Augmented-reality visualization for improved patient positioning workflow during MR-HIFU therapy

MR-guided high-intensity focused ultrasound (MR-HIFU) is a non-invasive therapeutic technology which has demonstrated clinical potential for tissue ablation. The application of this therapeutic approach facilitated to be a promising option to achieve faster pain palliation in patients with bone metastasis. However, its clinical adoption is still hampered by a lack of workflow integration. Currently, to ensure sufficient positioning, MR images have to be repeatedly acquired in between patient re-positioning tasks, leading to a time-consuming preparation phase of at least 30 minutes, involving extra costs and time to the available treatment time. Augmented reality (AR) is a promising technology that enables the fusion of medical images, such as MRI, with the view of an external camera. AR represents a valid tool for a faster localization and visualization of the lesion during positioning. The aim of this work is the implementation of a novel AR setup for accelerating the patient positioning during MRHIFU treatments by enabling adequate target positioning outside the MRI scanner. A marker-based approach was investigated for fusing the MR data with video data for providing an augmented view. Initial experiments on four volunteers show that MR images were overlaid on the camera views with an average re-projection error of 3.13 mm, which matches the clinical requirements for this specific application. It can be concluded that the implemented system is suitable for MR-HIFU procedures and supports its clinical adoption by improving the patient positioning, thereby offering potential for faster treatment time.