Augmented reality system helps surgeons tackle tumours

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A new augmented reality (AR) system developed at Germany’s Fraunhofer Institute is enabling surgeons to precisely identify the location of lymph nodes and remove cancerous tissue.

Augmented reality

(Credit: Fraunhofer Institute)

3D-ARILE uses a combination of hardware and software to assist in the removal of sentinel lymph nodes, important for the treatment of certain types of cancer such as skin, breast and prostate. An indocyanine green (ICG) fluorescent dye is first injected in the vicinity of the tumour, which is then exposed to infrared LEDs. A near infrared (NIR) camera captures the resulting fluorescence and produces a 3D reconstruction of the affected lymph nodes. This virtual image is then displayed to the surgeon in real time via a pair of AR glasses.

“To make the affected lymph nodes visible, the fluorescent dye is injected into the patient in the direct vicinity of the primary tumour. It then spreads along the lymphatic pathways and collects in the sentinel lymph nodes,” explained Fraunhofer research scientist Dr Stefan Wesarg.

“In our case, the malignant tissue is marked in green. In this way, the surgeon can verify that every last trace has been removed.”

Augmented reality

(Credit: Fraunhofer Institute)

Currently, radioisotopes such as technetium-99m are used as medical tracers. However, these require scintillation (or gamma) cameras that need around 30 minutes to capture the images to determine the precise location of a lymph node. On top of this, they also expose patients to a risk of radiation side effects. 3D-ARILE captures the images instantly and displays them in augmented reality so that doctors do not have to divide their attention between the patient and a screen.

“As a result, the doctor can focus entirely on the patient and carry out surgeries without hassle,” said Wesarg.

The system was developed in collaboration with The Clinic for Dermatology at Essen University Hospital and Trivisio Prototyping GmbH. According to the Fraunhofer Institute, the hospital dermatologists in Essen found the glasses comfortable to wear during trials. A prototype of 3D-ARILE will be presented by the researchers at the Medica trade fair in Düsseldorf, and a patent application for the system has been filed.

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