Feasibility of Augmented Reality-Guided Robotic Ultrasound with Cone-Beam CT Integration for Spine Procedures

2026-03-23

AI Summary

This study addresses the challenges of spinal interventional needle insertion, which demands precise anatomical localization and trajectory planning, yet conventional CT or X-ray guidance entails high radiation exposure and lacks real-time three-dimensional feedback. To overcome these limitations, this work proposes an optical see-through augmented reality (OST-AR)-guided robotic ultrasound system that, for the first time, integrates a cone-beam CT (CBCT)-reconstructed 3D spinal model with real-time ultrasound imaging, enabling synergistic visualization of global anatomy and local dynamic structures. Through multimodal image registration and intuitive human–robot interaction, the approach significantly reduces procedural time and targeting error in phantom experiments, while enhancing spatial awareness, system usability, user trust, and cognitive efficiency.

Technology Category

• Intelligent Robots: Multimodal Perception & Sensor Fusion
• Planning, Routing, and Scheduling: Optimization of Spatio-temporal Systems
• Cognitive Modeling & Cognitive Systems: Neural Spike Coding

Application Category

• Responsible Web: Machine-in-the-loop, human agency and autonomy
• User Modeling, Personalization and Recommendation: Federated recommendation systems and personalization
• Search and Retrieval-Augmented AI: Assisted, interactive, and conversational search

Abstract

Accurate needle placement in spine interventions is critical for effective pain management, yet it depends on reliable identification of anatomical landmarks and careful trajectory planning. Conventional imaging guidance often relies both on CT and X-ray fluoroscopy, exposing patients and staff to high dose of radiation while providing limited real-time 3D feedback. We present an optical see-through augmented reality (OST-AR)-guided robotic system for spine procedures that provides in situ visualization of spinal structures to support needle trajectory planning. We integrate a cone-beam CT (CBCT)-derived 3D spine model which is co-registered with live ultrasound, enabling users to combine global anatomical context with local, real-time imaging. We evaluated the system in a phantom user study involving two representative spine procedures: facet joint injection and lumbar puncture. Sixteen participants performed insertions under two visualization conditions: conventional screen vs. AR. Results show that AR significantly reduces execution time and across-task placement error, while also improving usability, trust, and spatial understanding and lowering cognitive workload. These findings demonstrate the feasibility of AR-guided robotic ultrasound for spine interventions, highlighting its potential to enhance accuracy, efficiency, and user experience in image-guided procedures.

Problem

• spine interventions
• needle placement
• imaging guidance
• radiation exposure
• real-time 3D feedback

Innovation

• Augmented Reality
• Robotic Ultrasound
• Cone-Beam CT
• Image Guidance
• Spine Intervention