Mixed Reality Assistance for Needle Insertion under Ultrasound Imaging: A Pilot Study

Abstract Ultrasound (US)-guided needle interventions require precise coordination between imaging and instrument handling, which can be ergonomically challenging with conventional displays. This work presents a mixed reality (MR) prototype that integrates live US and pre-interventional CT data into a video passthrough head-mounted display (HMD), enabling a spatially registered in-situ view and interactive virtual displays. Unlike prior work relying on optical see-through HMDs, our system combines immersive guidance and interactive tools to support image-guided needle insertion. A preliminary user study with six radiologists assessed usability and clinical potential. Results indicate slightly above-average usability, with participants valuing field-of-view integration. User feedback highlighted the need for features such as interactive planning and extended visualizations, e.g. patientspecific anatomy.With these refinements, the prototype shows strong potential to improve ergonomics and spatial awareness during US-guided procedures.