The machine is massive, its big articulated arm with 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 the target organs and reduce the dose of X-rays received by the 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, authorizes its patients to observe it under all his cutures, and even to go see the technicians in the control room at the end of a small corridor… at least in virtual reality.
With Dassault Systèmes, the establishment specializing in radiotherapy and radiosurgery has indeed put into service at the end of April 2022 an immersive experience unprecedented in the world. Called the VORTHEx project, it consists of allowing the patient to familiarize himself with the device that will treat him through an HP virtual reality headset and a pointer to move around in the simulated space.
Act against a time of fear
“Modelling the treatment of the patient implies a time of waiting 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 radiotherapy robot can be scarier than chemotherapy. For some, the very notion of robotization is synonymous with dehumanization. We had to reduce that fear.”
Some time before their treatment, the patient comes to the clinic to put on the virtual reality helmet in a room dedicated to the project. He discovers the care device as he will see it in real life. And as he will suffer, 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, obviously, all the technical equipment. The robot, the synchonia bar which detects the movements of the patient, the table where the latter lies down, the lights signaling the emission of rays in progress, the ceiling decorated with an image of blue sky and a palm tree, etc.
Restore the sound environment
“We took great care to restore the sound environment, adds Frédéric Vacher, director of the 3D Experience Lab at Dassault System, which developed this immersion. The robot makes noise because it moves or because it charges and it 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, using teleportation pointers, a classic process in virtual reality, can visit two technicians in front of monitors. On the screens appears the radiosurgery room and the Cyberknife, from various angles. “It’s a personalized solution, insists Alain Toledano. The person sees our Cyberknife, in our environment. It’s not like showing him a film that would be the same for everyone. He can look right, left, go see the robot, walk around the room.”
Change the mental representation
Until then, the preparation phase for radiosurgery went through images or, more technically, treatment follow-up and result curves. Or even anatomical drawings. “But the mental representation that the patient got from 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 manufacturers of medical machines do all the engineering of their devices with our solutions, the design, the simulation, before producing them, notes Frederic Vacher. We’ve been setting up experiments around the machines for quite some time.” Until then, the immersive applications designed by Dassault Systèmes mainly concerned dangerous industrial environments, to train personnel in delicate tasks.
If the immersion is experienced by the patient at 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 remains important to come on site, to meet the staff, ask questions, locate the real places. The virtual still has its limits.
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Radiotherapy: alleviating fears through virtual reality – Sciences et Avenir
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