Evaluation of Cinematic Rendering in Mixed Reality Holograms Compared to 3D-Printed Models and Their Value for Preoperative Planning of Congenital heart Surgery

Objectives: Cinematic rendering (CR) is a new 3D rendering technique, which has already proven its positive impact in preoperative planning in congenital heart surgery. So far CR images have been presented on 2D screen, but recently a new 3D-presenting application has been developed. By generating a 3D-hologram in CR-view, the patient’s heart can be presented in an extremely realistic way. A further already established 3D-imaging technique represents the 3D printing. The aim of this study is to show the benefit of realistic 3D-viewing in comparison to imaging only in 2D-view. Furthermore, the named 3D-imaging techniques were compared with each other.

Methods: CT-DICOM-data and MRI datasets were used to create STL-files to print a 3D-model, as well as to visualize the heart directly in CR-view by syngo. via (prototype application, Siemens Healthineers, Erlangen, Germany). The CR-image was visualized via HoloLensTM (Microsoft), a MR presenting device. A subjective evaluation of both tools was done by an interrogation of the surgeons with help of a questionnaire. Furthermore, an objective assessment was done by comparison of differences in preparation time of matched pairs. A paired t-test was used for statistical analysis (t < 0.05).

Result:30 patients were included in the study. The 3D imaging techniques showed a clear benefit in comparison to 2D-view for the surgeons in preoperative planning. Furthermore, a significant reduction of preparation time could be determined (p < 0.05%). A significant benefit of CR-holograms over 3D-printing in nearly all categories could be shown.

Conclusion: The 3D-view showed a clear benefit compared with monitor-imaging in preoperative planning. This is the first study, which described the use of CR-holograms. CR-holograms could surpass 3D-printing in all analyzed points.