High-Performance Virtual Reality Volume Rendering of Original Optical Coherence Tomography Point-Cloud Data Enhanced With Real-Time Ray Casting

Maloca, Peter; Carvalho, J. Emanuel Ramos de; Heeren, Tjebo; Hasler, Pascal W.; Mushtaq, Faisal; Mon-Williams, Mark; Scholl, Hendrik P. N.; Balaskas, Konstantinos; Egan, Catherine; Tufail, Adnan; Witthauer, L.; Cattin, Philippe C.

doi:10.1167/tvst.7.4.2

Cited by 29 publications

(27 citation statements)

References 37 publications

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“…There are increasing possibilities for presentation and interaction with virtual reality 14 . In this context, virtual reality (VR) has recently been optimized as an enhanced medical image display method and showed to safeguard visual comfort 15 , 16 .…”

Section: Introductionmentioning

confidence: 99%

Validation of virtual reality orbitometry bridges digital and physical worlds

Maloca

Faludi

Żelechowski

et al. 2020

Sci Rep

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Clinical science and medical imaging technology are traditionally displayed in two dimensions (2D) on a computer monitor. In contrast, three-dimensional (3D) virtual reality (VR) expands the realm of 2D image visualization, enabling an immersive VR experience with unhindered spatial interaction by the user. Thus far, analysis of data extracted from VR applications was mainly qualitative. In this study, we enhance VR and provide evidence for quantitative VR research by validating digital VR display of computed tomography (CT) data of the orbit. Volumetric CT data were transferred and rendered into a VR environment. Subsequently, seven graders performed repeated and blinded diameter measurements. the intergrader variability of the measurements in VR was much lower compared to measurements in the physical world and measurements were reasonably consistent with their corresponding elements in the real context. The overall VR measurements were 5.49% higher. As such, this study attests the ability of VR to provide similar quantitative data alongside the added benefit of VR interfaces. VR entails a lot of potential for the future research in ophthalmology and beyond in any scientific field that uses three-dimensional data. Orbital tumors can either be primary, arising from structures within the orbit, or secondary, due to metastatic spread of a primary tumor elsewhere 1-3. A myriad of clinical findings suggest the presence of an orbital mass, namely proptosis, diplopia, pain, conjunctival congestion and varying degrees of visual loss 4,5. Diagnosis relies on adequate clinical examination and orbital imaging like magnetic resonance imaging (MRI) and/or computed tomography (CT) 6. Despite the great progress in medical imaging, the diagnosis of orbital lesions based on neuroimaging features may lack characteristic imaging features. Often, the diagnosis of specific orbital disorders such as Graves' disease associated orbitopathy, orbital inflammation, orbital lymphoma, lacrimal gland epithelial tumor, metastatic carcinoma, and vascular orbital lesions is ambiguous 7-10. Confirmation of the diagnosis frequently relies on a biopsy which can be technically challenging and prone to complications due to the dense arrangement of tissue or inaccessibility of many of these lesions 11. Visualization of orbital lesions is still based on pre-surgery image assessment of two-dimensional (2D) data visualization on a computer monitor or on intraoperative exploration 12,13. There are increasing possibilities for presentation and interaction with virtual reality 14. In this context, virtual reality (VR) has recently been optimized as an enhanced medical image display method and showed to safeguard visual comfort 15,16. The main objective of this study was to extend current medical image display and validate the level of spatial precision in orbitometry of CT data, representing the physical world, compared to precision in three-dimensional (3D) virtual reality for the first time. This is especially important when new ways are explored to use ...

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Section: Introductionmentioning

confidence: 99%

Validation of virtual reality orbitometry bridges digital and physical worlds

Maloca

Faludi

Żelechowski

et al. 2020

Sci Rep

Self Cite

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“…Five studies evaluated the use of extended reality for the production of immersive and interactive content for diagnostic applications. Two studies evaluated the use of extended reality to display ocular imaging data [82,83], and 3 studies [84][85][86] evaluated the validity of extended reality as a simulation tool for the functional assessment of patients with ophthalmic diseases.…”

