Smartphone Augmented Reality CT-Based Platform for Needle Insertion Guidance: A Phantom Study

Objective To develop and assess the accuracy of an augmented reality (AR) needle guidance smartphone application. Methods A needle guidance AR smartphone application was developed using Unity and Vuforia SDK platforms, enabling real-time displays of planned and actual needle trajectories. To assess the application’s accuracy in a phantom, eleven operators (including interventional radiologists, non-interventional radiology physicians, and non-physicians) performed single-pass needle insertions using AR guidance ( n = 8) and CT-guided freehand ( n = 8). Placement errors were measured on post-placement CT scans. Two interventional radiologists then used AR guidance ( n = 3) and CT-guided freehand ( n = 3) to navigate needles to within 5 mm of targets with intermediate CT scans permitted to mimic clinical use. The total time and number of intermediate CT scans required for successful navigation were recorded. Results In the first experiment, the average operator insertion error for AR-guided needles was 78% less than that for CT-guided freehand (2.69 ± 2.61 mm vs. 12.51 ± 8.39 mm, respectively, p