Abstract
Virtual reality (VR) systems can offer benefits of improved ergonomics, but their resolution may currently be limited for the detection of small features. For detection of lung nodules, we compared the performance of VR versus standard picture archiving and communication system (PACS) monitor. Four radiologists and 1 novice radiologist reviewed axial computed tomography (CTs) of the thorax using standard PACS monitors (SM) and a VR system (HTC Vive, HTC). In this study, 3 radiologists evaluated axial lung-window CT images of a Lungman phantom. One radiologist and the novice radiologist reviewed axial lung-window patient CT thoracic images (32 patients). This HIPAA-compliant study was approved by the institutional review board. Detection of 227 lung nodules on patient CTs did not result in different sensitivity with SM compared with VR. Detection of 23 simulated Lungman phantom lung nodules on CT with SM resulted in statistically greater sensitivity (78.3%) than with VR (52.2%, P = .041) for 1 of 3 radiologists. The trend was similar but not significant for the other radiologists. There was no significant difference in the time spent by readers reviewing CT images with VR versus SM. These findings indicate that performance of a commercially available VR system for detection of lung nodules may be similar to traditional radiology monitors for assessment of small lung nodules on CTs of the thorax for most radiologists. These results, along with the potential of improving ergonomics for radiologists, are promising for the future development of VR in diagnostic radiology.
Highlights
Virtual reality (VR) is an emerging technological advancement that traces its origins to the establishment of stereoscopic viewing in the 1830s with the classic View-Master (Mattel Inc., Hawthorne, CA), which integrated rotating stills of stereoscopic 3-dimensional (3D) images [1]
VR technology today has become readily accessible through commercially available hardware such as the HTC Vive (HTC, New Taipei City, Taiwan), so that it no longer requires the use of expensive equipment and software [6, 7]
A cardiothoracic radiologist, who did not participate as an experimental reader in this study, selected from among the 87 computed tomography (CT) a final test group of scans reviewed in consecutive order until an approximate target num
Summary
Virtual reality (VR) is an emerging technological advancement that traces its origins to the establishment of stereoscopic viewing in the 1830s with the classic View-Master (Mattel Inc., Hawthorne, CA), which integrated rotating stills of stereoscopic 3-dimensional (3D) images [1]. Advances in technology and successive iterations have enabled users to be artificially immersed and interact with computer-simulated worlds that are customizable with editing software, which can be used to create application-specific environments. VR headset allows for the user’s field of vision to be fully replaced with a digital image, where each eye looks through a different lens to create a stereoscopic 3D effect [5]. Owing to extensive utilization of imaging technology, radiology may be well suited for VR adoption and integration. Radiology has undergone rapid change of the image interpretation environment when picture archiving and communication system (PACS) was introduced. PACS allows multimodality images to be displayed on monitors, which do not need to be located in the same geographic area as the medical scanners [8]. One of the disadvantages of PACS has been an increase in image complexity, resulting in increased physical and mental fatigue among radiologists, especially with repetitive movements
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