Evaluation of Virtual Reality for Detection of Lung Nodules on Computed Tomography

Diagnostic Performance of a Next-Generation Virtual/Augmented Reality Headset: A Pilot Study of Diverticulitis on CT

Next-generation virtual/augmented reality (VR/AR) headsets may rival the desktop computer systems that are approved for clinical interpretation of radiologic images, but require validation for high-resolution low-luminance diagnoses like diverticulitis. The primary aim of this study is to compare diagnostic performance for detecting diverticulitis on CT between radiologists using a headset versus a desktop. The secondary aim is to survey participating radiologists about the usage of both devices. This pilot study retrospectively included 110 patients (mean age 64 ± 14 years, 62 women) who had abdomen/pelvis CT scans for which the report mentioned the presence or absence of diverticulitis. Scans were dichotomized and matched by time, for a total of 55 cases with diverticulitis and 55 controls with no diverticulitis. Six radiologists were oriented to the VR/AR headset (Apple Vision Pro) and viewer app (Visage Ease VP) using ten scans. They each scored 100 unknown scans on a 6-level scale for diverticulitis (1 = no diverticulitis, 6 = diverticulitis) on the headset and then on a desktop. Time per case was recorded. Finally, they completed a survey using 5-level scales about the ease of use of the headset and viewer app (1 = difficult, 5 = easy), about their experience with the headset (1 = bad, 5 = good), and about their preference between devices (1 = desktop, 5 = headset). Summary statistics and multi-reader multi-case ROC curves were calculated. The AUC (and 95% confidence interval) for diverticulitis was 0.93 (0.88-0.97) with the headset and 0.94 (0.91-0.98) with the desktop (p = 0.40). The median (and first-third quartiles) of time per case was 57 (41-76) seconds for the headset and 31 (22-64) seconds for the desktop (p < 0.001). Average survey scores ranged from 3.3 to 5 for ease of use, from 3 to 4.7 for experience, and from 2.2 to 3.3 for preference. Diagnostic performance for detecting diverticulitis on CT was similar between the next-generation VR/AR headset and desktop. Ease of use, experience, and preference varied across different aspects of the devices and among radiologists.

Virtual reading room for diagnostic radiology

RATIONALE AND OBJECTIVE

To assess the perceptions of radiology staff regarding the role of virtual reality technology in diagnostic radiology after using a virtual reality (VR) headset METHODS: Participants completed a pre-study questionnaire assessing their familiarity with VR technology and its potential role in radiology. Using a VR headset, participants entered a simulated reading room (SieVRt, Luxsonic Technologies) with three large virtual monitors. They were able to view plain radiographs, ultrasound, CT, and MRI images and pull up and compare multiple images simultaneously. They then completed a post-study questionnaire to re-assess their perception about the role of VR technology for diagnostic radiology.

RESULTS

Fifteen participants were enrolled, with 33.3 % attendings, 40 % fellows, and 26.7 % residents. Pre-study, 60 % reported they were "not familiar" with VR technology and 66.7 % had never used it. On a 1 to 5 scale, the median perceived likelihood of VR having a role in radiology significantly increased from 3 (IQR 2-3) pre-study to 4 (IQR 4-4) post-study; p = 0.014. Image contrast and resolution were adequate according to most participants, with 53.3 % strongly agreeing and 33.3 % agreeing. The headset was comfortable for 73.3 % and did not induce nausea in any participant. Confidence in VR technology improved after using the headset for 80 %. According to 80 %, future VR technology could replace a PACS workstation.

DISCUSSION

Radiologists' perception regarding the role of virtual reality in diagnostic interpretation improves after a hands-on trial of the technology, and VR has the potential to replace a traditional workstation in certain situations.

A review of virtual reality in radiology

Virtual reality (VR) is not new to the field of medicine or radiology but has grown exponentially in recent years. Exploration of VR in medicine to augment educational experiences and aid in procedural training began in the 1990s. Surgeons have benefited from VR, both for training and planning purposes. The use of VR has been applied throughout the field of radiology with applications in imaging interpretation and procedural training. VR systems have been developed for integration with computed tomography (CT)-guided interventions and ultrasound (US)-guided interventions, and there is a growing amount of information available about the applications of the technology developed specifically for various organ systems, including breast, prostate, liver, renal, lung, cardiovascular, and thyroid. This review provides an overview and update of the use of VR in radiology.