Background

Personalised resection planning for hepatobiliary surgery is key to ensure successful outcomes with minimal risks or complications due to the complexity of hepatic anatomy and the relatively common presence of anatomical variants of the vascular and biliary structures. The emerging application of virtual reality (VR) technology in the medical domain has shown superior advantages over traditional visualisation techniques when planning complex or challenging surgeries.

Aims

This study aimed to develop a VR demonstration of hepatobiliary malignancies with surrounding hepatic anatomy, to investigate how VR assists clinicians in the pre-surgical planning of tumour resection.

Methods

3D Slicer was used to segment high-resolution computed tomography (CT) datasets, using manual and semi-automatic approaches in two selected cases of hepatobiliary malignancies: multifocal hepatocellular carcinoma and cholangiocarcinoma. The 3D segmented volume data were then demonstrated on a Meta Quest 2 VR headset using the SlicerVirtualReality extension for 3D Slicer.

Results

Two cases of hepatobiliary malignancies were successfully segmented and demonstrated in VR. Realistic 3D visualisation of hepatic tumours in relation to surrounding structures were clearly demonstrated with observers being able to visualise either individual segmented structures or the entire volume data together.

Conclusion

 The VR demonstration may allow clinicians to improve their understanding of the spatial relationships between the pathology and surrounding structures, compared to the current methods of 2D/3D image visualisations. Furthermore, improvement in pre-surgical planning has potential to increase treatment outcomes by decreasing inappropriate surgical procedures and postoperative complications.