Nested Semi-Transparent Isosurface Simulated Volume-Rendering (NESTIS-VR) – An efficient on-device rendering approach for Augmented Reality headsets increasing surgeon confidence of kidney donor arterial anatomy
Volume-renderings of computed tomography or magnetic resonance angiograms (MRAs) are routinely used by surgeons in the preoperative assessment of vascular anatomy in kidney donors. Stereoscopic headsets (OST-HMD) like Microsoft HoloLens allow intuitive interaction with three-dimensional content for...
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| creator | Necker, Fabian N. Melcher, Marc L. Busque, Stephan Leuze, Christoph W. Ghanouni, Pejman Le Castillo, Chris Nguyen, Elizabeth Daniel, Bruce L. |
| description | Volume-renderings of computed tomography or magnetic resonance angiograms (MRAs) are routinely used by surgeons in the preoperative assessment of vascular anatomy in kidney donors. Stereoscopic headsets (OST-HMD) like Microsoft HoloLens allow intuitive interaction with three-dimensional content for more intuitive comprehension, but do not allow real-time ray-casting volume-rendering of medical volume datasets on-device due to computational limitations.
We introduce NEsted Semi-Transparent Isosurface Simulated Volume-Rendering (NESTIS-VR), as an on-device alternative to ray-casting volume-rendering and developed an application for HoloLens to render kidney donor MRAs with interactive control of fundamental rendering parameters. We compared NESTIS-VR with current standard pre-calculated 2D ray-cast volume-renderings in an observational study with 2 expert kidney transplant surgeons, measuring their confidence in pre-operatively assessing the kidney pedicle arterial anatomy in 20 potential donors. We also compared it against other 3D rendering techniques to understand which features contributed most to any improvements.
Real-time stereoscopic three-dimensional (3D) NESTIS-VR in Augmented Reality significantly improves surgeons’ confidence compared with pre-calculated conventional two-dimensional (2D) ray-casting volume-rendered images (p = 0.0415/p = 0.00003). 2D non-stereoscopic NESTIS-VR was significantly superior to pre-calculated 2D ray-casting volume-rendered images for both surgeons (p = 0.044/p = 0.0003). Single isosurface 2D rendering was significantly superior than pre-calculated 2D volume-rendered images for one surgeon. There was no significant difference between binocular 3D display over 2D views with NESTIS-VR or between constrained and unconstrained vantage points for 2D viewing.
NESTIS-VR provides a new approach to rendering medical datasets in computationally limited OST-HMD headsets and significantly increases surgeons’ confidence of kidney donor arterial anatomy. The principal confidence benefit arises from providing surgeons interactive control over rendering parameters compared to pre-calculated renderings at preset parameters whilst rendering on-device and keeping the OST-HMD untethered from a workstation.
[Display omitted]
•Nesting multiple isosurfaces creates a rendering similar to raycasted Volume Rendering.•NESTIS-VR is running natively in real-time on HMDs like the HoloLens.•NESTIS-VR in 2D improves surgeon confidence compared with s |
| doi_str_mv | 10.1016/j.compbiomed.2024.109267 |
| format | Article |
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We introduce NEsted Semi-Transparent Isosurface Simulated Volume-Rendering (NESTIS-VR), as an on-device alternative to ray-casting volume-rendering and developed an application for HoloLens to render kidney donor MRAs with interactive control of fundamental rendering parameters. We compared NESTIS-VR with current standard pre-calculated 2D ray-cast volume-renderings in an observational study with 2 expert kidney transplant surgeons, measuring their confidence in pre-operatively assessing the kidney pedicle arterial anatomy in 20 potential donors. We also compared it against other 3D rendering techniques to understand which features contributed most to any improvements.
Real-time stereoscopic three-dimensional (3D) NESTIS-VR in Augmented Reality significantly improves surgeons’ confidence compared with pre-calculated conventional two-dimensional (2D) ray-casting volume-rendered images (p = 0.0415/p = 0.00003). 2D non-stereoscopic NESTIS-VR was significantly superior to pre-calculated 2D ray-casting volume-rendered images for both surgeons (p = 0.044/p = 0.0003). Single isosurface 2D rendering was significantly superior than pre-calculated 2D volume-rendered images for one surgeon. There was no significant difference between binocular 3D display over 2D views with NESTIS-VR or between constrained and unconstrained vantage points for 2D viewing.
