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<xml><records><record><source-app name="Bibcite" version="8.x">Drupal-Bibcite</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Matthias Süncksen</style></author><author><style face="normal" font="default" size="100%">Oliver Bott</style></author><author><style face="normal" font="default" size="100%">Klaus Dresing</style></author><author><style face="normal" font="default" size="100%">Michael Teistler</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Simulation of scattered radiation during intraoperative imaging in a virtual reality learning environment</style></title></titles><keywords/><dates><year><style face="normal" font="default" size="100%">2020</style></year><pub-dates><date><style face="normal" font="default" size="100%">04/2020</style></date></pub-dates></dates><secondary-title><style face="normal" font="default" size="100%">International Journal of Computer Assisted Radiology and Surgery </style></secondary-title><electronic-resource-num><style face="normal" font="default" size="100%">10.1007/s11548-020-02126-x</style></electronic-resource-num><pages><style face="normal" font="default" size="100%">691-701</style></pages><volume><style face="normal" font="default" size="100%">15</style></volume><abstract><style face="normal" font="default" size="100%">Purpose&#13;
Scattered radiation, which occurs when using a C-arm for intraoperative radiography, can be better understood through interactive visualization. We developed a virtual reality (VR) approach for the simulation of scattered radiation (SSR) as part of a C-arm training system. In VR, it is important to avoid cyber sickness, which is often caused by increased latency between head motion and image presentation inside the head-mounted display. As the latency requirement interferes with the computational complexity of the SSR, the goal has been to maintain a low latency during the simultaneous computation of the SSR on moderate-cost consumer hardware.&#13;
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Methods&#13;
For use with a VR C-arm simulator, a CUDA-based Monte Carlo SSR has been improved to utilize GPU resources unused by the VR image generation. Resulting SSR data are visualized through volume rendering with pseudo-colored scattered radiation superimposed onto the virtual operating room. The resulting interactive VR–SSR environment was evaluated with operating room personnel (ORP) and surgeons using questionnaires.&#13;
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Results&#13;
Depending on the imaged body part and computation parameters, the required computation time to complete one SSR run was between 1.6 and 4.2 s (ankle) and between 7.9 and 14.9 s (thigh), and VR frame times from 11 to 12 ms (95th percentile). The system was evaluated with ORP (n = 46) and surgeons (n = 25). The median of professional C-arm experience was 5 (range 1 to 34) years (ORP) and 12.5 (range 2 to 48) years (surgeons), respectively. The demonstrated prototype was found useful by 78% of ORP and 88% of the surgeons. On a Likert scale, more than 90% of both groups “agreed fully” that the presented way of visualizing SSR in VR helps understanding intraoperative exposure to scattered radiation.&#13;
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Conclusions&#13;
Leveraging off-the-shelf computer equipment, the feasibility of SSR and VR for interactive training has been demonstrated. Evaluation participants showed a high interest for the presented approach. Feedback suggests that the visualization experienced by the users helps understanding radiation hazards in the operating room.</style></abstract></record></records></xml>
