{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:09:34Z","timestamp":1776319774256,"version":"3.50.1"},"reference-count":73,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Virtual Worlds"],"abstract":"<jats:p>Pediatric diffuse midline gliomas in the brainstem (bDMGs) are malignant primary brain neoplasms with poor prognosis. Conventional dogma cites that biopsy procedures have risks of devastating injury to the eloquent brainstem and have no direct benefit to affected patients. In recent years, the use of augmented reality (AR) adjuncts has demonstrated potential in providing excellent intraoperative three-dimensional (3D) visualization of intracranial structures. Put together, we hypothesize that the application of AR will be useful as a training tool for brainstem biopsy procedures. Anatomical models of bDMG tumors are created and uploaded to an AR application. The processed data is transferred into designated AR head-mounted devices. Briefly, individual 3D-rendered bDMG images are overlaid with an age-matched, life-sized child mannequin in prone position. A virtual stereotactic brain biopsy needle is deployed by the user into the lesion. At the end of the exercise, each user evaluates their trajectory of choice to assess its accuracy. Overall, the participants reported that the AR platform was useful in reviewing technical nuances for brainstem biopsy in a safe environment. This focused, proof-of-concept study adds to the growing body of literature that AR platforms demonstrate feasibility for neurosurgeons in the understanding of challenging operative neuroanatomy.<\/jats:p>","DOI":"10.3390\/virtualworlds4040048","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T04:26:29Z","timestamp":1761711989000},"page":"48","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Augmented Reality as a Teaching Tool for Pediatric Brainstem Biopsy"],"prefix":"10.3390","volume":"4","author":[{"given":"Jonis M.","family":"Esguerra","sequence":"first","affiliation":[{"name":"Neurological Surgery, Vicente Sotto Memorial Medical Center, B. Rodriguez St, Cebu City 6000, Cebu, Philippines"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4234-8991","authenticated-orcid":false,"given":"Y. T.","family":"Lo","sequence":"additional","affiliation":[{"name":"Neurosurgical Service, KK Women\u2019s and Children\u2019s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore"}]},{"given":"Yilong","family":"Wu","sequence":"additional","affiliation":[{"name":"Neurosurgical Service, KK Women\u2019s and Children\u2019s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4767-6830","authenticated-orcid":false,"given":"Jing Chun","family":"Teo","sequence":"additional","affiliation":[{"name":"School of Engineering, Ngee Ann Polytechnic, 535 Clementi Road, Singapore 599489, Singapore"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7317-670X","authenticated-orcid":false,"given":"Sharon Y. Y.","family":"Low","sequence":"additional","affiliation":[{"name":"Neurosurgical Service, KK Women\u2019s and Children\u2019s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore"},{"name":"Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore"},{"name":"SingHealth Duke-NUS Neuroscience Academic Clinical Program, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore"},{"name":"SingHealth Duke-NUS Pediatrics Academic Clinical Program, 100 Bukit Timah Road, Singapore 229899, Singapore"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1056\/NEJMra2116344","article-title":"Brain Tumors in Children","volume":"386","author":"Cohen","year":"2022","journal-title":"N. Engl. J. 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