Effectiveness of stereoscopic displays in medicine: A review

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In this paper we review empirical studies concerning the effectiveness of stereoscopic displays in medicine. The domains covered in this review are: diagnosis, pre-operative planning, minimally invasive surgery (MIS) and training/teaching. For diagnosis, stereoscopic viewing of medical data has been shown to improve the sensitivity of tumor detection in breast imaging, and to improve the visualization of internal structures in 3D ultrasound. For MRI and CT data, where images are frequently rendered in 3D perspective, the added value of binocular depth has not yet been convincingly demonstrated. For MIS, stereoscopic displays decrease surgery time and increase accuracy of surgical procedures when the resolution of the stereoscopic displays is comparable to that of 2D displays. Training and surgical planning already use computer simulations; more research however is needed to assess the potential benefits of stereoscopic displays in those applications. Overall, there is a clear need for more empirical evidence that quantifies the added value of stereoscopic displays in medical domains.

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  1. 1.

    R. T. Held, T. T. Hui (2011) A guide to stereoscopic 3D displays in medicine. Academic Radiology. 8(8):1035–1048

  2. 2.

    W. A. IJsselsteijn, P. J. H. Seuntiëns, L. M. J. Meesters (2005) Human factors of 3D displays. In: Schreer O, Kauff P, Sikora T, (eds.), 3D Videocommunication — Algorithms, concepts and real-time systems in human-centred communication. John Wiley & Sons, Ltd., 219–234

  3. 3.

    M. Lambooij, W. A. IJsselsteijn, M. Fortuin, I. Heynderickx (2009) Visual discomfort in stereoscopic displays: A review. Journal of Imaging Science and Technology. 53(3):1–14

  4. 4.

    R. Patterson (2009) Human Factors of stereo displays: An update. Journal of society for Information Display. 17(12):987–996

  5. 5.

    I. P. Howard, B. J. Rogers (2002) Seeing in Depth: Depth Perception Vol 1. Porteous Publishing, Toronto.

  6. 6.

    N. S. Holliman, N. A. Dodgson, G. E. Favalora, L. Pockett (2011) Three-dimensional displays: A review and application analysis. IEEE Transactions on Broadcasting. 57(2):362–371

  7. 7.

    T. Okoshi (1980) Three dimensional displays. Proceedings of the IEEE. 68:548–564

  8. 8.

    S. Pastoor (1997) 3-D displays: A review of current technologies, Displays. 17(2): 100–110

  9. 9.

    H. Urey, K.V. Chelleppan, E. Erden, P. Surman (2011) State of the Art in Stereoscopic and Autostereoscopic Displays. Proceedings of the IEEE. 99(4):540–555

  10. 10.

    M. H. P. H. van Beurden, A. Kuijsters, W. A. IJsselsteijn (2010) Performance of a path tracing task using stereo and motion based depth cues, Quality of Multimedia Experience (QoMEX), 2010 Second International Workshop. 176–181

  11. 11.

    J. Cutting, P. Vishton (1995) Perceiving layout and knowing distances: The integration, relative potency, and contextual use of different information about depth. In: Epstein W and Rogers S (ed) Perception of Space and Motion, Academic Press, San Diego, CA: 69–117

  12. 12.

    B. Rogers, M. Graham (1982) Similarities between motion parallax and stereopsis in human depth perception. Vision Research. 22(2):261–270

  13. 13.

    M. Hershenson (1999) Visual Space Perception. The MIT Press, Cambridge.

  14. 14.

    H. A. Sedgwick (2001) Visual space perception. Blackwell Handbook of Perception, Blackwell Publishers Ltd., Oxford, 128–167

  15. 15.

    W.A. IJsselsteijn, H. de Ridder, R. Hamberg, D. Bouwhuis, J. Freeman (1998) Perceived depth and the feeling of presence in 3DTV. Displays. 18(4):207–214

  16. 16.

    P. Seuntiëns, I. Heynderickx, W. A. IJsselsteijn (2008) Capturing the added value of 3D-TV: Viewing experience and naturalness of stereoscopic images. Journal of Imaging Science and Technology. 52(2):1–5

  17. 17.

    J. O. Merritt (1991) Evaluation of stereoscopic display benefits. In: Introduction to Stereoscopic Displays and Applications, Short Course Notes, Hodges L, McAllister D, Merritt J, (ed), SPIE The International Society for Optical Engineering, Washington.

  18. 18.

    N. Holliman (2005) 3D display systems. Technical Report, Department of Computer Science, Univ. Durham.

  19. 19.

    S. Pastoor (2006) Human factors of 3D displays in advanced image communications. Displays. 14:150–157

  20. 20.

