Projet VORTHEx

Radiotherapy: alleviating fears through virtual reality

The machine is massive, its big arm articulated at six degrees of movement, impressive. The Cyberknife, that’s its name, is a radiosurgery robot designed by a Californian company, capable of rotating around the patient to better target target organs and reduce the dose of X-rays received by organs at risk. But because being confronted with such a machine can quickly generate stress and discomfort, adding to the anxiety of the disease itself, the H. Hartmann clinic, in Levallois-Perret, allows its patients to observe it from all angles, and even to go to the technicians in the control room at the end of a small corridor … at least in virtual reality.

With Dassault Systèmes, the specialist radiotherapy and radiosurgery establishment has indeed put into operation at the end of April 2022 an immersive experience unprecedented in the world. Called the Vortex project, it consists in allowing the patient to familiarize himself with the device that will treat him through an HP virtual reality headset and a pointer to move in the simulated space.

Acting against a time of fear

“Modeling the patient’s treatment involves a waiting time for the latter, but it is a time of fear, explains Alain Toledano, oncologist and radiotherapist at the clinic. People want to be treated right away. A radiation therapy robot can be more scary than chemotherapy. For some, the very notion of robotization is synonymous with dehumanization. We had to reduce this fear.”

Some time before his treatment, the patient comes to the clinic to put on the virtual reality headset in a room dedicated to the project. He discovers the care device as he will see it in real life. And as he will undergo it, by lying down for real on a bench to see the Cyberknife virtually approaching him.

Not only does the experiment simulate the machine, but it simulates its environment. Everything has been modeled with precision, from the texture of the materials to the configuration of the premises, including, of course, all the technical equipment. The robot, the synchrony bar that detects the movements of the patient, the table where the latter lies down, the LEDs signaling the emission of rays in progress, the ceiling decorated with an image of blue sky and palm tree, etc.

Restore the sound atmosphere

“We took great care to restore the sound atmosphere,” adds Frédéric Vacher, director of the Dassault System 3D Experience Lab, which developed this immersion. The robot is making noise because it is moving or because they are charging and this can scare. If the patient first hears these noises in virtual reality, he will find it less strange to hear them again in real life.”

Even the control room, therefore, has been reconstructed. The patient, with the help of teleportation pointers, a classic method in virtual reality, can visit two technicians in front of monitors. The radiosurgery room and the Cyberknife appear on the screens, from various angles. “It’s a personalized solution,” insists Alain Toledano. The person sees our Cyberknife, in our environment. It’s not as if we were passing him a movie that would be the same for everyone. He can look to the right, to the left, go to the robot, walk around the room.”

Modify the mental representation

Until then, the preparation phase for radiosurgery consisted of images or, more technically, curves of follow-up and result of the treatment. Or even anatomical drawings. “But the mental representation that the patient got out of it was not terrible,” admits the oncologist. The project helps to raise the level of this representation.

Due to the Covid-19 pandemic, Dassault Systèmes took a year and a half to develop the experience. “Most medical machine manufacturers do all the engineering of their devices with our solutions, the design, the simulation, before producing them, notes Frédéric Vacher. For some time now, we have been setting up experiments around machines.”Until then, the immersive applications designed by Dassault Systèmes mainly concerned hazardous industrial environments, to train personnel for delicate tasks.

If the immersion is experienced by the patient in the clinic, it is technically hosted on the Dassault Systèmes cloud platform. So potentially accessible from anywhere in the world. But for the medical team, it is still important to come on site, to meet the staff, ask questions, spot the real places. The virtual world still has its limits.

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