AR Imaging

Reduce the time and cost while improving patient outcomes by revolutionizing visualizations during surgery using augmented reality

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Check out AR Imaging on @MedStartr Today Reduce the time and cost while improving patient outcomes by revolutionizing visualizations during surgery using augmented reality. #MedMo #MedStartrVentures

https://www.medstartr.ai/s/PFn6HNuk72M

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<table align="left" cellpadding="0" cellspacing="0"> <tbody> <tr> <td> <p>AR Imaging uses augmented reality to revolutionize clinical visualizations to enhance tissue differentiation.  We do this by providing AR-enabled glasses (digital loupes), that enable the surgeon to view 3D color images of the patient with coregistration of fluorescent contrast agents and pre-operative diagnostic images (e.g. CT, MRI) superimposed on the surgical field.</p> <p>Fluorescent imaging helps quickly identify tissue perfusion (viability) and helps identify cancerous areas (they light up like a Christmas tree). The superimposed preoperative images provide a highly effective image guided surgery solution that improves decision making and situational awareness.</p> <p>All targeted procedures have current solutions and related DRGs and ICDs for reimbursements and payments associated with fluorescent and image guided surgery. In addition to providing a major cost savings, these solutions have other shortcomings that impact surgical experiences.  This includes:</p> <ul> <li>Procedures require clinicians to view multiple 2D monitors, creating eye-hand coordination and depth perception issues that can increase procedure time & reduce quality of outcomes.</li> <li>The limited ability to differentiate tissue and accurately gauge perfusion can negatively impact decision-making, leading to increased complications, patient morbidity and reoperation rates.</li> <li>Current attempts to improve tissue differentiation and perfusion are challenged by workflow issues from cumbersome equipment.</li> <li>Use of radioisotopes for sentinel lymph node mapping have significant purchase and disposal costs as well as exposing patients and staff to well-known health risk.</li> <li>Preoperative images, patient vitals and other data that are critical to improved decision-making still require visual and verbal distractions during procedures.</li> <li>Current loupes have a single focal point and have shown to cause chronic pain and related issues for surgeons.</li> </ul> <p>Specifically, the following value for each user that addresses their respective pain point(s) is listed in the table below:</p> <table border="1" cellpadding="0" cellspacing="0"> <tbody> <tr> <td> <p>User or Patient</p> </td> <td> <p>Pain</p> </td> <td> <p>Value</p> </td> </tr> <tr> <td> <p>Hospital</p> </td> <td> <ul> <li>Costly equipment</li> <li>OR capacity</li> <li>Disposable costs</li> </ul> </td> <td> <ul> <li>$1.3M to $2.4M cost savings over 3 years</li> <li>Est. 10-50% reduction in procedure time (reduced anesthesiologist costs, increased capacity, etc.)</li> <li>Reduced complication costs ($10K to $100s K per event)</li> </ul> </td> </tr> <tr> <td> <p>Surgeon</p> </td> <td> <ul> <li>Neck discomfort</li> <li>Workflow impacts and usability issues (e.g. lights off)</li> <li>Procedure capacity</li> <li>Verbal and visual distractions</li> <li>Poor tissue differentiation</li> <li>Radiation exposure</li> <li>Multiple 2D monitors</li> <li>Verbal and visual distractions</li> </ul> </td> <td> <ul> <li>Auto-focus and variable magnification lessen neck issues</li> <li>Reduced stress and improved decision-making increase quality and reduces time – driving up patient satisfaction</li> <li>Eliminates radiation exposure</li> <li>Improves communications and eliminates distractions</li> </ul> </td> </tr> <tr> <td> <p>Patient</p> </td> <td> <ul> <li>Morbidity due to excessive tissue removal, surgical errors, higher reoperation rates and radiation exposure</li> </ul> </td> <td> <ul> <li>Shorter surgeries, less blood loss, less morbidity, fewer reoperations, etc.</li> <li>Eliminates radiation exposure</li> </ul> </td> </tr> <tr> <td> <p>Others in OR</p> </td> <td> <ul> <li>Multiple 2D monitors</li> <li>Verbal and visual distractions</li> </ul> </td> <td> <ul> <li>Improves communications and eliminates distractions</li> </ul> </td> </tr> </tbody> </table> </td> </tr> </tbody> </table>

