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A Novel Virtual Reality Medical Image Display System for Group Discussions of Congenital Heart Disease: Development
Byeol Kim1, Yue-Hin Loke2, Paige Mass2
1University of Maryland, College Park, MD, United States.
Insights
Full-immersive virtual reality (VR) significantly improves diagnostic accuracy for congenital heart disease (CHD) compared to traditional 2D displays. This advanced VR technology is preferred by medical trainees for complex case reviews.
Area of Science:
- Medical imaging
- Virtual reality applications
- Congenital heart disease diagnostics
Background:
- Complex 3D anatomy in congenital heart disease (CHD) requires multidisciplinary review of medical images.
- Current 2D displays of 3D scans pose challenges for accurate mental reconstruction and diagnosis.
- Existing virtual reality (VR) medical applications lack multiuser collaboration and studies on display immersion for CHD diagnosis.
Purpose of the Study:
- To evaluate and compare diagnostic accuracies and user preferences for different display systems in group CHD discussions.
- To assess conventional 2D displays against a novel group VR software, Cardiac Review 3D.
Main Methods:
- 22 medical trainees were divided into groups to discuss three CHD cases of varying complexity.
- Utilized conventional 2D displays and group VR software in nonimmersive and full-immersive settings.
- Collected data on discussion time, diagnostic accuracy scores, and peer assessments, with final preferences surveyed.
Main Results:
- Full-immersive VR yielded the highest diagnostic accuracies, outperforming conventional and nonimmersive VR (P=.01).
- Accuracy improvements with full-immersive VR were more pronounced in complex cases, showing 54.49% and 146.82% higher scores than conventional and nonimmersive VR, respectively (P<.001).
- 68% of participants preferred full-immersive VR for group CHD discussions.
Conclusions:
- Full-immersive VR is the preferred display system for medical trainees in group diagnostic discussions of CHD.
- A trend towards improved diagnostic accuracy was observed with full-immersive VR, especially for complex anatomical abnormalities.
- Display immersion is a critical factor for enhancing diagnostic accuracy in collaborative medical image reviews.
Background:
The complex 3-dimensional (3D) nature of anatomical abnormalities in congenital heart disease (CHD) necessitates multidisciplinary group discussions centered around the review of medical images such as magnetic resonance imaging. Currently, group viewings of medical images are constrained to 2-dimensional (2D) cross-sectional displays of 3D scans. However, 2D display methods could introduce additional challenges since they require physicians to accurately reconstruct the images mentally into 3D anatomies for diagnosis, staging, and planning of surgery or other therapies. Virtual reality (VR) software may enhance diagnosis and care of CHD via 3D visualization of medical images. Yet, present-day VR developments for medicine lack the emphasis on multiuser collaborative environments, and the effect of displays and level of immersion for diagnosing CHDs have not been studied.
Objective:
The objective of the study was to evaluate and compare the diagnostic accuracies and preferences of various display systems, including the conventional 2D display and a novel group VR software, in group discussions of CHD.
Methods:
A total of 22 medical trainees consisting of 1 first-year, 10 second-year, 4 third-year, and 1 fourth-year residents and 6 medical students, who volunteered for the study, were formed into groups of 4 to 5 participants. Each group discussed three diagnostic cases of CHD with varying structural complexity using conventional 2D display and group VR software. A group VR software, Cardiac Review 3D, was developed by our team using the Unity engine. By using different display hardware, VR was classified into nonimmersive and full-immersive settings. The discussion time, diagnostic accuracy score, and peer assessment were collected to capture the group and individual diagnostic performances. The diagnostic accuracies for each participant were scored by two experienced cardiologists following a predetermined answer rubric. At the end of the study, all participants were provided a survey to rank their preferences of the display systems for performing group medical discussions.
Results:
Diagnostic accuracies were highest when groups used the full-immersive VR compared with the conventional and nonimmersive VR (χ22=9.0, P=.01) displays. Differences between the display systems were more prominent with increasing case complexity (χ22=14.1, P<.001) where full-immersive VR had accuracy scores that were 54.49% and 146.82% higher than conventional and nonimmersive VR, respectively. The diagnostic accuracies provided by the two cardiologists for each participant did not statistically differ from each other (t=-1.01, P=.31). The full-immersive VR was ranked as the most preferred display for performing group CHD discussions by 68% of the participants.
Conclusions:
The most preferred display system among medical trainees for visualizing medical images during group diagnostic discussions is full-immersive VR, with a trend toward improved diagnostic accuracy in complex anatomical abnormalities. Immersion is a crucial feature of displays of medical images for diagnostic accuracy in collaborative discussions.
