Augmented depth perception visualization in 2D/3D image fusion

• We investigate several concepts enabling improvement of current image fusion visualization.
• We propose a contour enhanced visualization to circumvent hidden information in the X-ray.
• We implement a new occlusion and depth color-coding algorithm to improve perception in X-ray.
• Our occlusion correction provides 100% correctness when determining the position of an aneurysm in X-ray.
• The color-coding schemes improve visualization in 2D/3D overlay images.

2D/3D image fusion applications are widely used in endovascular interventions. Complaints from interventionists about existing state-of-art visualization software are usually related to the strong compromise between 2D and 3D visibility or the lack of depth perception. In this paper, we investigate several concepts enabling improvement of current image fusion visualization found in the operating room. First, a contour enhanced visualization is used to circumvent hidden information in the X-ray image. Second, an occlusion and depth color-coding scheme is considered to improve depth perception. To validate our visualization technique both phantom and clinical data are considered. An evaluation is performed in the form of a questionnaire which included 24 participants: ten clinicians and fourteen non-clinicians. Results indicate that the occlusion correction method provides 100% correctness when determining the true position of an aneurysm in X-ray. Further, when integrating an RGB or RB color-depth encoding in the image fusion both perception and intuitiveness are improved.