title: Auditory feedback to support image-guided medical needle placement.
abstract: OBJECTIVE
  During medical needle placement using image-guided navigation systems, the clinician must concentrate on a screen. To reduce the clinician's visual reliance on the screen, this work proposes an auditory feedback method as a stand-alone method or to support visual feedback for placing the navigated medical instrument, in this case a needle.
  
  
  METHODS
  An auditory synthesis model using pitch comparison and stereo panning parameter mapping was developed to augment or replace visual feedback for navigated needle placement. In contrast to existing approaches which augment but still require a visual display, this method allows view-free needle placement. An evaluation with 12 novice participants compared both auditory and combined audiovisual feedback against existing visual methods.
  
  
  RESULTS
  Using combined audiovisual display, participants show similar task completion times and report similar subjective workload and accuracy while viewing the screen less compared to using the conventional visual method. The auditory feedback leads to higher task completion times and subjective workload compared to both combined and visual feedback.
  
  
  CONCLUSIONS
  Audiovisual feedback shows promising results and establishes a basis for applying auditory feedback as a supplement to visual information to other navigated interventions, especially those for which viewing a patient is beneficial or necessary.
authors.affiliation: Jacobs University, Bremen, Germany. david.black@mevis.fraunhofer.de.|Medical Image Computing, University of Bremen, Bremen, Germany. david.black@mevis.fraunhofer.de.|Fraunhofer MEVIS, Bremen, Germany. david.black@mevis.fraunhofer.de.
authors.forename: David
authors.identifier: http://orcid.org/0000-0002-1917-5615
authors.initials: D
authors.lastname: Black
authors.affiliation: Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Hettig
authors.affiliation: Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Luz
authors.affiliation: Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hansen
authors.affiliation: Medical Image Computing, University of Bremen, Bremen, Germany.|Fraunhofer MEVIS, Bremen, Germany.|Surgical Planning Laboratory, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Ron
authors.initials: R
authors.lastname: Kikinis
authors.affiliation: Jacobs University, Bremen, Germany.|Fraunhofer MEVIS, Bremen, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Hahn
mesh_terms: D056228:Feedback, Sensory; D006801:Humans; D009339:Needles; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014584:User-Computer Interface
keywords: Auditory display; Human–computer interfaces; Image-guided therapy; Needle placement