Future Directions in 3-Dimensional Imaging and Neurosurgery

Abstract

Recent advances in 3-dimensional (3-D) stereoscopic imaging have enabled 3-D display technologies in the operating room. We find 2 beneficial applications for the inclusion of 3-D imaging in clinical practice. The first is the real-time 3-D display in the surgical theater, which is useful for the neurosurgeon and observers. In surgery, a 3-D display can include a cutting-edge mixed-mode graphic overlay for image-guided surgery. The second application is to improve the training of residents and observers in neurosurgical techniques. This article documents the requirements of both applications for a 3-D system in the operating room and for clinical neurosurgical training, followed by a discussion of the strengths and weaknesses of the current and emerging 3-D display technologies. An important comparison between a new autostereoscopic display without glasses and current stereo display with glasses improves our understanding of the best applications for 3-D in neurosurgery. Today's multiview autostereoscopic display has 3 major benefits: It does not require glasses for viewing; it allows multiple views; and it improves the workflow for image-guided surgery registration and overlay tasks because of its depth-rendering format and tools. Two current limitations of the autostereoscopic display are that resolution is reduced and depth can be perceived as too shallow in some cases. Higher-resolution displays will be available soon, and the algorithms for depth inference from stereo can be improved. The stereoscopic and autostereoscopic systems from microscope cameras to displays were compared by the use of recorded and live content from surgery. To the best of our knowledge, this is the first report of application of autostereoscopy in neurosurgery.

First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery

“…However, with the emergence of 4K and 8K imaging (the so-called ultra-high definition), it is imaginable that further evolutions could be imminent. Ever smaller imaging sensors, virtual and augmented reality devices, and novel 3D interfaces could refine intraoperative visualization [ 3 - 4 ]. Recently, a high-definition 3D exoscope was developed with the attributes of being smaller and less expensive than microscopes and not confining surgeons to eyepieces.…”

Stereoscopic 3D teaching material usability analysis for interactive boards

“…43 There are application examples of autostereoscopic imaging techniques for undergraduate medical education 44 and neurosurgical techniques. 45 Images of stereoscopic monitoring types are given in Figure 1.…”

Autostereoscopic 3D visualization and image processing system for neurosurgery

“…In literature, the advantage of autostereoscopic 3D displays compared with 2D displays was shown on the example of angiographic data sets [1]. Compared with 3D displays using viewing aids, autostereoscopic displays were found to be beneficial [5,22], especially in the OR, where the use of viewing aids may be disadvantageous because of hygienic reasons [1].…”

“…The most commonly used visualization of medical data sets in clinical routine is the presentation on twodimensional (2D) displays [5]. Especially for complex multimodal data (e.g., spatial relation of vessels, nerve fiber bundles, tumor), depth information can enhance perceptibility of the reconstructed 3D data significantly.…”