Further developments of the medical virtual reality application MedicVR were achieved by new approaches to direct volume rendering with the HTC Vive head mounted display. Even though the necessary real-time performance for a smooth interactive experience is accomplished by the shader technologies, the rendered image quality and performance is influenced by several parameters. We propose in this paper multiple technological upgrades to our application including: Lens Matched Shading, interactive volume clipping, semi-adaptive sampling, global illumination in direct volume rendering with shadow rays as well as an optimisation method for shadow rays and multiple light source integration. The quality of the rendered images is increased while keeping impact on performance at minimal levels. The application is currently used in study and planning in the field of dentofacial surgery.
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