Clinical Scorecard: Exploring the Use of Mixed Reality and 3D Brain Imaging for Patient Consultations in Neurosurgery: A Feasibility Study at IDEAL Stage 2a

At a Glance

Key Highlights

• Mixed reality enhances spatial understanding of brain tumours compared to conventional 2D MRI imaging.
• MR technology allows simultaneous visualization by surgeon and patient, improving communication and informed consent.
• MR reduces cybersickness and nausea compared to virtual reality due to anchoring virtual objects in the real environment.

Guideline-Based Recommendations

Diagnosis

• Use standard pre-operative MRI sequences (T1 with contrast, FLAIR) for imaging brain tumours.
• Apply automated volumetric reconstruction and auto-segmentation software for 3D anatomical visualization.

Management

• Incorporate mixed reality visualization during neurosurgical consultations to enhance patient understanding.
• Use MR headsets synchronized with patient-specific imaging to facilitate interactive discussion of pathology and surgical plans.

Monitoring & Follow-up

• Ensure visual and cognitive eligibility of patients prior to MR use (exclude significant impairments).
• Monitor patient comfort and any adverse effects during MR visualization.

Risks

• Potential for reduced information retention in patients due to anxiety or age, especially in neuro-oncology.
• Minimal risk of cybersickness with MR compared to VR, but monitor for any discomfort.

Patient & Prescribing Data

Patients with newly diagnosed brain tumours referred for neurosurgical consultation

MR visualization added to standard consultation may improve patient understanding and consent quality without additional imaging burden.

Clinical Best Practices

• Use a single trained neurosurgeon to maintain consistency in communication during consultations.
• Employ Brainlab Elements software for automated segmentation and 3D reconstruction of MRI data.
• Provide a training session for clinical staff on MR hardware and software prior to patient use.
• Randomize patients to MR or conventional 2D imaging groups to assess feasibility and benefits objectively.

References

• Ethical principles of patient-centred care and informed consent
• Challenges in neurosurgical imaging communication
• Benefits of interactive 3D models and immersive technology in patient understanding
• Differences between VR and MR technologies and their clinical applications
• IDEAL Stage 2a feasibility trial design and ethics approval