Via Research Recognition Day 2024 VCOM-Carolinas

Educational Reports

Feasibility Study of a Virtual Reality Breast Biopsy Simulation Kyle Kleiman, OMS-III; Corey Shum; Stefanie Woodard, DO. Edward Via College of Osteopathic Medicine – Carolinas; Immersive Experience Laboratories; The University of Alabama at Birmingham – Department of Radiology.

Abstract

Results

Results (cont.)

Ultrasound-guided breast biopsies are the most performed imaging-guided breast procedures. During training, learners may lack exposure due to limited volume and sensitive anatomy. Current simulation training is limited to manufactured and homemade (chicken breast) phantoms. Virtual reality (VR) is an emerging technology, allowing learners to have flexibility in learning. The Breast Biopsy Simulator is a VR educational device featuring a headset and two handheld controllers. The system includes a VR headset, VR handpieces with insertable 3-D printed ultrasound probe model. The user enters a simulation setting as a physician performing a core needle breast biopsy on a patient. Fellowship-trained breast radiologists participated in the simulation to assess performance of the system and provide measures of feasibility, including time to successful biopsy and survey metrics. Objective Use of the VR Breast Biopsy simulation is expected to lead to increased user confidence and decreased time to perform breast biopsy. This was a HIPAA-compliant, IRB-approved prospective feasibility study. The participants were three fellowship-trained breast radiologists with varying years of experience. Participants received the same brief training session, which showed them how to enter the simulation and navigate controls. The users were instructed to perform as many breast biopsies as possible (one cycle consisted of entering the breast with the biopsy needle, taking a biopsy sample and removing the needle) within a 15-minute time period. Time to successfully biopsy the mass was recorded by the program, and this data was recorded to assess improvement from start to finish of the simulation. A post-procedure survey was administered to all participants immediately after completion of the simulation, as well as a request for subjective feedback. Introduction or Methods

Data demonstrated a decreased time to successful biopsy across consecutive trials for each of the three attending breast radiologists. The R 2 value was 0.5776, indicating moderate fit (approximately 57.8% of variability in time to biopsy can be accounted for by the linear regression model). Mean responses for survey results were high for the scores of user engagement (4.67/5.00 ± 0.47), sense of realism (2.67/3.00 ± 0.47), and likeliness to recommend to other healthcare professionals (2.67/3.00 ± 0.47). Subjective feedback from the attendings was overall positive. Comments included “Overall I am very excited about this project and think it is a fantastic idea. I think it will give students and residents that haven’t ever biopsied something a feel for what it is like and the challenges of lining up a needle and probe.”

Figure 4 . Survey results

Conclusion

Use of the VR breast biopsy simulation resulted in decreased time to biopsy with each subsequent use for all users. Subjective feedback from fellowship trained breast radiologists was positive and supported the use of the simulation in medical student and resident training. Future studies are needed to see if the simulation is translatable into practice.

Figure 2 . Time to successfully biopsy mass for each individual attending.

References

Special thanks to Immersive Experience Laboratories for creating the VR Breast Biopsy Simulation. Acknowledgements 2. Ward BM, Charissis V, Rowley D, Anderson P, Brady L. An evaluation of prototype VR medical training environment: applied surgical anatomy training for malignant breast disease. Stud Health Technol Inform. 2008;132:550–5. 3. Gresens AA, Britt RC, Feliberti EC, Britt LD. Ultrasound-guided breast biopsy for surgical residents: evaluation of a phantom model. J Surg Educ. 2012 Jun;69(3):411–5. 4. Rathbun KM, Harryman CF, Re AT. Prolonging the shelf life of homemade gelatin ultrasound phantoms. J Med Ultrasound. 2022 May 25;30(2):130–4. 5. Wu Y, Mondal P, Stewart M, Ngo R, Burbridge B. Bringing radiology education to a new reality: A pilot study of using virtual reality as a remote educational tool. Can Assoc Radiol J. 2023 May;74(2):251–63. 1. Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, et al. Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg. 2002 Oct;236(4):458–63; discussion 463.

Figure 1. Photos of VR Breast Biopsy Simulation. Preparing to enter mass (left) and firing needle inside mass (right).

Figure 3 . Average time to successfully biopsy mass for all 3 attendings.

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2024 Research Recognition Day