Clinical Applications of Virtual and Augmented Reality in Radiology: A Scoping Review

Background: Virtual reality (VR) and augmented reality (AR) have emerged as innovative tools in healthcare, particularly using diagnostic and interventional imaging methods, offering new avenues for enhancing patient care and procedural outcomes. Their applications range from improving preoperative planning and pain management to providing advanced procedural support and training. Despite their growing integration into clinical practice, evidence of their cost-effectiveness and specific clinical benefits when using radiological tools remains limited. This review aims to map the current landscape of VR and AR applications using radiological modalities and highlight areas for future research. Objective: This scoping review explores the clinical applications of VR and AR in different radiological fields, aiming at assessing target areas, cost-effectiveness, and benefits of these technologies. Methods: We conducted a comprehensive literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. A total of 15 primary studies were included, covering diverse populations and applications of VR and AR. Results: In total, 15 studies (N = 781 patients) were included, with sample sizes ranging from 6 to 120. These studies highlighted various clinical applications of VR and AR, including imaging-guided preoperative planning, pain management, and procedural support. Although several studies demonstrated improvements in patient experiences and diagnostic accuracy, cost-effectiveness data were lacking. Notably, 47% of the studies focused exclusively on pediatric populations (N = 363), and 33% were randomized controlled trials. Quality assessment using the STARD criteria revealed that 60% of studies were rated as good (score > 12), 27% as fair (score 10-12), and 13% as suboptimal (score < 10), with inter-reader reliability showing substantial agreement (ICC = 0.76; 95% CI: 0.64-0.91). Out of 15 included studies, only 6 (40%) reported statistically significant improvements in patient experiences, with the remaining studies reporting positive trends (e.g., feasibility, usability, improved planning). Individual studies demonstrated significant benefits of VR interventions; for instance, one study reported a reduction in distress scores by a mean of 3.0 (95% CI: 1.0-5.0) and a decreased need for parental presence (risk ratio 0.3; 95% CI: 0.1-0.7; p < 0.001) compared to conventional methods. Conclusions: VR and AR technologies hold promise in enhancing patient care and procedural outcomes. Future research should focus on the cost-effectiveness of these technologies and identify specific target populations that would benefit the most. Additionally, adherence to the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines should be encouraged to ensure transparent and comprehensive reporting in VR and AR studies.