    B. S. Kuszyk, D. G. Heath, D. F. Bliss, E. K. Fishman (1996) Skeletal 3-D CT: Advantages of volume rendering over surface rendering. Skeletal Radiology. 25(3):207–214

  21. 21.

    J. Faubert (2001) Motion parallax, stereoscopy, and the perception of depth: practical and theoretical issues. Bahram J (Ed), Proceedings of SPIE CR76:168–191

  22. 22.

    R. L. Sollenberger, P. Milgram (1993) Effects of stereoscopic and rotational displays in a three-dimensional path-tracing task. Human Factors. 35(3):483–499

  23. 23.

    C. Ware, P. Mitchell (2005) Reevaluating stereo and motion cues for visualizing graphs in three dimensions. Proceedings of the 2nd symposium on Applied perception in graphics and visualization:51–58

  24. 24.

    M. H. P. H. van Beurden, W. A. IJsselsteijn, Y. A. W. Kort de (2011) Evaluating stereoscopic displays: Both efficiency measures and perceived workload sensitive to manipulations in binocular disparity. Proceeding of SPIE-IS&T Electronic imaging. 7863:786316 1–786316 7

  25. 25.

    D. R. Melmoth, S. Grant (2006) Advantages of binocular vision for control of reaching and grasping. Experimental Brain Research. 171(3):371–388

  26. 26.

    P. Servos, M. A. Goodale, L. S. Jakobson (1992) The role of binocular vision in prehension: A kinematic analysis. Vision Research. 32(8):1513–1521

  27. 27.

    S. McWhorter, L. Hodges, W. Roderiguez (1991) Evaluation of display parameters affecting user performance of an interactive task in a virtual environment. Rep. No. GIT-GVU-91-31, Graphics, Visualization & Usability Center, Georgia Institute of Technology, Atlanta.

  28. 28.

    D.C. Smith, R.E. Cole, J.O. Merritt, R.L. Pepper (1979) Remote operator performance comparing mono and stereo TV displays: The effects of visibility, learning and task factors. Technical report Naval Ocean Systems Center. San Diego.

  29. 29.

    B. G. Blundell, A. J. Schwarz (2006) Creative 3-D displays and Interaction Interfaces. Wiley-Interscience, New Jersey.

  30. 30.

    J. T. Case (1912) The Importance of Stereoradiography, especially of the Alimentary Tract, with Demonstration of Plates. Proceedings of the Royal Society of Medicine. 5:73–86

  31. 31.

    J. M. Davidson (1918) Stereoscopic Radiography. Proceedings of the Royal Society of Medicine, 12:1–8

  32. 32.

    A. B. Johnson (1901) Stereoscopic radiography. Annals of Surgery. 35:455–466

  33. 33.

    J. K. Udupa, G. T. Herman (2000) 3D imaging in medicine, CRC Press LLC, Boca Raton

  34. 34.

    Zonneveld FW, Fukuta K (1994) A decade of clinical three-dimensional imaging: a review. Part II: Clinical applications. Investigative Radiology 29(5):574–589.

  35. 35.

    F. W. Zonneveld (1994) A decade of clinical three-dimensional imaging: a review. Part III. Image analysis and interaction, display options, and physical models. Investigative Radiology. 29(5):716–725

  36. 36.

    M. Tory, M. S. Akins, A. E. Kirkpatrick, M. Nicolaou, G. Z. Yang (2005) Eyegaze analysis of displays with combined 2D and 3D views. IEEE Visualization. 2005:519–526

  37. 37.

    M. S. Atkins, A. Moise, R. Rohling (2006) An application of eye-gaze tracking for designing radiologists workstation: Insights for comparative visual search task. ACM Transaction on Applied Perception. 3(2):136–151

  38. 38.

    A. E. Krupinski (2010) Perceptual factors in reading medical images. In Samei, E, and Krupinski E (ed) The handbook of medical image perception and techniques. Cambridge: Cambridge University Press, 81–90

  39. 39.

    M. F. Verde, N. A. Macmillan, C. M. Rotello (2006) Measures of sensitivity based on a single hit rate and false alarm rate: The accuracy, precision, and robustness of d', Az, and A'. Perception and Psychophysics. 68(4):643–654

  40. 40.

    H. L. Kundel (1990) Visual cues in the interpretation of medical imaging. Journal of Clinical Neurophysiology. 7(4):472–483

  41. 41.

    R. Kickuth, G. Hartung, U. Laufer, C. Gruening, C. Stueckle, D. Liermann (2002) Stereoscopic 3D CT vs. standard 3D CT in the classification of acetabular fractures: An experimental study. British Journal of Radiology. 75(893): 422–427

  42. 42.

