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Virtual Reality Case at CIO: Thyroid Ablation

Virtual Reality Case at CIO: Thyroid Ablation


Ziv J. Haskal, MD, is a pioneer of novel educational methods, and he is excited to bring the benefits of VR educational technology to the CIO audience. Dr. Haskal will present the first virtual reality thyroid ablation case at CIO 2019 on Saturday, October 12, 2019. In this Q&A, he talks about the process of VR filming, as well as why he chose thyroid ablation to spotlight in the VR case. Dr. Haskal is a CIO course director, a professor of interventional radiology at the University of Virginia, and the editor of the Journal of Vascular and Interventional Radiology (JVIR).

We’re excited to hear that you’re doing the first VR thyroid ablation case. Is this your first VR case?

I released the first IR Virtual Reality case on YouTube over a year ago— a 10-segment case on Transjugular Intrahepatic Portosystemic Shunt creation.1,2 I learned a lot about VR filming from that 4-camera shoot. But the thyroid ablation case for CIO is the first of its kind. We have shot nearly two hours of tape of Prof. Au Whan Park, using a 4-camera shoot, and have edited it into about 11 minutes. Production of this case took a great deal of work that, if we have done it well, will be invisible to the viewers, including ergonomics, framing, positioning of add-ins, audio, etc. Creating a VR case is essentially film-making, but the complexity of the platform, balanced with content expertise, makes it a very different animal from traditional film. 

Why did you choose this particular procedure as your first case?  Are certain procedures more difficult to perform/practice with VR?

Thyroid surgery is very common. The ability to replace open, often disfiguring surgery with image-guided ablation for benign thyroid masses is well established outside the U.S. However, somewhat inexplicably, image-guided thyroid ablation has not been adopted by U.S. physicians. For some years, I have been trying to increase recognition, through educational events, the JVIR, and other channels.  The ability to reach an interested, expert audience at a major, leading conference—CIO—may be just the catalyst necessary for the procedure to begin to take off in the U.S. Putting image-guided thyroid ablation together with a VR case could be the rocket booster needed. Our hope is to take this relatively unknown procedure to U.S. physicians by placing the attendees in a seat they can’t otherwise get, outside of being in the interventional suite. They will be in the room, right there, part of the procedure, with Dr. Park. I believe this vantage point will demystify the procedure and make it clear to our attendees that they can learn to do image-guided thyroid ablation and that they can imagine themselves offering the procedure to patients. We hope to inspire physicians to seek the specific training they need. CIO is the perfect dynamic forum for this kind of debut. 

How long has VR technology been around? What are the challenges involved in producing a VR case?

VR technology is relatively new, but it’s really broken through in the past few years. I have been interested in novel means to educate students, colleagues, conference audiences, and larger remote audiences, for decades. My educational efforts have spanned the SIR Case Club, the first web-based IR case forum, where I published over 450 discussed cases nearly 25 years ago, to the entire MasterClass genre I created and held at conferences for 12 years— including at ISET and CIO. That stemmed from being taken to masterclasses as young piano student. I see versions of these teaching tools everywhere now—and I’m flattered by their wide adoption. VR was a natural next tool to pursue. 

We have a professional team of camera and audio personnel, a VR editor, and an Emmy-winning producer, and we are also collaborating with software developers and students. We are grant-supported, and we are shooting or planning multiple films across disciplines, as well as conference-focused experiences. We are also beginning to experiment with augmented features that might improve procedural outcomes, create consistency, improve operator confidence, and expand adoption of important new technologies. Additionally, we have VR materials for patients.  

When is the case at CIO, and why should people attend?

The session begins at 4:05 PM on Saturday at CIO, and the case itself will be shown from 4:35 – 5:00 PM and includes discussion with a panel of experts. Be sure to visit our pit-crew booth beforehand to download the app and ensure you’re good-to-go for the event. We’re looking forward to seeing everyone at the event. It’s a fantastic opportunity to better understand both thyroid ablation and VR education.


  1. Haskal ZJ. A taste of the future now—The JVIR virtual reality project: transjugular intrahepatic portosystemic shunt. J Vasc Interv Radiol. 2018 Jul;29(7):909-911. doi: 10.1016/j.jvir.2018.05.011.
  2. Haskal ZJ. JVIR VR Tips. YouTube. Available online at Accessed October 2, 2019.


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