The use of technology to improve the quality of care and reduce the cost of healthcare is increasingly essential. The United States has one of the highest costs of healthcare in the world. In 2020, the U.S. spend on healthcare reached $4.1 trillion, which averages to over $12,500 per person. This number is expected to increase, exceeding over $20,000 per person by 2025.
One of the technologies that is revolutionizing the world of neurosurgery is the use of augmented reality (AR) in preoperatory planning and surgery. By leveraging Microsoft HoloLens 2, a pair of mixed reality smart glasses developed by Microsoft, neurosurgeons can visualize a 3D image of the tumor, thus virtually simulating the surgery before getting into the operating room. This technology has already been successfully leveraged in mechanics and construction and is currently in the first phases of testing for its medical applications.
Accurate preoperative planning and safe intraoperative management of cerebral pathologies requires expert anatomical knowledge and years of experience. The complexity of the anatomy of brain tumors and arteriovenous malformations could be easily misunderstood by inexperienced neurosurgeons, thus jeopardizing the planning of the surgery and the intraoperative strategy. Current technologies such as CTs and MRIs only allows a 2D image of the patient’s tumor, which does not allow the surgeon to get a precise sense of its depth. This reduces his effectiveness in the planning of the surgery as it is harder to establish the tumor’s boundaries and its interactions with other tissues.
Automatic segmentation of intracranial lesions provides a tridimensional delineation to better characterize their anatomical relationships, which can be enhanced by integration with augmented reality (AR). One potential lever to achieve automatic segmentation is the use of machine learning-based mathematical algorithms. The integration of tridimensional vascular models into AR will provide neurosurgeons a great help to learn to assess the anatomy of the lesion correctly, plan the surgery and increase the safety of intraoperative management.
The incorporation of these algorithms into a cloud environment could allow an entirely automatic workflow, thus shortening segmentation timing, and provide a technically easy visualization in augmented reality. This will give an accurate tridimensional visualization of complex brain pathologies. This could be a critical step in the daily clinical routine, allowing virtual reality- assisted perioperative management and training of residents for complex surgical procedures.
Therefore, the leveraging of augmented reality could represent a first important step to increase operating room efficiency, enhance the preparation of the neurosurgeons, thus increasing patient safety and potentially better clinical outcomes. Furthermore, the creation of pathology- specific tridimensional anatomical models will provide eachs patient with the unique experience of visualizing their pathology and getting a better understanding of how the surgery will play out.
Less time in the operating room will also mean a lower chance of postoperative complications for the patients as well as reduced pain and faster time to recovery. This would as a result lead to a faster discharge from the hospital, thus lowering the pressure on the healthcare system and decreasing the average cost per patient.
Sources
- CMS Center for Medicare and Medicaid Services, National Expenditure Data
- Automatic segmentation of intracranial lesions, M.D. Elisa Colombo, Universitätsspital Zürich
Sara Mattei Gentili is a second-year student at Harvard Business School. Prior to HBS, she was a consultant at McKinsey & Company where she was part of the Strategy & Corporate Finance practice focusing on mergers and acquisitions across multiple sectors.
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