Augmented Reality-based Feedback for Technician-in-the-loop C-arm Repositioning

Interventional C-arm imaging is crucial to percutaneous orthopedic procedures as it enables the surgeon to monitor the progress of surgery on the anatomy level. Minimally invasive interventions require repeated acquisition of X-ray images from different anatomical views to verify tool placement. Achieving and reproducing these views often comes at the cost of increased surgical time and radiation dose to both patient and staff. This work proposes a marker-free "technician-in-the-loop" Augmented Reality (AR) solution for C-arm repositioning. The X-ray technician operating the C-arm interventionally is equipped with a head-mounted display capable of recording desired C-arm poses in 3D via an integrated infrared sensor. For C-arm repositioning to a particular target view, the recorded C-arm pose is restored as a virtual object and visualized in an AR environment, serving as a perceptual reference for the technician. We conduct experiments in a setting simulating orthopedic trauma surgery. Our proof-of-principle findings indicate that the proposed system can decrease the 2.76 X-ray images required per desired view down to zero, suggesting substantial reductions of radiation dose during C-arm repositioning. The proposed AR solution is a first step towards facilitating communication between the surgeon and the surgical staff, improving the quality of surgical image acquisition, and enabling context-aware guidance for surgery rooms of the future. The concept of technician-in-the-loop design will become relevant to various interventions considering the expected advancements of sensing and wearable computing in the near future

Visual Perception and Cognition in Image-Guided Intervention

Surgical image visualization and interaction systems can dramatically affect the efficacy and efficiency of surgical training, planning, and interventions. This is even more profound in the case of minimally-invasive surgery where restricted access to the operative field in conjunction with limited field of view necessitate a visualization medium to provide patient-specific information at any given moment. Unfortunately, little research has been devoted to studying human factors associated with medical image displays and the need for a robust, intuitive visualization and interaction interfaces has remained largely unfulfilled to this day. Failure to engineer efficient medical solutions and design intuitive visualization interfaces is argued to be one of the major barriers to the meaningful transfer of innovative technology to the operating room. This thesis was, therefore, motivated by the need to study various cognitive and perceptual aspects of human factors in surgical image visualization systems, to increase the efficiency and effectiveness of medical interfaces, and ultimately to improve patient outcomes. To this end, we chose four different minimally-invasive interventions in the realm of surgical training, planning, training for planning, and navigation: The first chapter involves the use of stereoendoscopes to reduce morbidity in endoscopic third ventriculostomy. The results of this study suggest that, compared with conventional endoscopes, the detection of the basilar artery on the surface of the third ventricle can be facilitated with the use of stereoendoscopes, increasing the safety of targeting in third ventriculostomy procedures. In the second chapter, a contour enhancement technique is described to improve preoperative planning of arteriovenous malformation interventions. The proposed method, particularly when combined with stereopsis, is shown to increase the speed and accuracy of understanding the spatial relationship between vascular structures. In the third chapter, an augmented-reality system is proposed to facilitate the training of planning brain tumour resection. The results of our user study indicate that the proposed system improves subjects\u27 performance, particularly novices\u27, in formulating the optimal point of entry and surgical path independent of the sensorimotor tasks performed. In the last chapter, the role of fully-immersive simulation environments on the surgeons\u27 non-technical skills to perform vertebroplasty procedure is investigated. Our results suggest that while training surgeons may increase their technical skills, the introduction of crisis scenarios significantly disturbs the performance, emphasizing the need of realistic simulation environments as part of training curriculum

Augmented reality X-ray vision on optical see-through head mounted displays

Abstract. In this thesis, we present the development and evaluation of an augmented reality X-ray system on optical see-through head-mounted displays. Augmented reality X-ray vision allows users to see through solid surfaces such as walls and facades, by augmenting the real view with virtual images representing the hidden objects. Our system is developed based on the optical see-through mixed reality headset Microsoft Hololens. We have developed an X-ray cutout algorithm that uses the geometric data of the environment and enables seeing through surfaces. We have developed four different visualizations as well based on the algorithm. The first visualization renders simply the X-ray cutout without displaying any information about the occluding surface. The other three visualizations display features extracted from the occluder surface to help the user to get better depth perception of the virtual objects. We have used Sobel edge detection to extract the information. The three visualizations differ in the way to render the extracted features. A subjective experiment is conducted to test and evaluate the visualizations and to compare them with each other. The experiment consists of two parts; depth estimation task and a questionnaire. Both the experiment and its results are presented in the thesis

