Reduced Recurrence Rates Are Associated with Photodynamic Diagnostics Compared to White Light after Extended Transurethral Resection of Bladder Tumors.

One pillar in treating non-muscle-invasive bladder cancer (NMIBC) is the complete and high-quality transurethral resection of the primary tumor (TURBT). However, even after a high-quality primary resection, the residual tumor risk is considerable, thus requiring a re-TURBT. Resections performed with the aid of a photodynamic diagnostics report improved recurrence-free survival rates and increased detection rates of carcinoma in situ (CIS). This monocentric retrospective study reports on patients treated with an extended TURBT procedure using conventional white-light cystoscopy or photodynamic diagnostics (PDD). Only patients undergoing a TURBT resection for their primary tumor were included in the statistical analysis. Recurrence-free survival and overall survival were the clinical endpoints. Mann−Whitney U tests and chi-squared tests were used for descriptive intergroup comparisons. The associations with overall survival and recurrence-free survival were determined by univariate and multivariate analyses. The test results were considered significant when p was < 0.05. In comparison to conventional white-light cystoscopy, PDD increased the detection rates of CIS (p = 0.004) and tumor multifocality (p = 0.005) and led to reduced residual tumor incidence at the primary resection site (p < 0.001). Likewise, tumor recurrence rates were reduced in the PDD cohort (p < 0.001). Patient age and the presence of residual tumor at the primary resection site were identified as independent predictors of overall survival. For recurrence-free survival, only the PDD resection method was an independent predictor (HR = 0.43; p < 0.001). In summary, we demonstrated that the utilization of PDD techniques was associated with improved detection rates of CIS and multifocal tumors and with reduced recurrence rates. The extended resection protocol allowed us to determine that PDD resections lead to a reduced residual tumor rate at the initial resection site. This residual tumor state at the resection site, determined by extended TURBT, became an independent predictor of long-term survival. On the other hand, the PDD technique was confirmed as the only independent predictor of recurrence-free survival.

Multisensory Proximity and Transition Cues for Improving Target Awareness in Narrow Field of View Augmented Reality Displays.

Augmented reality applications allow users to enrich their real surroundings with additional digital content. However, due to the limited field of view of augmented reality devices, it can sometimes be difficult to become aware of newly emerging information inside or outside the field of view. Typical visual conflicts like clutter and occlusion of augmentations occur and can be further aggravated especially in the context of dense information spaces. In this article, we evaluate how multisensory cue combinations can improve the awareness for moving out-of-view objects in narrow field of view augmented reality displays. We distinguish between proximity and transition cues in either visual, auditory or tactile manner. Proximity cues are intended to enhance spatial awareness of approaching out-of-view objects while transition cues inform the user that the object just entered the field of view. In study 1, user preference was determined for 6 different cue combinations via forced-choice decisions. In study 2, the 3 most preferred modes were then evaluated with respect to performance and awareness measures in a divided attention reaction task. Both studies were conducted under varying noise levels. We show that on average the Visual-Tactile combination leads to 63% and Audio-Tactile to 65% faster reactions to incoming out-of-view augmentations than their Visual-Audio counterpart, indicating a high usefulness of tactile transition cues. We further show a detrimental effect of visual and audio noise on performance when feedback included visual proximity cues. Based on these results, we make recommendations to determine which cue combination is appropriate for which application.

Comparing Non-Visual and Visual Guidance Methods for Narrow Field of View Augmented Reality Displays.

Current augmented reality displays still have a very limited field of view compared to the human vision. In order to localize out-of-view objects, researchers have predominantly explored visual guidance approaches to visualize information in the limited (in-view) screen space. Unfortunately, visual conflicts like cluttering or occlusion of information often arise, which can lead to search performance issues and a decreased awareness about the physical environment. In this paper, we compare an innovative non-visual guidance approach based on audio-tactile cues with the state-of-the-art visual guidance technique EyeSee360 for localizing out-of-view objects in augmented reality displays with limited field of view. In our user study, we evaluate both guidance methods in terms of search performance and situation awareness. We show that although audio-tactile guidance is generally slower than the well-performing EyeSee360 in terms of search times, it is on a par regarding the hit rate. Even more so, the audio-tactile method provides a significant improvement in situation awareness compared to the visual approach.