title: Hybrid simulation using mixed reality for interventional ultrasound imaging training.
abstract: OBJECTIVE
  Ultrasound (US) imaging offers advantages over other imaging modalities and has become the most widespread modality for many diagnostic and interventional procedures. However, traditional 2D US requires a long training period, especially to learn how to manipulate the probe. A hybrid interactive system based on mixed reality was designed, implemented and tested for hand-eye coordination training in diagnostic and interventional US.
  
  
  METHODS
  A hybrid simulator was developed integrating a physical US phantom and a software application with a 3D virtual scene. In this scene, a 3D model of the probe with its relative scan plane is coherently displayed with a 3D representation of the phantom internal structures. An evaluation study of the diagnostic module was performed by recruiting thirty-six novices and four experts. The performances of the hybrid (HG) versus physical (PG) simulator were compared. After the training session, each novice was required to visualize a particular target structure. The four experts completed a 5-point Likert scale questionnaire.
  
  
  RESULTS
  Seventy-eight percentage of the HG novices successfully visualized the target structure, whereas only 45% of the PG reached this goal. The mean scores from the questionnaires were 5.00 for usefulness, 4.25 for ease of use, 4.75 for 3D perception, and 3.25 for phantom realism.
  
  
  CONCLUSIONS
  The hybrid US training simulator provides ease of use and is effective as a hand-eye coordination teaching tool. Mixed reality can improve US probe manipulation training.
authors.affiliation: EndoCAS Center, Università di Pisa, Pisa, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Freschi
authors.forename: S
authors.initials: S
authors.lastname: Parrini
authors.forename: N
authors.initials: N
authors.lastname: Dinelli
authors.forename: M
authors.initials: M
authors.lastname: Ferrari
authors.forename: V
authors.initials: V
authors.lastname: Ferrari
mesh_terms: D002983:Clinical Competence; D006801:Humans; D019047:Phantoms, Imaging; D012984:Software; D018084:Ultrasonography, Interventional; D014584:User-Computer Interface