A Data-Driven XR Environment for Understanding Probe Manipulation in Musculoskeletal Ultrasound

Competency in musculoskeletal (MSK) ultrasound requires learners to relate probe manipulation to spatial reasoning, image projection, and the appearance of characteristic artefacts, which remains challenging during early training due to the limited spatial context provided by conventional instructional resources. This study investigates whether reconstructing real MSK ultrasound examinations in an immersive extended reality (XR) environment is perceived as useful for early familiarisation with probe handling and image interpretation. The proposed system reproduces ultrasound acquisitions using synchronised ultrasound video, six-degree-of-freedom probe tracking, and surface scans acquired from cadaveric specimens, enabling the reconstruction of spatially accurate probe trajectories with each ultrasound frame linked to a corresponding position and orientation. Within the XR environment, users can interactively explore these trajectories or observe automated playback in which the recorded probe motion is presented together with the corresponding ultrasound sequence. An exploratory evaluation with healthcare professionals was conducted to assess perceived usefulness and clarity of spatial relationships. The results indicate that participants perceived spatially coherent playback of real ultrasound examinations in XR as a potentially useful aid for understanding probe–image relationships. These findings suggest the feasibility of this approach as a complementary resource for introductory MSK ultrasound training.