Section: Overviewmentioning

confidence: 99%

Applications of Extended Reality in Ophthalmology: Systematic Review

Ong¹,

Tan²,

Lam³

et al. 2021

J Med Internet Res

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Background: Virtual reality, augmented reality, and mixed reality make use of a variety of different software and hardware, but they share three main characteristics: immersion, presence, and interaction. The umbrella term for technologies with these characteristics is extended reality. The ability of extended reality to create environments that are otherwise impossible in the real world has practical implications in the medical discipline. In ophthalmology, virtual reality simulators have become increasingly popular as tools for surgical education. Recent developments have also explored diagnostic and therapeutic uses in ophthalmology.Objective: This systematic review aims to identify and investigate the utility of extended reality in ophthalmic education, diagnostics, and therapeutics. Methods: A literature search was conducted using PubMed, Embase, and Cochrane Register of Controlled Trials. Publications from January 1, 1956 to April 15, 2020 were included. Inclusion criteria were studies evaluating the use of extended reality in ophthalmic education, diagnostics, and therapeutics. Eligible studies were evaluated using the Oxford Centre for Evidence-Based Medicine levels of evidence. Relevant studies were also evaluated using a validity framework. Findings and relevant data from the studies were extracted, evaluated, and compared to determine the utility of extended reality in ophthalmology.Results: We identified 12,490 unique records in our literature search; 87 met final eligibility criteria, comprising studies that evaluated the use of extended reality in education (n=54), diagnostics (n=5), and therapeutics (n=28). Of these, 79 studies (91%) achieved evidence levels in the range 2b to 4, indicating poor quality. Only 2 (9%) out of 22 relevant studies addressed all 5 sources of validity evidence. In education, we found that ophthalmic surgical simulators demonstrated efficacy and validity in improving surgical performance and reducing complication rates. Ophthalmoscopy simulators demonstrated efficacy and validity evidence in improving ophthalmoscopy skills in the clinical setting. In diagnostics, studies demonstrated proof-of-concept in presenting ocular imaging data on extended reality platforms and validity in assessing the function of patients with ophthalmic diseases. In therapeutics, heads-up surgical systems had similar complication rates, procedural success rates, and outcomes in comparison with conventional ophthalmic surgery. Conclusions:Extended reality has promising areas of application in ophthalmology, but additional high-quality comparative studies are needed to assess their roles among incumbent methods of ophthalmic education, diagnostics, and therapeutics.

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“…It was CE certified as a class I medical device (Diffuse Inc.), and its geometrical and anatomical accuracy has been previously verified. 16,17 The algorithm used is based on ray casting, in which a ray of light is cast through space, and color and opacity are accumulated along this ray. The visualization is based on a real-time calculation with 180 frames per second, each one corrected for the user's current perspective on the object and the user's manipulation of the object with a controller (scaling, movement in space, interaction with the model), ensuring an immersive viewing experience through a commercial VR headset.…”

Section: Spectovr Software Descriptionmentioning

confidence: 99%

Randomized study comparing 3D virtual reality and conventional 2D on-screen teaching of cerebrovascular anatomy

Greuter

Rosa

Cattin

et al. 2021

Neurosurgical Focus

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OBJECTIVE Performing aneurysmal clipping requires years of training to successfully understand the 3D neurovascular anatomy. This training has traditionally been obtained by learning through observation. Currently, with fewer operative aneurysm clippings, stricter work-hour regulations, and increased patient safety concerns, novel teaching methods are required for young neurosurgeons. Virtual-reality (VR) models offer the opportunity to either train a specific surgical skill or prepare for an individual surgery. With this study, the authors aimed to compare the spatial orientation between traditional 2D images and 3D VR models in neurosurgical residents or medical students. METHODS Residents and students were each randomly assigned to describe 4 aneurysm cases, which could be either 2D images or 3D VR models. The time to aneurysm detection as well as a spatial anatomical description was assessed via an online questionnaire and compared between the groups. The aneurysm cases were 10 selected patient cases treated at the authors’ institution. RESULTS Overall, the time to aneurysm detection was shorter in the 3D VR model compared to 2D images, with a trend toward statistical significance (25.77 ± 37.26 vs 45.70 ± 51.94 seconds, p = 0.052). No significant difference was observed for residents (3D VR 24.47 ± 40.16 vs 2D 33.52 ± 56.06 seconds, p = 0.564), while in students a significantly shorter time to aneurysm detection was measured using 3D VR models (26.95 ± 35.39 vs 59.16 ± 44.60 seconds, p = 0.015). No significant differences between the modalities for anatomical and descriptive spatial mistakes were observed. Most participants (90%) preferred the 3D VR models for aneurysm detection and description, and only 1 participant (5%) described VR-related side effects such as dizziness or nausea. CONCLUSIONS VR platforms facilitate aneurysm recognition and understanding of its spatial anatomy, which could make them the preferred method compared to 2D images in the years to come.

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High-Performance Virtual Reality Volume Rendering of Original Optical Coherence Tomography Point-Cloud Data Enhanced With Real-Time Ray Casting

Cited by 29 publications

References 37 publications

Validation of virtual reality orbitometry bridges digital and physical worlds

Validation of virtual reality orbitometry bridges digital and physical worlds

Applications of Extended Reality in Ophthalmology: Systematic Review

Randomized study comparing 3D virtual reality and conventional 2D on-screen teaching of cerebrovascular anatomy

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