# Augmented Reality Visualization and Navigation Operationalized in Biopsy of Indeterminate Splenic Mass

## TL;DR

Augmented reality helped guide a biopsy of a splenic mass with improved precision and safety compared to traditional imaging methods.

## Contribution

Demonstrates the first successful use of AR for splenic biopsy in an outpatient setting.

## Key findings

- AR guidance enabled accurate first-pass needle placement without complications.
- AR reduced cognitive load and improved spatial awareness during the procedure.
- Pathology confirmed high-grade B-cell lymphoma from the biopsy samples.

## Abstract

This case report describes the successful use of an augmented reality (AR) guidance system (XR90, MediView XR Inc., Cleveland Ohio) to assist in the percutaneous biopsy of a splenic mass performed in a minor procedure room. Traditional two‐dimensional (2D) imaging modalities such as ultrasound and computed tomography (CT) present limitations in depth perception, spatial orientation, and procedural ergonomics, particularly in anatomically complex and mobile regions like the spleen. The AR system integrates real‐time ultrasound, electromagnetic (EM) tracking, and pre‐procedural CT data to generate a 3D holographic overlay within a heads‐up display (HUD), enhancing operator spatial awareness and needle control. A 69‐year‐old male with a 6 cm splenic mass underwent biopsy using the AR platform alongside ultrasound. The system enabled accurate needle placement, reduced cognitive load, and provided continuous visual confirmation during the procedure. All biopsy samples were successfully obtained on the first pass without complications, and pathology confirmed high‐grade B‐cell lymphoma. This case highlights the feasibility and clinical utility of deploying AR‐guided interventions in outpatient procedure rooms, supporting broader adoption of AR technologies in settings beyond the operating room or angiography suite.

Augmented reality (AR) provided enhanced 3D visualization and precision guidance during biopsy of a splenic mass, helping to overcome limitations of traditional 2D imaging. By improving spatial awareness in complex anatomy, AR reduced cognitive load and supported safe, efficient needle placement in a minimally invasive procedural setting.

First‐person intraprocedural view of XR90 providing a live holographic 3D rendering of a spleen, splenic mass, and nearby lung parenchyma is used to drive procedural planning, allow for biopsy instrument tracking, define optimal trajectory, and subsequently visualize parenchymal tract closure with SinglePass biopsy tract electrocautery.