An Easy and User Independent Augmented Reality Based Navigation System for Radiation-Free Interventional Procedure

Despite offering numerous advantages, percutaneous treatments in interventional cardiology still present several limitations, including the recurrent use of fluoroscopy to track the route of the catheter during the intervention. In this study we propose an augmented reality (AR)-based navigation system for radiation-free interventional procedures using electromagnetic (EM) sensors. A customized tool embedding an EM sensor and a QRcode (automatically tracked in AR) was designed to perform the registration procedure. The accuracy of the system was assessed asking the user to evaluate the distance between the real position of the sensor and its holographic counterpart by means of a holographic measurement tool. Variability between intra-and inter-operator accuracy was assessed, each one performing 10 evaluation tests. Results showed a mean error of 2.70 ± 0.36 mm and 2.68 ± 0.79 mm for the intra-and inter-operator tests, respectively. To the best of our knowledge this is the first study that proposes a user independent procedure for calibrating an AR device with an EM system presenting a quantitative evaluation between intra-and inter-operators.