Comparing Virtual Reality Headsets With Standard Diagnostic Workstations for MRI Grading of Knee Meniscus Lesions: A Small‐Scale Pilot Study

ABSTRACT Background Virtual reality (VR) is becoming increasingly popular in radiology, with a variety of diagnostic applications being tested. However, VR is yet to be tested in the context of MRI studies. This study evaluated the agreement between a VR headset and a standard radiology workstation in grading meniscus lesions on knee MRI. Methods Fifty‐two knee MRIs were reviewed by a consultant musculoskeletal radiologist and a radiology resident. Each interpreted the examinations on a diagnostic screen and then re‐evaluated them using a VR headset. Meniscus lesions were graded using Lotysch's five‐segment classification. Agreement was assessed using Cohen's kappa and descriptive statistics, with significance at p < 0.05. Results Cohen's kappa was not always calculable due to asymmetry in data. The consultant showed moderate‐to‐near‐perfect agreement between VR and standard screens, 76% for the medial and 87% for the lateral meniscus. The resident showed moderate to minor agreement, 64% for the medial and 70% for the lateral meniscus. Agreement for nonpathological segments was high: 94% (consultant) and 76% (resident). Agreement dropped for pathological segments, particularly type 2b superior lesions (29% consultant and 0% resident). Conclusions VR headsets demonstrate strong comparability for excluding meniscal lesions and moderate accuracy in grading pathology, although agreement for pathological segments was limited. Although not a replacement for diagnostic screens, they may be useful in select cases. As technology advances, VR could support remote interpretation and supplement traditional radiology workflows.