NESTIS-VR provides a new approach to rendering medical datasets in computationally limited OST-HMD headsets and significantly increases surgeons’ confidence of kidney donor arterial anatomy. The principal confidence benefit arises from providing surgeons interactive control over rendering parameters compared to pre-calculated renderings at preset parameters whilst rendering on-device and keeping the OST-HMD untethered from a workstation.
[Display omitted]
•Nesting multiple isosurfaces creates a rendering similar to raycasted Volume Rendering.•NESTIS-VR is running natively in real-time on HMDs like the HoloLens.•NESTIS-VR in 2D improves surgeon confidence compared with single isosurface rendering.•NESTIS-VR in 3D improves confidence against 2D precomputed Volume Rendering.•Interactively controlling rendering has biggest effect on surgeons' confidence.</description><identifier>ISSN: 0010-4825</identifier><identifier>ISSN: 1879-0534</identifier><identifier>EISSN: 1879-0534</identifier><identifier>DOI: 10.1016/j.compbiomed.2024.109267</identifier><identifier>PMID: 39405728</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Anatomy ; Augmented Reality ; Computed tomography ; Computer-aided surgery ; Datasets ; Depth cues ; Female ; Headsets ; Humans ; Imaging, Three-Dimensional - methods ; Interactive control ; Kidney - anatomy & histology ; Kidney - blood supply ; Kidney - diagnostic imaging ; Kidney - surgery ; Kidney Transplantation ; Kidneys ; Magnetic resonance ; Magnetic Resonance Angiography - methods ; Male ; Medical imaging ; Organ donors ; Parameters ; Ray tracing ; Real time ; Renal Artery - anatomy & histology ; Renal Artery - diagnostic imaging ; Renal Artery - surgery ; Rendering ; Rendering techniques ; Stereoscopy ; Surgeons ; Surgical planning ; Tomography, X-Ray Computed ; Transplants & implants ; Vascular anatomy ; Veins & arteries ; Virtual reality ; Work stations</subject><ispartof>Computers in biology and medicine, 2024-12, Vol.183, p.109267, Article 109267</ispartof><rights>2024 Elsevier Ltd</rights><rights>Copyright © 2024 Elsevier Ltd. All rights reserved.</rights><rights>2024. Elsevier Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1928-f734c46a71a64868b4835902e87026521bc2c5705caadc9a094fe5351f1d0be73</cites><orcidid>0000-0002-6393-0964 ; 0000-0002-4044-4330 ; 0000-0002-7185-4383</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.compbiomed.2024.109267$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39405728$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Necker, Fabian N.</creatorcontrib><creatorcontrib>Melcher, Marc L.</creatorcontrib><creatorcontrib>Busque, Stephan</creatorcontrib><creatorcontrib>Leuze, Christoph W.</creatorcontrib><creatorcontrib>Ghanouni, Pejman</creatorcontrib><creatorcontrib>Le Castillo, Chris</creatorcontrib><creatorcontrib>Nguyen, Elizabeth</creatorcontrib><creatorcontrib>Daniel, Bruce L.</creatorcontrib><title>Nested Semi-Transparent Isosurface Simulated Volume-Rendering (NESTIS-VR) – An efficient on-device rendering approach for Augmented Reality headsets increasing surgeon confidence of kidney donor arterial anatomy</title><title>Computers in biology and medicine</title><addtitle>Comput Biol Med</addtitle><description>Volume-renderings of computed tomography or magnetic resonance angiograms (MRAs) are routinely used by surgeons in the preoperative assessment of vascular anatomy in kidney donors. Stereoscopic headsets (OST-HMD) like Microsoft HoloLens allow intuitive interaction with three-dimensional content for more intuitive comprehension, but do not allow real-time ray-casting volume-rendering of medical volume datasets on-device due to computational limitations.
