Evaluating the Perceptual Impact of Virtual and Physical Lighting on Medical Volume Rendering in AR

Abstract Augmented Reality (AR) in surgery relies heavily on visual clarity, which is influenced by the interplay of physical and virtual illumination. This study evaluates how different color combinations of ambient room light and virtual illumination of the hologram affect the visibility, detail perception, and comfort of volume-rendered medical CT data on a HoloLens 2. Fifteen medically skilled participants assessed 21 lighting setups in a realistic operation room (OR) environment using a remote-rendered abdominal CT dataset. Results show that virtual light color significantly impacts perception, with white and orange lights performing best across all metrics. The physical light setting showed no significant influence. These findings support the optimization of virtual lighting of AR application in the OR.