Assessment of cybersickness induced by augmented reality ultrasound procedures using head-mounted display

Augmented Reality (AR) has emerging applications in medical imaging, particularly ultrasound. However, concerns about cybersickness may hinder widespread adoption. This is the first study to evaluate cybersickness symptoms experienced by healthcare professionals using a commercially available AR head-mounted display (HMD) during simulated abdominal ultrasound and vascular access procedures.

Fifty-two radiologists, sonographers, and CT technologists performed either an abdominal ultrasound (n = 29) or a venous cannulation (n = 23) on phantoms using an augmented reality headset paired with an ultrasound probe. Participants received minimal training and were evaluated using the Simulator Sickness Questionnaire (SSQ), which quantifies nausea (N), oculomotor disturbance (O), and disorientation (D). Task completion times and first-pass success rates (for vascular access) were recorded. Statistical analysis included Mann-Whitney U and Spearman's correlation tests.

Median task completion times were 11.83 min for abdominal ultrasound and 7 min for venous cannulation, with an 87% first-pass success rate in the latter. Median SSQ total scores remained below the threshold of concern [abdominal: 15 (N = 10, O = 15, D = 14); cannulation: 11 (N = 0, O = 15, D = 14)]. Pooled scores followed the pattern O > D > N (N = 5, O = 15, D = 14), consistent with previous AR research. No significant differences in SSQ scores were found between groups, though small effects cannot be formally ruled out due to a weak experimental power. A weak positive correlation (r = 0.27) existed between task time and SSQ scores.

AR-guided ultrasound using a commercially available HMD is feasible and well-tolerated by healthcare professionals, with minimal cybersickness irrespective of age or sex. The setup demonstrated ease of adoption and may theoretically offer ergonomic and workflow advantages in clinical settings.