feedback, automatic image orientation, and multi-user interactions. The available features were evaluated by imaging and non-imaging clinicians, showing that the virtual reality system can help improve understanding and communication of the three-dimensional echocardiography imaging and potentially benefit congenital heart disease treatment.


2015 ◽  
Vol 16 (8) ◽  
pp. 556-561 ◽  
Author(s):  
Natale D. Brunetti ◽  
Simona Rosania ◽  
Carmine D’Antuono ◽  
Annamaria D’Antuono ◽  
Luisa De Gennaro ◽  
...  

Electronics ◽  
2021 ◽  
Vol 10 (16) ◽  
pp. 1889
Author(s):  
Endrit Pajaziti ◽  
Silvia Schievano ◽  
Emilie Sauvage ◽  
Andrew Cook ◽  
Claudio Capelli

Congenital heart disease (CHD) is the most common defect at birth. Effective training for clinical professionals is essential in order to provide a high standard of care for patients. Visual aids for teaching complex CHD have remained mostly unchanged in recent years, with traditional methods such as diagrams and specimens still essential for delivering educational content. Diagrams and other 2D visualisations for teaching are in most cases artistic illustrations with no direct relation to true, 3D medical data. Specimens are rare, difficult for students to access and are limited to specific institutions. Digital, patient-specific models could potentially address these problems within educational programmes. Virtual Reality (VR) can facilitate the access to digital models and enhance the educational experience. In this study, we recorded and analysed the sentiment of clinical professionals towards VR when learning about CHD. A VR application (VheaRts) containing a set of patient-specific models was developed in-house. The application was incorporated into a specialised cardiac morphology course to assess the feasibility of integrating such a tool, and to measure levels of acceptance. Attendees were clinical professionals from a diverse range of specialities. VR allowed users to interact with six different patient-derived models immersed within a 3D space. Feedback was recorded for 58 participants. The general response towards the use of VR was overwhelmingly positive, with 88% of attendees rating 4 or 5 for ‘helpfulness of VR in learning CHD’ (5-points Likert scale). Additionally, 70% of participants with no prior VR experience rated 4 or 5 for ‘intuitiveness and ease of use’. Our study indicates that VR has a high level of acceptance amongst clinical trainees when used as an effective aid for learning congenital heart disease. Additionally, we noted three specific use-cases where VR offered novel teaching experiences not possible with conventional methods.


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