We introduce NEsted Semi-Transparent Isosurface Simulated Volume-Rendering (NESTIS-VR), as an on-device alternative to ray-casting volume-rendering and developed an application for HoloLens to render kidney donor MRAs with interactive control of fundamental rendering parameters. We compared NESTIS-VR with current standard pre-calculated 2D ray-cast volume-renderings in an observational study with 2 expert kidney transplant surgeons, measuring their confidence in pre-operatively assessing the kidney pedicle arterial anatomy in 20 potential donors. We also compared it against other 3D rendering techniques to understand which features contributed most to any improvements.
Real-time stereoscopic three-dimensional (3D) NESTIS-VR in Augmented Reality significantly improves surgeons’ confidence compared with pre-calculated conventional two-dimensional (2D) ray-casting volume-rendered images (p = 0.0415/p = 0.00003). 2D non-stereoscopic NESTIS-VR was significantly superior to pre-calculated 2D ray-casting volume-rendered images for both surgeons (p = 0.044/p = 0.0003). Single isosurface 2D rendering was significantly superior than pre-calculated 2D volume-rendered images for one surgeon. There was no significant difference between binocular 3D display over 2D views with NESTIS-VR or between constrained and unconstrained vantage points for 2D viewing.
NESTIS-VR provides a new approach to rendering medical datasets in computationally limited OST-HMD headsets and significantly increases surgeons’ confidence of kidney donor arterial anatomy. The principal confidence benefit arises from providing surgeons interactive control over rendering parameters compared to pre-calculated renderings at preset parameters whilst rendering on-device and keeping the OST-HMD untethered from a workstation.
[Display omitted]
•Nesting multiple isosurfaces creates a rendering similar to raycasted Volume Rendering.•NESTIS-VR is running natively in real-time on HMDs like the HoloLens.•NESTIS-VR in 2D improves surgeon confidence compared with single isosurface rendering.•NESTIS-VR in 3D improves confidence against 2D precomputed Volume Rendering.•Interactively controlling rendering has biggest effect on surgeons' confidence.</description><subject>Anatomy</subject><subject>Augmented Reality</subject><subject>Computed tomography</subject><subject>Computer-aided surgery</subject><subject>Datasets</subject><subject>Depth cues</subject><subject>Female</subject><subject>Headsets</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional - methods</subject><subject>Interactive control</subject><subject>Kidney - anatomy & histology</subject><subject>Kidney - blood supply</subject><subject>Kidney - diagnostic imaging</subject><subject>Kidney - surgery</subject><subject>Kidney Transplantation</subject><subject>Kidneys</subject><subject>Magnetic resonance</subject><subject>Magnetic Resonance Angiography - methods</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Organ donors</subject><subject>Parameters</subject><subject>Ray tracing</subject><subject>Real time</subject><subject>Renal Artery - anatomy & histology</subject><subject>Renal Artery - diagnostic imaging</subject><subject>Renal Artery - surgery</subject><subject>Rendering</subject><subject>Rendering techniques</subject><subject>Stereoscopy</subject><subject>Surgeons</subject><subject>Surgical planning</subject><subject>Tomography, X-Ray Computed</subject><subject>Transplants & implants</subject><subject>Vascular anatomy</subject><subject>Veins & arteries</subject><subject>Virtual reality</subject><subject>Work stations</subject><issn>0010-4825</issn><issn>1879-0534</issn><issn>1879-0534</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcFu1DAQhiMEokvhFZAlLuWQxXacODkuVYGVqiLtLr1ajj3eeknsYCeV9sY78Gy8AE-Co21B4sLJkv3NN-P5swwRvCSYVO8OS-X7obW-B72kmLJ03dCKP8kWpOZNjsuCPc0WGBOcs5qWZ9mLGA8YY4YL_Dw7KxqGS07rRfbzBuIIGm2ht_kuSBcHGcCNaB19nIKRCtDW9lMnZ-rWd1MP-QachmDdHl3cXG13621-u3mLfn3_gVYOgTFW2VnhXa7h3iZD-FMghyF4qe6Q8QGtpn2fwCTegOzseER3IHWEMSLrVAAZ55I0xh68Q8o7YzW45PMGfbXawRFp75JIhjHpZYekk6Pvjy-zZ0Z2EV49nOfZlw9Xu8tP-fXnj-vL1XWuSEPr3PCCKVZJTmTF6qpuWV2UDaZQc0yrkpJWUVVyXCoptWokbpiBsiiJIRq3wIvz7OLkTZ_6NqVNit5GBV0nHfgpioIQjjktOUvom3_Qg5-CS9MliqaMKk5IouoTpYKPMYARQ7C9DEdBsJijFwfxN3oxRy9O0afS1w8NpnZ-eyx8zDoB708ApI3cWwgizjkp0DaAGoX29v9dfgMiLsir</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Necker, Fabian N.