Ann Hepatobiliary Pancreat Surg.  2022 Aug;26(3):285-288. 10.14701/ahbps.21-163.

Virtual reality education program including three-dimensional individualized liver model and education videos: A pilot case report in a patient with hepatocellular carcinoma

• Rhu J
• Lim S
• Kang D
• Cho J
• Lee H
• Choi GS
• Kim JM
• Joh JW

• KMID: 2532647
• DOI: http://doi.org/10.14701/ahbps.21-163

Abstract

Three-dimensional (3D) modeling of the liver can be especially useful for both the surgeon and patient to understand the actual location of the tumor and planning the resection plane. Virtual reality (VR) can enhance the understanding of 3D structures and create an environment where the user can focus on contents provided. In the present study, a VR platform was developed using Unreal Engine 4 software (Epic Games, Potomac, MD, USA). Patient’s liver based on magnetic resonance image was imported as a 3D model that could distinguish liver parenchyma, vascular structure, and cancer. Preoperative education videos for patients were developed. They could be viewed inside the VR platform. To evaluate the usefulness of VR education program for patients undergoing liver resection for hepatocellular carcinoma, a randomized clinical trial evaluating the knowledge and anxiety of the patient was designed. The case presented in this report was the first experience of performing the VR education program and examining the knowledge and anxiety using questionnaires. When the knowledge score increased, the anxiety score also increased after the education program. Based on findings of this pilot case study, the timing and place where the questionnaire will be answered can be modified for formal initiation of the randomized controlled study to examine the usefulness of VR in patient education.

Keyword

Hepatocellular carcinoma; Virtual reality; Education

Figure

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  Fig. 1 Pictures of the virtual reality (VR) education program. (A) Three-dimensional (3D) model of the tumor showing the tumor’s sophisticated location abutting to the middle hepatic vein. (B) The VR education program was applied by the author to the patient before operation. (C) The 3D model imported into the VR platform visualized the tumor location within the liver. (D) An education video for liver resection patients was also played in the VR platform.

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  Fig. 2 The protocol for a clinical trial. HCC, hepatocellular carcinoma; VR, virtual reality; 3D, three-dimensional; STAI, State-Trait anxiety inventory-X.

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