Design and Validation of an Augmented Reality Training Platform for Patient Setup in Radiation Therapy Using Multimodal 3D Modeling

This study presents the development and evaluation of an Augmented Reality (AR)-based training system aimed at improving patient setup accuracy in radiation therapy. Leveraging Microsoft HoloLens 2, the system provides an immersive environment for medical staff to enhance their understanding of patient setup procedures. High-resolution 3D anatomical models were reconstructed from CT scans using 3D Slicer, while Luma AI was employed to rapidly capture complete body surface models. Due to limitations in each method—such as missing extremities or back surfaces—Blender was used to merge the models, improving completeness and anatomical fidelity. The AR application was developed in Unity, employing spatial anchors and 125 × 125 mm2 QR code markers to stabilize and align virtual models in real space. System accuracy testing demonstrated that QR code tracking achieved millimeter-level variation, with an expanded uncertainty of ±2.74 mm. Training trials for setup showed larger deviations in the X (left–right), Y (up-down), and Z (front-back) axes at the centimeter scale. This meant that we were able to quantify the user’s patient setup skills. While QR code positioning was relatively stable, manual placement of markers and the absence of real-time verification contributed to these errors. The system offers a radiation-free and interactive platform for training, enhancing spatial awareness and procedural skills. Future work will focus on improving tracking stability, optimizing the workflow, and integrating real-time feedback to move toward clinical applicability.