Usefulness of a glass-free medical three-dimensional autostereoscopic display in neurosurgery

Purpose  Many stereoscopic displays require glasses that are awkward or inappropriate for use in a neurosurgical operating room. A glass-free three-dimensional autostereoscopic display (3DAD) monitor was developed and tested for neurosurgical applications.Methods   Our 3DAD system uses images acquired from nine directions projected into the viewer’s eyes through 1,280 lenticular lenses ($$\text {1,280} \times 720$$1,280×720 pixels). The viewer interprets these as a single stereoscopic image. To evaluate the 3D visualization capabilities of the 3DAD system, 3D images of blood vessels created from brain magnetic resonance angiography were presented to 20 neurosurgeons on both a standard medical two-dimensional (2D) monitor and our 3DAD monitor. Discrimination of the positional relationships for each vessel was recorded. The observers were asked to identify blood vessels located in front of three pairs of points on each image.Results   The neurosurgeon observers achieved significantly higher correct responses using the 3DAD monitor compared with the 2D monitor (91.7 vs. 56.7 %, $$p<0.0001$$p<0.0001). There were no reports of problems such as eye fatigue or discomfort.Conclusion   Displaying 3D volume rendered multimodality images with a 3DAD monitor is useful for anatomical discrimination of 3D vessels in MR angiography. This technology may be useful for a wide variety of clinical applications such as rapid and precise diagnosis, surgical simulation, and medical education.