Three-Dimensional Sonification as a Surgical Guidance Tool

TL;DR

A surgical use case, simulating a craniotomy preparation with a skull phantom, shows that interactive sonification enables novice users to navigate through three-dimensional space with a high precision.

Abstract

Interactive Sonification is a well-known guidance method in navigation tasks. Researchers have repeatedly suggested the use of interactive sonification in neuronavigation and image-guided surgery. The hope is to reduce clinicians' cognitive load through a relief of the visual channel, while preserving the precision provided through image guidance. In this paper, we present a surgical use case, simulating a craniotomy preparation with a skull phantom. Through auditory, visual, and audiovisual guidance, non-clinicians successfully find targets on a skull that provides hardly any visual or haptic landmarks. The results show that interactive sonification enables novice users to navigate through three-dimensional space with a high precision. The precision along the depth axis is highest in the audiovisual guidance mode, but adding audio leads to higher durations and longer motion trajectories.

Figures (5)

• Figure 1: Experiment setup with a styrofoam skull and an electromagnetic transmitter glued on a board. The position of the stylus tip is tracked. In the auditory guidance mode, the direction between the tip position and the target position is sonified through loudspeakers, and the screen is black. In the visual guidance mode, the tip position and the target is visualized together with a pseudo 3D-model of the skull. In the audiovisual guidance mode, both sonification and visualization are active. Photo taken from ijis.
• Figure 2: Distribution of targets along the skull. Six groups of five circularly arranged targets have to be found in pseudo-random order. Only the target is being sonified and/or visualized. The participants never got to see or hear this distribution. Graphic taken from icad2023.
• Figure 3: Magnitude spectrum of the sonification. Five sound characteristics represent the six orthogonal directions in three-dimensional space. The arrows indicate how the spectrum changes when the target lies in either of the $6$ directions. The legend indicates how these changes affect the auditory perception. Graphic modified from icad2019.
• Figure 4: Sound impression of the sonification depending on the location of the target. Chroma changes indicate that the target lies to the left or right. Loudness fluctuation indicates that the target lies above, roughness indicates that the target lies below. Brightness indicates that the target lies to the rear, a narrow bandwidth indicates that the target lies to the front. Graphic taken from gfm2020.
• Figure 5: Exemplary trajectory in the audiovisual guidance mode. Near the target, micro-adjustments are carried out, especially along the $y$-axis. In the experiment, the viewpoint lies above the skull, so the $y$-axis is hardly visible, but distinctly audible during the experiment.