</creator><creator>Melcher, Marc L.</creator><creator>Busque, Stephan</creator><creator>Leuze, Christoph W.</creator><creator>Ghanouni, Pejman</creator><creator>Le Castillo, Chris</creator><creator>Nguyen, Elizabeth</creator><creator>Daniel, Bruce L.</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>JQ2</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6393-0964</orcidid><orcidid>https://orcid.org/0000-0002-4044-4330</orcidid><orcidid>https://orcid.org/0000-0002-7185-4383</orcidid></search><sort><creationdate>202412</creationdate><title>Nested Semi-Transparent Isosurface Simulated Volume-Rendering (NESTIS-VR) – An efficient on-device rendering approach for Augmented Reality headsets increasing surgeon confidence of kidney donor arterial anatomy</title><author>Necker, Fabian N. ; Melcher, Marc L. ; Busque, Stephan ; Leuze, Christoph W. ; Ghanouni, Pejman ; Le Castillo, Chris ; Nguyen, Elizabeth ; Daniel, Bruce L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1928-f734c46a71a64868b4835902e87026521bc2c5705caadc9a094fe5351f1d0be73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Anatomy</topic><topic>Augmented Reality</topic><topic>Computed tomography</topic><topic>Computer-aided surgery</topic><topic>Datasets</topic><topic>Depth cues</topic><topic>Female</topic><topic>Headsets</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional - methods</topic><topic>Interactive control</topic><topic>Kidney - anatomy & histology</topic><topic>Kidney - blood supply</topic><topic>Kidney - diagnostic imaging</topic><topic>Kidney - surgery</topic><topic>Kidney Transplantation</topic><topic>Kidneys</topic><topic>Magnetic resonance</topic><topic>Magnetic Resonance Angiography - methods</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Organ donors</topic><topic>Parameters</topic><topic>Ray tracing</topic><topic>Real time</topic><topic>Renal Artery - anatomy & histology</topic><topic>Renal Artery - diagnostic imaging</topic><topic>Renal Artery - surgery</topic><topic>Rendering</topic><topic>Rendering techniques</topic><topic>Stereoscopy</topic><topic>Surgeons</topic><topic>Surgical planning</topic><topic>Tomography, X-Ray Computed</topic><topic>Transplants & implants</topic><topic>Vascular anatomy</topic><topic>Veins & arteries</topic><topic>Virtual reality</topic><topic>Work stations</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Necker, Fabian N.</creatorcontrib><creatorcontrib>Melcher, Marc L.</creatorcontrib><creatorcontrib>Busque, Stephan</creatorcontrib><creatorcontrib>Leuze, Christoph W.</creatorcontrib><creatorcontrib>Ghanouni, Pejman</creatorcontrib><creatorcontrib>Le Castillo, Chris</creatorcontrib><creatorcontrib>Nguyen, Elizabeth</creatorcontrib><creatorcontrib>Daniel, Bruce L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Computer Science Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Computers in biology and medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Necker, Fabian N.</au><au>Melcher, Marc L.</au><au>Busque, Stephan</au><au>Leuze, Christoph W.</au><au>Ghanouni, Pejman</au><au>Le Castillo, Chris</au><au>Nguyen, Elizabeth</au><au>Daniel, Bruce L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nested Semi-Transparent Isosurface Simulated Volume-Rendering (NESTIS-VR) – An efficient on-device rendering approach for Augmented Reality headsets increasing surgeon confidence of kidney donor arterial anatomy</atitle><jtitle>Computers in biology and medicine</jtitle><addtitle>Comput Biol Med</addtitle><date>2024-12</date><risdate>2024</risdate><volume>183</volume><spage>109267</spage><pages>109267-</pages><artnum>109267</artnum><issn>0010-4825</issn><issn>1879-0534</issn><eissn>1879-0534</eissn><abstract>Volume-renderings of computed tomography or magnetic resonance angiograms (MRAs) are routinely used by surgeons in the preoperative assessment of vascular anatomy in kidney donors. Stereoscopic headsets (OST-HMD) like Microsoft HoloLens allow intuitive interaction with three-dimensional content for more intuitive comprehension, but do not allow real-time ray-casting volume-rendering of medical volume datasets on-device due to computational limitations.
