Pietro Zappala, M L J Smits, P W K Vos, P Goossen-Nachtigall, D A F van den Heuvel, P C Jacobs, K P van Lienden, M van Leersum, M van Strijen
The AZURION-AR medical device proved feasible for use during routine interventional radiology offering unanimously rated perceived ergonomic advantages. Although usability was moderate, limitations in image resolution, technical reliability, and battery life require further refinement before reliable routine clinical implementation can be achieved, particularly for procedures requiring high spatial resolution and detailed anatomical assessment.
PURPOSE: To evaluate the feasibility, usability, and perceived workload of the AZURION-AR augmented reality (AR) medical device during routine interventional radiology procedures in a real-world clinical setting.
MATERIALS AND METHODS: This prospective, single-center, single-arm feasibility study included six interventional radiologists performing 34 AR-assisted vascular and non-vascular procedures. The AZURION-AR system projected virtual monitor and touchscreen interfaces within the operator's visual field. Post-procedural structured interviews and standardized 5-point Likert questionnaires assessed usability (System Usability Scale, SUS; 1-5 per item, max score: 100), workload (NASA Task Load Index, NASA-TLX; 0-21 per domain), and image quality (1-5 scale).
RESULTS: Continuous head-mounted display use throughout the procedure occurred in 20 cases (58%); mean wearing time was 40 min [5-140 min] versus a mean procedure duration of 59 min [20-240 min]. Mean SUS score was 64.5 ± 11.1, indicating moderate usability with considerable inter-operator variability. Mean NASA-TLX score was 7.6 ± 1.4, reflecting acceptable workload. Mean image quality score was 3.5 ± 0.6, with substantial variability across interventions. Scores tended to be lower in vascular and complex drainage procedures, reflecting increased effort and frustration, reduced anatomical detail, limited spatial resolution, and technical issues such as battery depletion and signal lag.
CONCLUSION: The AZURION-AR medical device proved feasible for use during routine interventional radiology offering unanimously rated perceived ergonomic advantages. Although usability was moderate, limitations in image resolution, technical reliability, and battery life require further refinement before reliable routine clinical implementation can be achieved, particularly for procedures requiring high spatial resolution and detailed anatomical assessment.