Angiography-like neurovascular training without radiation utilizing optical cameras and virtual roadmap imaging

Background At present, nonvirtual neurovascular training can be performed using either an angiographic suite under fluoroscopic guidance (entailing radiation exposure) or direct optical visualization with a camera-based system. The angiographic approach offers high-fidelity visualization and catheter control but is constrained by the limited availability of such specialized facilities, whereas the camera-based approach can be implemented virtually anywhere yet lacks comparable realism in key procedural aspects. The objective of this work is to develop and evaluate a novel camera-based angiography training system (CBATS) that generates artificial angiograms and roadmaps, thereby combining the advantages of both imaging techniques while eliminating radiation exposure. Methods Three distinct aneurysm models were integrated into a novel neurointerventional training platform, which was evaluated by neurointerventionalists across three training imaging modalities (conventional digital subtraction angiography DSA, camera-only visualization, and CBATS) to simulate general endovascular procedures. Following the training sessions, a questionnaire-based evaluation was conducted to compare the performances of the camera-only and CBATS approaches with the conventional DSA, which served as the gold standard. Results Ninety percent of the raters agree that the visual realism of our CBATS training system is comparable to real angiography and offers a significant advantage over the camera-only variant. The absence of radiation, in particular, was rated as a major advantage by 89.3% of the raters. Conclusions In summary, our angiography-like training system is considered comparable to a real angiography system in terms of realism for the training scenarios addressed. However, it offers the advantage of being radiation-free and can be set up in almost any location.