We introduce NEsted Semi-Transparent Isosurface Simulated Volume-Rendering (NESTIS-VR), as an on-device alternative to ray-casting volume-rendering and developed an application for HoloLens to render kidney donor MRAs with interactive control of fundamental rendering parameters. We compared NESTIS-VR with current standard pre-calculated 2D ray-cast volume-renderings in an observational study with 2 expert kidney transplant surgeons, measuring their confidence in pre-operatively assessing the kidney pedicle arterial anatomy in 20 potential donors. We also compared it against other 3D rendering techniques to understand which features contributed most to any improvements.
Real-time stereoscopic three-dimensional (3D) NESTIS-VR in Augmented Reality significantly improves surgeons’ confidence compared with pre-calculated conventional two-dimensional (2D) ray-casting volume-rendered images (p = 0.0415/p = 0.00003). 2D non-stereoscopic NESTIS-VR was significantly superior to pre-calculated 2D ray-casting volume-rendered images for both surgeons (p = 0.044/p = 0.0003). Single isosurface 2D rendering was significantly superior than pre-calculated 2D volume-rendered images for one surgeon. There was no significant difference between binocular 3D display over 2D views with NESTIS-VR or between constrained and unconstrained vantage points for 2D viewing.
NESTIS-VR provides a new approach to rendering medical datasets in computationally limited OST-HMD headsets and significantly increases surgeons’ confidence of kidney donor arterial anatomy. The principal confidence benefit arises from providing surgeons interactive control over rendering parameters compared to pre-calculated renderings at preset parameters whilst rendering on-device and keeping the OST-HMD untethered from a workstation.
[Display omitted]
•Nesting multiple isosurfaces creates a rendering similar to raycasted Volume Rendering.•NESTIS-VR is running natively in real-time on HMDs like the HoloLens.•NESTIS-VR in 2D improves surgeon confidence compared with single isosurface rendering.•NESTIS-VR in 3D improves confidence against 2D precomputed Volume Rendering.•Interactively controlling rendering has biggest effect on surgeons' confidence.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>39405728</pmid><doi>10.1016/j.compbiomed.2024.109267</doi><orcidid>https://orcid.org/0000-0002-6393-0964</orcidid><orcidid>https://orcid.org/0000-0002-4044-4330</orcidid><orcidid>https://orcid.org/0000-0002-7185-4383</orcidid></addata></record> |
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| ispartof | Computers in biology and medicine, 2024-12, Vol.183, p.109267, Article 109267 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Anatomy Augmented Reality Computed tomography Computer-aided surgery Datasets Depth cues Female Headsets Humans Imaging, Three-Dimensional - methods Interactive control Kidney - anatomy & histology Kidney - blood supply Kidney - diagnostic imaging Kidney - surgery Kidney Transplantation Kidneys Magnetic resonance Magnetic Resonance Angiography - methods Male Medical imaging Organ donors Parameters Ray tracing Real time Renal Artery - anatomy & histology Renal Artery - diagnostic imaging Renal Artery - surgery Rendering Rendering techniques Stereoscopy Surgeons Surgical planning Tomography, X-Ray Computed Transplants & implants Vascular anatomy Veins & arteries Virtual reality Work stations |
| title | Nested Semi-Transparent Isosurface Simulated Volume-Rendering (NESTIS-VR) – An efficient on-device rendering approach for Augmented Reality headsets increasing surgeon confidence of kidney donor arterial anatomy |
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