    A. E. Rosenbaum, W. Huda, K. A. Lieberman, R. D. Caruso (2000) Binocular three-dimensional perception through stereoscopic generation from rotating images. Academic Radiology. 7(1):21–26

  43. 43.

    M. A. Kersten, A. J. Stewart, N. Troje, R. Ellis (2006) Enhancing depth perception in translucent volumes. IEEE Transactions on Visualization and Computer Graphics. 12:1117–1123

  44. 44.

    X. H. Wang, J. E. Durick, D. L. Herbert, S. K. Lu A Golla, D. D. Shinde, S. Piracha, K. Foley, C. R. Fuhrman, B. E. Shindel, J. K. Leader, W. F. Good (2010) Compare display schemes for lung nodule CT screening. Journal of Digital imaging. 24(3):478–484

  45. 45.

    C. A. Mistretta (1993) Relative characteristics of MR angiography and competing vascular imaging modalities Journal of Magnetic Resonance Imaging. 3(5):685–698

  46. 46.

    K. Doi, E. E. Duda (1983) Detectability of depth information by use of magnification stereoscopic technique in cerebral angiography. Radiology. 146:91–95

  47. 47.

    T. H. Moll, F. Turjman, C. Picard, J. P. Bres, M. Amiel (1997) Depth separation in ten observers with a new stereoscopic X-ray acquisition system. European Radiology 7(8):1343–1347

  48. 48.

    M. Takahashi, H. Bussaka, M. Miyawaki (1986) Stereoscopic DSA of the central nervous system. Neuroradiology. 28(2):105–108

  49. 49.

    K. U. Wentz, H. P. Mattle, R. R. Edelman, J. Kleefield, G. V. O’Reilly, C. Liu (1991) Stereoscopic display of MR angiograms. Neuroradiology. 33(2):123–125

  50. 50.

    A. Abildgaard, A. K. Witwit, J. S. Karlsen, E. A. Jacopsen, B. Tennoe, G. Ringstad, P. Due-Tonnessen (2010) An autostereoscopic 3D display can improve visualization of 3D models from intracranial MR angiography. International Journal of computer Assisted Radiology and Surgery. 5:549–554

  51. 51.

    A. Hernandez, O. Basset, A. Bremond, I.E. Magnin (1998) Stereoscopic visualization of three-dimensional ultrasonic data applied to breast tumours. European Journal of Ultrasound 8(1):51–65

  52. 52.

    T. R. Nelson, E. K. Ji, J. H. Lee, M. J. Bailey, D. H. Pretorius (2008) Stereoscopic evaluation of fetal bony structures. Journal of Ultrasound in Medicine. 27(1):15–24

  53. 53.

    A. H. J. Koning (2011) How 3D immersive visualization is changing medical diagnostics. Proceedings of SPIE-IS&T Electronic imaging. 7865:786503 1–786503 7

  54. 54.

    G. Bol Raap, A. H. J. Koning, T. V. Scohy, A. D. Ten Harkel, F. J. Meijboom, A. P. Kappetein, P. J. Spek van der, A. J. J. C. Bogers (2007) Virtual reality 3D echocardiography in the assessment of tricuspid valve function aftersurgical closure of ventricular septum defect. Cardiovascular Ultrasound. 5(8)

  55. 55.

    C. M. Verwoerd-Dikkeboom, A. H. J. Koning, P. J. Spek van der, N. Exalto, E. A. P. Steegers (2008) Embryonic staging using a 3D virtual reality system. Human Reproduction. 23(7):1479–1484

  56. 56.

    A. N. Cherniy, B. M. Kanter, E. V. Serova, G. V. Ratobylski (2007) Use of stereoscopic vision for analysis of digital X-ray images of lungs. Biomedical Engineering. 41(5):214–217

  57. 57.

    D. J. Getty, P. J. Green (2007) Clinical applications for stereoscopic 3-D displays. Journal of the Society for Information Display. 15(6):377–384

  58. 58.

    J. Hsu, C. F. Babbs, D. M. Chelberg, Z. Pizlo (1993) Study of the effectiveness of stereo imaging with applications in mammography. Proceedings of SPIE. 1913:154–165

  59. 59.

    A. Smith (2005) Full field breast tomosynthesis. Radiological Management. 27(5):25–31

  60. 60.

    L. J. Webb, E. Samei, J. Y. Lo, J. A. Baker, S. V. Ghate, C. Kim, M. S. Soo, R. Walsh (2011) Comparaive performance of multiview stereoscopic mammographic display modalities for breast lesion detection. Med. Phys. 38(4):1972–1980

  61. 61.

