2D versus 3D: A Comparison of Needle Navigation Concepts between Augmented Reality Display Devices

Surgical procedures requiring needle navigation assistance suffer from complicated hand-eye coordination and are mentally demanding. Augmented reality (AR) can help overcome these issues. However, only an insufficient amount of fundamental research has focused on the design and hardware selection of such AR needle navigation systems. This work contributes to this research area by presenting a user study (n=24) comparing three state-of-the-art navigation concepts displayed by an optical see-through head-mounted display and a stereoscopic projection system. A two-dimensional glyph visualization resulted in higher targeting accuracy but required more needle insertion time. In contrast, punctures guided by a three-dimensional see-through vision concept were less accurate but faster and were favored in a qualitative interview. The third concept, a static representation of the correctly positioned needle, showed too high target errors for clinical accuracy needs. This concept performed worse when displayed by the projection system. Besides that, no meaningful differences between the evaluated AR display devices were detected. User preferences and use case restrictions, e.g., sterility requirements, seem to be more crucial selection criteria. Future work should focus on improving the accuracy of the see-through vision concept. Until then, the glyph visualization is recommended.