Diagnostic Performance of a Next-Generation Virtual/Augmented Reality Headset: A Pilot Study of Diverticulitis on CT

Next-generation virtual/augmented reality (VR/AR) headsets may rival the desktop computer systems that are approved for clinical interpretation of radiologic images, but require validation for high-resolution low-luminance diagnoses like diverticulitis. The primary aim of this study is to compare diagnostic performance for detecting diverticulitis on CT between radiologists using a headset versus a desktop. The secondary aim is to survey participating radiologists about the usage of both devices. This pilot study retrospectively included 110 patients (mean age 64 ± 14 years, 62 women) who had abdomen/pelvis CT scans for which the report mentioned the presence or absence of diverticulitis. Scans were dichotomized and matched by time, for a total of 55 cases with diverticulitis and 55 controls with no diverticulitis. Six radiologists were oriented to the VR/AR headset (Apple Vision Pro) and viewer app (Visage Ease VP) using ten scans. They each scored 100 unknown scans on a 6-level scale for diverticulitis (1 = no diverticulitis, 6 = diverticulitis) on the headset and then on a desktop. Time per case was recorded. Finally, they completed a survey using 5-level scales about the ease of use of the headset and viewer app (1 = difficult, 5 = easy), about their experience with the headset (1 = bad, 5 = good), and about their preference between devices (1 = desktop, 5 = headset). Summary statistics and multi-reader multi-case ROC curves were calculated. The AUC (and 95% confidence interval) for diverticulitis was 0.93 (0.88-0.97) with the headset and 0.94 (0.91-0.98) with the desktop (p = 0.40). The median (and first-third quartiles) of time per case was 57 (41-76) seconds for the headset and 31 (22-64) seconds for the desktop (p < 0.001). Average survey scores ranged from 3.3 to 5 for ease of use, from 3 to 4.7 for experience, and from 2.2 to 3.3 for preference. Diagnostic performance for detecting diverticulitis on CT was similar between the next-generation VR/AR headset and desktop. Ease of use, experience, and preference varied across different aspects of the devices and among radiologists.