    T. M. Satava, S. B. Jones (2002) Medical applications of virtual environments. In: Stanney, KM (ed) Handbook of Virtual Environments: Design, Implementation, and Applications, Lawrence Erlbaum Associates, New Jersey 937–957

  62. 62.

    T. J. White, G. R. Avery, N. Kennan, A. M. Syed, J. E. Hartley, J. R. T. Monson (2009) Virtual colonoscopy versus conventional colonoscopy in patients at high risk of colorectal cancer — a prospective trial of 150 patients. Colorectal Disease. 11(2):138–145

  63. 63.

    P. Sharma, P. A. Sample, L. M. Zangwill, J. S. Schuman (2008) Diagnostic tools for glaucoma detection and management. Survey of Opthalmology. 53(1):s17–s32

  64. 64.

    P. Seuntiëns, L. M. J. Meesters, W. A. IJsselsteijn (2005) Perceptual attributes of crosstalk in 3D images. Displays. 26(4):177–183

  65. 65.

    B. Reitinger, A. Bornik, R. Beichel, D. Schmalstieg (2006) Liver surgery planning using virtual reality. IEEE Computer Graphics and Applications. 26(6): 36–47

  66. 66.

    R. Shahidi, R. Tombropoulos, P. Grzeszczuk (1998) Clinical applications of three-dimensional rendering of medical data sets. Proceedings of the IEEE. 86(3):555–568

  67. 67.

    B. Reggiani, L. Cristofolini, E. Varini, M. Viceconti (2007) Predicting the subject-specific primary stability of cementless implants during pre-operative planning: Preliminary validation of subject-specific finite-element models. Journal of Biomechanics. 40(11):2552–2558

  68. 68.

    R. J. Hubbold, D. J. Hancock, C. J. Moore (1999) Autostereoscopic display for radiotherapy planning. Proceedings SPIE. 3012: 16–27

  69. 69.

    M. Hegarty, M. Keehner, C. Cohen, D. R Montello, Y. Lippa (2007) The role of spatial cognition in medicine: Applications for selecting and training professionals. In Allen, G.L. (ed) Applied spatial cognition, Lawrence Erlbaum Associates, Mahwah, New Jersey, 285–315

  70. 70.

    A. Cuschieri (1995) Visual displays and visual perception in minimal access surgery. Seminars in Laparoscopic Surgery. 2(3):209–214

  71. 71.

    J. Hofmeister, T. G. Frank, A. Cuschieri, N. J. Wade (2001) Perceptual aspects of two-dimensional and stereoscopic display techniques in endoscopic surgery: review and current problems. Seminars of Laparoscopic Surgery. 8(1):12–24

  72. 72.

    Hanna GB, Cuschieri A (2000) Influence of two-dimensional and three-dimensional imaging on endoscopic bowel suturing. World Journal of Surgery 24(4): 444–449.

  73. 73.

    S. H. Kong, B. M. Oh, H. Yoon, H. S. Ahn, H. J. Lee, S. G. Chung, N. Shiraishi, S. Kitano, H. K. Yang (2010) Comparison of two and three dimensional camera systems in laparoscopic performance: A novel 3D system with one camera. Surgical endoscopy. 24(5):1132–1143

  74. 74.

    U. D. Mueller-Richter, A. Limberger, P. Weber, W. Spitzer, M. Schilling (2003) Comparison between three-dimensional presentation of endoscopic procedures with polarization glasses and an autostereoscopic display. Surgical Endoscopy. 17(3):502–504s

  75. 75.

    A. Tabaee, V. K. Anand, J. F. Fraser, S. M. Brown, A. Singh, T. H. Schwartz (2009) Three dimensional endoscopic pituitary surgery. Operative neurosurgery. 64(5):288–295

  76. 76.

    M. N. Thomsen, D. Robert, M. D. Lang (2004) An experimental comparison of 3-dimensional and 2-dimensional endoscopic systems in a model. The Journal of Arthroscopic and Related Surgery. 20(4):419–423

  77. 77.

    M. Wentink, J. J. Jakimowicz, L. M. Vos, D. W. Meijer, P. A. Wieringa (2002) Quantitative evaluation of three advanced laparoscopic viewing technologies: a stereo endoscope, an image projection display, and a TFT display. Surgical Endoscopy. 16(8):1237–1241

  78. 78.

    A. Pietrabissa, E. Scarcello, A. Carobbi, F. Mosca (1994) Three-dimensional versus two-dimensional video system for the trained endoscopic surgeon and the beginner. Endoscopic Surgery and allied technologies. 2(6):315–317

  79. 79.

