Auditory and visio-temporal distance coding for 3-dimensional perception in medical augmented reality

Image-guided medical interventions more frequently rely on Augmented Reality (AR) visualization to enable surgical navigation. Current systems use 2-D monitors to present the view from external cameras, which does not provide an ideal perception of the 3-D position of the region of interest. Despite this problem, most research targets the direct overlay of diagnostic imaging data, and only few studies attempt to improve the perception of occluded structures in external camera views. The focus of this paper lies on improving the 3-D perception of an augmented external camera view by combining both auditory and visual stimuli in a dynamic multi-sensory AR environment for medical applications. Our approach is based on Temporal Distance Coding (TDC) and an active surgical tool to interact with occluded virtual objects of interest in the scene in order to gain an improved perception of their 3-D location. Users performed a simulated needle biopsy by targeting virtual lesions rendered inside a patient phantom. Experimental results demonstrate that our TDC-based visualization technique significantly improves the localization accuracy, while the addition of auditory feedback results in increased intuitiveness and faster completion of the task.