Developing serious games for cultural heritage: a state-of-the-art review

Although the widespread use of gaming for leisure purposes has been well documented, the use of games to support cultural heritage purposes, such as historical teaching and learning, or for enhancing museum visits, has been less well considered. The state-of-the-art in serious game technology is identical to that of the state-of-the-art in entertainment games technology. As a result, the field of serious heritage games concerns itself with recent advances in computer games, real-time computer graphics, virtual and augmented reality and artificial intelligence. On the other hand, the main strengths of serious gaming applications may be generalised as being in the areas of communication, visual expression of information, collaboration mechanisms, interactivity and entertainment. In this report, we will focus on the state-of-the-art with respect to the theories, methods and technologies used in serious heritage games. We provide an overview of existing literature of relevance to the domain, discuss the strengths and weaknesses of the described methods and point out unsolved problems and challenges. In addition, several case studies illustrating the application of methods and technologies used in cultural heritage are presented

X-ray vision at action space distances: depth perception in context

Accurate and usable x-ray vision has long been a goal in augmented reality (AR) research and development. X-ray vision, or the ability to comprehend location and object information when such is viewed through an opaque barrier, would be imminently useful in a variety of contexts, including industrial, disaster reconnaissance, and tactical applications. In order for x-ray vision to be a useful tool for many of these applications, it would need to extend operators’ perceptual awareness of the task or environment. The effectiveness with which x-ray vision can do this is of significant research interest and is a determinant of its usefulness in an application context. In substance, then, it is crucial to evaluate the effectiveness of x-ray vision—how does information presented through x-ray vision compare to real-world information? This approach requires narrowing as x-ray vision suffers from inherent limitations, analogous to viewing an object through a window. In both cases, information is presented beyond the local context, exists past an apparently solid object, and is limited by certain conditions. Further, in both cases, the naturally suggestive use cases occur over action space distances. These distances range from 1.5 to 30 meters and represent the area in which observers might contemplate immediate visually directed actions. These actions, simple tasks with a visual antecedent, represent action potentials for x-ray vision; in effect, x-ray vision extends an operators’ awareness and ability to visualize these actions into a new context. Thus, this work seeks to answer the question “Can a real window be replaced with an AR window?” This evaluation focuses on perceived object location, investigated through a series of experiments using visually directed actions as experimental measures. This approach leverages established methodology to investigate this topic by experimentally analyzing each of several distinct variables on a continuum between real-world depth perception and fully realized x-ray vision. It was found that a real window could not be replaced with an AR window without some loss of depth perception acuity and accuracy. However, no significant difference was found between a target viewed through an opaque wall and a target viewed through a real window

Deformable Beamsplitters: Enhancing Perception with Wide Field of View, Varifocal Augmented Reality Displays

An augmented reality head-mounted display with full environmental awareness could present data in new ways and provide a new type of experience, allowing seamless transitions between real life and virtual content. However, creating a light-weight, optical see-through display providing both focus support and wide field of view remains a challenge. This dissertation describes a new dynamic optical element, the deformable beamsplitter, and its applications for wide field of view, varifocal, augmented reality displays. Deformable beamsplitters combine a traditional deformable membrane mirror and a beamsplitter into a single element, allowing reflected light to be manipulated by the deforming membrane mirror, while transmitted light remains unchanged. This research enables both single element optical design and correct focus while maintaining a wide field of view, as demonstrated by the description and analysis of two prototype hardware display systems which incorporate deformable beamsplitters. As a user changes the depth of their gaze when looking through these displays, the focus of virtual content can quickly be altered to match the real world by simply modulating air pressure in a chamber behind the deformable beamsplitter; thus ameliorating vergence–accommodation conflict. Two user studies verify the display prototypes’ capabilities and show the potential of the display in enhancing human performance at quickly perceiving visual stimuli. This work shows that near-eye displays built with deformable beamsplitters allow for simple optical designs that enable wide field of view and comfortable viewing experiences with the potential to enhance user perception.Doctor of Philosoph