    V. Falk, D. Mintz, J. Grunenfelder, J. I. Fann, T. A. Burdon (2001) Influence of three-dimensional vision on surgical telemanipulator performance. Surgical Endoscopy. 15(11):1282–1288

  80. 80.

    C. A. Lagrange, C. J. Clark, E. W. Gerber, S. E. Strup (2008) Evaluation of three laparoscopic modalities: Robotics versus three-dimensional vision laparoscopy versus standard laparoscopy. Journal of Endourology. 22(3):511–516

  81. 81.

    A. Blavier, Q. Gaudissart, G. B. Cadiere, A. S. Nyssen (2007) Perceptual and instrumental impacts of robotic laparoscopy on surgical performance. Surgical Endoscopy. 21(10):1875–1882

  82. 82.

    G. Hubens, H. Coveliers, L. Balliu, M. Ruppert, W. Vaneerdeweg (2003) A performance study comparing manual and robotically assisted laparoscopic surgery using the da Vinci system. Surgical Endoscopy. 17(10):1595–1599

  83. 83.

    J. W. Huber, N. Taffinder, R. C. G. Russell, A. Darzi (2003) The effects of different viewing conditions on performance in simulated minimal access surgery. Ergonomics. 46(10): 999–1016

  84. 84.

    J. C. Byrn, S. Schluender, C. M. Divino, J. Conrad, B. Gurland, E. Shlasko (2007) Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System. The American Journal of Surgery. 193(4):519–522

  85. 85.

    I. C. Jourdan, E. Dutson, A. Garcia, T. Vleugels, J. Leroy, D. Mutter (2004) Stereoscopic vision provides a significant advantage for precision robotic laparoscopy. British Journal of Surgery. 91(7):879–885

  86. 86.

    Y. Munz, K. Moorthy, A. Dosis, D. Hernandez (2004) The benefits of stereoscopic vision in robotic-assisted performance on bench models. Surgical Endoscopy. 18(4):611–616

  87. 87.

    J.F. Fraser, B. Allen, V.K. Anand, T.H. Schwartz (2009) Three dimensional neurostereoendoscopy: Subjective and objective comparison to 2D. Minimal invasive neurosurgery 52(1):25–31

  88. 88.

    N. V. Vasilyev, P. M. Novotny, J. F. Martinez, H. Loyola, I. S. Salgo, R. D. Howe, P. J. del Nido (2008) Stereoscopic vision displays technology in real-time three-dimensional echocardiography-guided intracardiac beating-heart surgery. The Journal of Thoracic and Cardiovascular Surgery. 135:1334–1341

  89. 89.

    J. M. Luursema, P. A. M. Kommers, W. B. Verweij (2004) Stereopsis in medical virtual learning environments. Studies in Health Technology and Informatics. 103:262–269

  90. 90.

    C. E. Lathan, M. R. Tracey, M. M. Sebrechts, D. M. Clawson, G. A. Higgens (2002) Using virtual environments as training simulators: Measuring transfer. In: Stanney, KM (ed), Handbook of Virtual Environments: Design, Implementation, and Applications, Lawrence Erlbaum Associates, New Jersey, 403–414

  91. 91.

    J. Owczarczyk, B. Owczarczyk (1990) Evaluation of true 3D display systems for visualizing medical volume data, The Visual Computer. 6(4):219–226

  92. 92.

    J. M. Luursema, W. B. Verweij, P. A. M. Kommers, J. H. Annema (2008) The role of stereopsis in virtual anatomical learning. Interacting with Computers. 20(4–5):455–460

  93. 93.

    J. Ilgner, J. Jae-Hyun park, D. Labbé (2007) Using a high-definition stereoscopic video system to teach microscopic surgery. Proceedings of the SPIE. 6490:1–7

  94. 94.

    R. Aggarwal K. Moorthy, A. Darz (2004) Laparoscopic skills training and assessment. British Journal of Surgery 91(12):1549–1558

  95. 95.

    K. Votanopoulos, F. C. Brunicardi, J. Thornby, C. F. Bellows (2008) Impact of three-dimensional vision in laparoscopic training. World Journal of Surgery. 32(1):110–118

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van Beurden, M.H.P.H., IJsselsteijn, W.A. & Juola, J.F. Effectiveness of stereoscopic displays in medicine: A review. 3D Res 3, 3 (2012) doi:10.1007/3DRes.01(2012)3

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  • Stereoscopic Displays
  • Performance
  • Perception
  • Diagnosis
  • Medicine Pre-operative planning
  • Minimally Invasive Surgery
  • Training
  • Teaching