Company Info

Clinical & IP

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Clinical Validation

<p><em><strong>Animal studies completed and published.</strong></em></p> <p><a href="https://www.spiedigitallibrary.org/conference-proceedings-of-spie/9311/93110Z/A-miniature-wearable-optical-imaging-system-for-guiding-surgeries/10.1117/12.2076226.short?SSO=1">A miniature wearable optical imaging system for guiding surgeries</a></p> <p>Image guidance can result in improved surgical outcomes, shorter operating times as well as a reduced likelihood of requiring a follow-up surgery for various medical interventions. Many intraoperative imaging systems utilize 2D computer monitors, making it difficult to correlate the surgical landscape with the displayed functional information as well as potentially distracting the surgeon. To address this issue, a miniature, wearable Near Infrared (NIR) fluorescent imaging system entitled Stereoscopic Optical Imaging Goggle is developed. The system is made up of two imaging sensors affixed to a wearable stereoscopic display, providing the surgeon with functional data in 3 dimensions with depth perception. We have characterized the system’s optical properties and fluorescent detection limits. In addition, we have demonstrated the efficacy of the system during surgical studies in chicken. We have found that the system can resolve fluorescent structures down to 0.25mm. The system was successfully guided the excision of fluorescent tissue from a chicken. To the best of our knowledge, the Stereoscopic Optical Imaging Goggle is the first wearable wide-field fluorescence imaging system that offers stereoscopic imaging capability and 3D depth perception.</p> <p><a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0141956">Stereoscopic Integrated Imaging Goggles for Multimodal Intraoperative Image Guidance</a></p> <p>We have developed novel stereoscopic wearable multimodal intraoperative imaging and display systems entitled Integrated Imaging Goggles for guiding surgeries. The prototype systems offer real time stereoscopic fluorescence imaging and color reflectance imaging capacity, along with in vivo handheld microscopy and ultrasound imaging. With the Integrated Imaging Goggle, both wide-field fluorescence imaging and in vivo microscopy are provided. The real time ultrasound images can also be presented in the goggle display. Furthermore, real time goggle-to-goggle stereoscopic video sharing is demonstrated, which can greatly facilitate telemedicine. In this paper, the prototype systems are described, characterized and tested in surgeries in biological tissues ex vivo. We have found that the system can detect fluorescent targets with as low as 60 nM indocyanine green and can resolve structures down to 0.25 mm with large FOV stereoscopic imaging. The system has successfully guided simulated cancer surgeries in chicken. The Integrated Imaging Goggle is novel in 4 aspects: it is (a) the first wearable stereoscopic wide-field intraoperative fluorescence imaging and display system, (b) the first wearable system offering both large FOV and microscopic imaging simultaneously, (c) the first wearable system that offers both ultrasound imaging and fluorescence imaging capacities, and (d) the first demonstration of goggle-to-goggle communication to share stereoscopic views for medical guidance.</p> <p><a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0174928">Fluorescence Imaging Topography Scanning System for intraoperative multimodal imaging</a></p> <p>Fluorescence imaging is a powerful technique with diverse applications in intraoperative settings. Visualization of three dimensional (3D) structures and depth assessment of lesions, however, are oftentimes limited in planar fluorescence imaging systems. In this study, a novel Fluorescence Imaging Topography Scanning (FITS) system has been developed, which offers color reflectance imaging, fluorescence imaging and surface topography scanning capabilities. The system is compact and portable, and thus suitable for deployment in the operating room without disturbing the surgical flow. For system performance, parameters including near infrared fluorescence detection limit, contrast transfer functions and topography depth resolution were characterized. The developed system was tested in chicken tissues ex vivo with simulated tumors for intraoperative imaging. We subsequently conducted in vivo multimodal imaging of sentinel lymph nodes in mice using FITS and PET/CT. The PET/CT/optical multimodal images were co-registered and conveniently presented to users to guide surgeries. Our results show that the developed system can facilitate multimodal intraoperative imaging.</p> <table align="left" cellpadding="0" cellspacing="0"> <tbody> <tr> <td> <p><a href="https://link.springer.com/protocol/10.1007/978-1-4939-3721-9_9">Intraoperative Fluorescence Imaging and Multimodal Surgical Navigation Using Goggle System</a></p> <p>Intraoperative imaging is an invaluable tool in many surgical procedures. We have developed a wearable stereoscopic imaging and display system entitled Integrated Imaging Goggle, which can provide real-time multimodal image guidance. With the Integrated Imaging Goggle, wide field-of-view fluorescence imaging is tracked and registered with intraoperative ultrasound imaging and preoperative tomography-based surgical navigation, to provide integrated multimodal imaging capabilities in real-time. Herein we describe the system instrumentation and the methods of using the Integrated Imaging Goggle to guide surgeries.</p> </td> </tr> </tbody> </table> <p><em><strong>AR Imaging has a working prototype being used in surgery in trials at the Cleveland Clinic. Initial surgery performed by Dr. Stephen R. Grobmyer, Director, Surgical Oncology at the Cleveland Clinic.</strong></em></p> <p>The first active IRB is directed toward sentinel node lymph node biopsies for breast cancer (NCT02802553), the second concerns basal/squamous cell carcinoma (skin cancers) auto-fluorescence with Levulon (alpha-levulinic acid) versus actinic keratosis differentiation and the third submitted IRB is perfusion of reconstruction flaps in plastic surgery mainly free flaps in breast reconstruction. Approved IRBs at CCF go through a lengthy process that also includes Case Western Reserve Medical School, University Hospitals and Metro General) </p>

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