Purpose: Biopsies play a crucial role in determining the classification and staging of tumors. Ultrasound is frequently used in this procedure to provide real-time anatomical information. Using augmented reality (AR), surgeons can visualize ultrasound data and spatial navigation information seamlessly integrated with real tissues. This innovation facilitates faster and more precise biopsy operations. Methods: We developed an AR biopsy navigation system with low display latency and high accuracy. Ultrasound data is initially read by an image capture card and streamed to Unity via net communication. In Unity, navigation information is rendered and transmitted to the HoloLens 2 device using holographic remoting. Retro-reflective tool tracking is implemented on the HoloLens 2, enabling simultaneous tracking of the ultrasound probe and biopsy needle. Distinct navigation information is provided during in-plane and out-of-plane punctuation. To evaluate the effectiveness of our system, we conducted a study involving ten participants, for puncture accuracy and biopsy time, comparing to traditional methods. Results: Our proposed framework enables ultrasound visualization in AR with only $16.22\pm11.45ms$ additional latency. Navigation accuracy reached $1.23\pm 0.68mm$ in the image plane and $0.95\pm 0.70mm$ outside the image plane. Remarkably, the utilization of our system led to $98\%$ and $95\%$ success rate in out-of-plane and in-plane biopsy. Conclusion: To sum up, this paper introduces an AR-based ultrasound biopsy navigation system characterized by high navigation accuracy and minimal latency. The system provides distinct visualization contents during in-plane and out-of-plane operations according to their different characteristics. Use case study in this paper proved that our system can help young surgeons perform biopsy faster and more accurately.

翻译：目的：穿刺活检在肿瘤分类与分期中具有关键作用。超声常被用于该过程以提供实时解剖信息。通过增强现实技术，外科医生可将超声数据与空间导航信息无缝融合于真实组织之上进行可视化，这一创新有助于实现更快速、更精准的穿刺操作。方法：我们开发了一种低显示延迟、高精度的增强现实穿刺活检导航系统。超声数据首先通过图像采集卡读取，经网络通信传输至Unity平台。在Unity中，导航信息被渲染后通过全息远程传输至HoloLens 2设备。基于HoloLens 2实现逆反射式器械追踪，可同步追踪超声探头与穿刺针。针对平面内与平面外穿刺分别提供差异化导航信息。为验证系统有效性，我们招募十名受试者开展穿刺精度与活检时间的对比实验（与传统方法对照）。结果：本系统实现超声图像增强现实可视化仅增加$16.22\pm11.45ms$延迟，导航精度在图像平面内达到$1.23\pm 0.68mm$，平面外达到$0.95\pm 0.70mm$。值得注意的是，采用本系统后平面内与平面外穿刺成功率分别达到$98\%$与$95\%$。结论：本文提出一种基于增强现实的超声穿刺活检导航系统，具有高导航精度与低延迟特性。系统根据平面内/平面外操作的不同特性提供差异化可视化内容。实验证明本系统可帮助青年医生更快速、更精准地完成穿刺活检。