Development and Usability Testing of a User-Centered 3D Virtual Liver Surgery Planning System

Objective: The present study developed a user-centered 3D virtual liver surgery planning (VLSP) system called Dr. Liver to provide preoperative information for safe and rational surgery. Background: Preoperative 3D VLSP is needed for patients' safety in liver surgery. Existing systems either do not provide functions specialized for liver surgery planning or do not provide functions for cross-check of the accuracy of analysis results. Method: Use scenarios of Dr. Liver were developed through literature review, benchmarking, and interviews with surgeons. User interfaces of Dr. Liver with various user-friendly features (e.g., context-sensitive hotkey menu and 3D view navigation box) was designed. Novel image processing algorithms (e.g., hybrid semi-automatic algorithm for liver extraction and customized region growing algorithm for vessel extraction) were developed for accurate and efficient liver surgery planning. Usability problems of a preliminary version of Dr. Liver were identified by surgeons and system developers and then design changes were made to resolve the identified usability problems. Results: A usability testing showed that the revised version of Dr. Liver achieved a high level of satisfaction (6.1 ± 0.8 out of 7) and an acceptable time efficiency (26.7 ± 0.9 min) in liver surgery planning. Conclusion: Involvement of usability testing in system development process from the beginning is useful to identify potential usability problems to improve for shortening system development period and cost. Application: The development and evaluation process of Dr. Liver in this study can be referred in designing a user-centered system.22kc