Interaction driven enhancement of depth perception in angiographic volumes

User interaction has the potential to greatly facilitate the exploration and understanding of 3D medical images for diagnosis and treatment. However, in certain specialized environments such as in an operating room (OR), technical and physical constraints such as the need to enforce strict sterility rules, make interaction challenging. In this paper, we propose to facilitate the intraoperative exploration of angiographic volumes by leveraging the motion of a tracked surgical pointer, a tool that is already manipulated by the surgeon when using a navigation system in the OR. We designed and implemented three interactive rendering techniques based on this principle. The benefit of each of these techniques is compared to its non-interactive counterpart in a psychophysics experiment where 20 medical imaging experts were asked to perform a reaching/targeting task while visualizing a 3D volume of angiographic data. The study showed a significant improvement of the appreciation of local vascular structure when using dynamic techniques, while not having a negative impact on the appreciation of the global structure and only a marginal impact on the execution speed. A qualitative evaluation of the different techniques showed a preference for dynamic chroma-depth in accordance with the objective metrics but a discrepancy between objective and subjective measures for dynamic aerial perspective and shading.