Radically Improving Medicine & Surgery with Light Field Technology

It’s no secret that the healthcare industry is slow to adopt new technology. As we look at the pace of innovation in the consumer space, we see technology transforming life at a breakneck pace. How we shop, bank, communicate – even dating has moved from analog to digital: swipe right.
 
For an industry that touches every human life around the planet – healthcare is often simply felt to be too fragmented, wide-ranging and highly-regulated to be disrupted in the same way that technology has shaped and pushed all other aspects of our everyday world. However, this concept and framework is changing largely due to the pace, scale and potential of new technology.
 
Computational science, the bedrock of technology innovation, is finding its way into the operating room and innovations in technology such as light field imaging stand to transform and displace long-relied on modalities such as X-rays and CT scans.
 
The use of light field technology has the potential to take medicine to a new level and to radically change surgery allowing for computer vision, machine learning and big data to finally arrive in a meaningful way in surgery.
 
Leonardo da Vinci conceptualized light field technology in the late 15th century, exploring how light at different angles can be analyzed and understood. The vast capabilities of light fields has led Silicon Valley tech giants to explore light field’s applications for years and only more recently has this technology been looked at for use in medicine.
 
Our interest has been understanding how light field can impact spine surgery in a variety of ways, including providing better data, improving surgical performance, and surgical training advancement. With more than 1.3 million people receiving spine surgery in the United States each year, light field technology has the potential to impact a lot of lives.

How Light Field Can Be Applied to Surgery

Navigated spine surgery today relies on static registration by taking a pre-operative image and matching that to the patient’s position on the operating room table. The current systems need to establish “ground truth” about the patient’s position using fluoroscopy or 3D radiographic scans. While the value of navigation is clear, traditional navigation technologies lack precision and are rudimentary compared to where we are headed with technologies like light fields.
 
At Proprio, we are creating the process of utilizing light field technology to dynamically track the patient’s anatomy in situ, eliminating the need for radiation or re-registration. Light field creates an understanding of the entire operative scene, location, depth, color, and texture.
 
Computationally deriving information we would analogize as human proprioception. Light field technology uses a multitude of microlenses that capture the angle and intensity of light from many angles, then computationally creates interactive and dynamic 3-D images. It allows for more precise and dynamic registration by continuously seeing and sampling the scene.
 
Because the operative scene is captured digitally, the surgeon can combine volumetric patient imaging with the live surgical scene. This complex computational integration of the surgical scene and imaging data allows the surgeon to visually explore the combined data sets in high definition, from any perspective, for the first time.

The Potential for Data

While spine surgery has seen developments in robotics, first-generation computer-assisted navigation, expansion of minimally invasive surgery, and simplistic integration of virtual reality, there remains a profound and striking overdependence on radiation exposure to enable all of these modalities. While radiography provides moment in time information, it is limited and comes with known risks. Radiography also fails to provide the depth of usable data that can enable meaningful computation innovation.
 
Looked at objectively, relatively little data is generated inside operating rooms each day. We capture basic information, start/stop times, estimates of blood loss, implants, needle/sponge counts, etc. Everything inside of the case, the black box of surgery, is ethereal and largely lost. Currently, there aren’t solutions capable of collecting all of this data or applying it in any particular way.
 
By applying light field technology to spine surgery, we have an opportunity to collect specific, multi-dimensional, comprehensive data about all aspects of the procedure, longitudinally throughout the case. When captured in an intentional way, the data can then be fed into algorithms to be used for machine learning, teaching and training opportunities, and for the analysis of patient data and surgical performance.
 
This data has the power to transform surgery. By understanding what kind of data we want to collect and how we want to apply it, we’ll be able to advance how we understand patient conditions and a surgeon’s performance. As we gain more information, we will be able to conduct procedures with greater precision, provide real-time surgical decision support and drive efficiency, safety and reproducibility of these complex procedure sets.

Conclusion

Light field technology has the potential to transform the enabling surgical tools of today and derive data to teach us much more about surgery than any modality previously brought into the OR.
 
We have the opportunity to understand and track deliverables in an operation in an unprecedented way: what was intended, what was altered, what was achieved, how surgical procedures could be improved for enhanced clinical and economic outcomes. We’ve only just begun to tap into light field’s potential applications in surgery, but the benefits could be immense; for both the surgeon and patient.
 
Deep tech and surgery is the new frontier of computer science and will profoundly shape our industry just like what has happened to industry and life outside of our hallowed halls.
 

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Dr. Samuel Browd is the co-founder and chief medical officer at Proprio, professor of Neurological Surgery at the University of Washington, and board-certified attending neurosurgeon at Seattle Children’s Hospital, Harborview Medical Center and the University of Washington (UW) Medical Center. He received his M.D., Ph.D. at the University of Florida, completed neurosurgical residency at the University of Utah, and Pediatric Neurosurgery Fellowship at the University of Washington/Seattle Children’s Hospital. He also completed a research post-doctoral fellowship on functional magnetic resonance imaging and operative navigation.
 
In co-founding Proprio alongside University of Washington’s Sensor Systems Labs’ Dr. Joshua Smith, UW MBA graduate Gabriel Jones, and computer vision specialist James Youngquist, Browd sought to leverage the emerging technologies of AR/VR and AI to revolutionize the way surgeons navigate human anatomy. Proprio was created with a mission to use technology and data to transform surgical care and improve outcomes.