A Survey of auditory display in image-guided interventions <s> Introduction <s> Image-guided interventions are medical procedures that use computer-based systems to provide virtual image overlays to help the physician precisely visualize and target the surgical site. This field has been greatly expanded by the advances in medical imaging and computing power over the past 20 years. This review begins with a historical overview and then describes the component technologies of tracking, registration, visualization, and software. Clinical applications in neurosurgery, orthopedics, and the cardiac and thoracoabdominal areas are discussed, together with a description of an evolving technology named Natural Orifice Transluminal Endoscopic Surgery (NOTES). As the trend toward minimally invasive procedures continues, image-guided interventions will play an important role in enabling new procedures, while improving the accuracy and success of existing approaches. Despite this promise, the role of image-guided systems must be validated by clinical trials facilitated by partnerships between scie... <s> BIB001 </s> A Survey of auditory display in image-guided interventions <s> Introduction <s> Background ::: ::: An alternative mode of interaction with navigation systems for open liver surgery was requested. Surgeons who use such systems are impeded by having to constantly switch between viewing the navigation system screen and the patient during an operation. ::: ::: ::: ::: Methods ::: ::: To this end, an auditory display system for open liver surgery is introduced with support for guiding the tracked instrument towards and remaining on a predefined resection line. To evaluate the method, a clinically orientated user study with 12 surgeons was conducted. ::: ::: ::: ::: Results ::: ::: It is shown in qualitative results from the user study that the proposed auditory display is recognized as a useful addition to the current visual mode of interaction. It was revealed in a statistical analysis that participants spent less time looking on the screen (10% vs. 96%). Accuracy for resection guidance was significantly improved when using auditory display as an additional information channel (0.6 vs. 1.4 mm); however, the overall time for the resection task was shorter without auditory display (47 vs. 24 s). ::: ::: ::: ::: Conclusions ::: ::: By reducing dependence on the visual modality during resection guidance, the auditory display is well suited to become integrated in navigation systems for liver surgery. Copyright © 2012 John Wiley & Sons, Ltd. <s> BIB002 </s> A Survey of auditory display in image-guided interventions <s> Introduction <s> 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. <s> BIB003 </s> A Survey of auditory display in image-guided interventions <s> Introduction <s> PURPOSE ::: In this article, we systematically examine the current state of research of systems that focus on touchless human-computer interaction in operating rooms and interventional radiology suites. We further discuss the drawbacks of current solutions and underline promising technologies for future development. ::: ::: ::: METHODS ::: A systematic literature search of scientific papers that deal with touchless control of medical software in the immediate environment of the operation room and interventional radiology suite was performed. This includes methods for touchless gesture interaction, voice control and eye tracking. ::: ::: ::: RESULTS ::: Fifty-five research papers were identified and analyzed in detail including 33 journal publications. Most of the identified literature (62 %) deals with the control of medical image viewers. The others present interaction techniques for laparoscopic assistance (13 %), telerobotic assistance and operating room control (9 % each) as well as for robotic operating room assistance and intraoperative registration (3.5 % each). Only 8 systems (14.5 %) were tested in a real clinical environment, and 7 (12.7 %) were not evaluated at all. ::: ::: ::: CONCLUSION ::: In the last 10 years, many advancements have led to robust touchless interaction approaches. However, only a few have been systematically evaluated in real operating room settings. Further research is required to cope with current limitations of touchless software interfaces in clinical environments. The main challenges for future research are the improvement and evaluation of usability and intuitiveness of touchless human-computer interaction and the full integration into productive systems as well as the reduction of necessary interaction steps and further development of hands-free interaction. <s> BIB004
Modern medical image-guided interventions depend on reliable access to patient data to ensure a successful procedure. Navigated interventions typically employ virtual images of planning data overlaid on images of patient anatomy to aid surgeons during the procedure, for instance, to view the location of a tracked instrument in relation to patient anatomy, to locate the target site, or to become better aware of the locations of risk structures or objects of interest. The field of image-guided interventions has grown greatly over the last 20 years thanks to progress in medical imaging and computing technology. For an overview of image-guided intervention technology and clinical applications, see Cleary and Peters BIB001 . Using image guidance during an intervention, clinicians can access important information that was previously unavailable, typically on a computer screen placed in the operating room. However, despite the benefits of image guidance in medicine, displaying information on a screen is sometimes not ideal BIB004 and alternatives to traditional computer screens are being researched. Clinicians must remove their view from the operating situs to receive information BIB002 , meaning important notifications might not be perceived  , and 3-D information might not be correctly interpreted BIB003 . To remedy some of the deficiencies inherent in visual display, the relatively new field of auditory display  presents an interesting possibility for image-guided medicine. Auditory display harnesses sound to present information; changes in a data sources can be mapped to parameters in a sound synthesizer so that a user can hear information as opposed to viewing it on a screen. This article presents a review of the literature on the use of auditory display in image-guided interventions, including systems for volumetric resection, telerobotic suture tying, resection path guidance, needle placement, and temporal bone drilling. Various motivations, auditory display approaches, and evaluation results are presented and discussed, and the primary problems and future trends in auditory display in image guidance are presented.