Real-time AI-assisted nerve tracking for ultrasound-guided nerve identification: a prospective randomized trial

BACKGROUND: Artificial intelligence (AI)-assisted nerve tracking facilitates real-time ultrasound-guided nerve identification, but its effect on independent nerve identification after AI support is removed remains uncertain. METHODS: In this prospective randomized trial, 80 ultrasound novices (60 medical students and 20 anesthesiology residents) were assigned to either a control group receiving B-mode ultrasound training without AI assistance or an AI-assisted group using a real-time nerve tracking system (NerveTrack). Following a standardized lecture and a 10-minute hands-on training session, participants underwent assessment with the AI function disabled. The primary outcome was first-attempt independent identification success for the median nerve and supraclavicular brachial plexus. Secondary outcomes included performance after additional training and self-reported confidence. RESULTS: 78 participants completed the study. First-attempt independent identification success rates did not differ significantly between the control and AI-assisted groups for the median nerve (57.5% vs 65.8%; RR 1.14, 95% CI 0.81 to 1.62; p=0.452) or the brachial plexus (35.0% vs 42.1%; RR 1.20, 95% CI 0.68 to 2.11; p=0.519). Following additional AI-assisted training, participants in the AI-assisted group reported greater confidence in identifying the brachial plexus than those in the control group (4.7±0.5 vs 4.4±0.9; p=0.046). No significant differences were observed in independent identification success after additional training. CONCLUSIONS: Brief AI-assisted training did not improve immediate independent ultrasound identification of the median nerve or supraclavicular brachial plexus after AI support was removed. These findings do not establish long-term retention, transfer to unfamiliar anatomy, or clinical procedural performance. THE REGISTRATION NUMBER: NCT05857787.