What a time to be alive! At the touch of a button, we can have hot, steaming pizzas delivered to us, tsunamis of entertainment 🌊 are a click away and we have access to the sum of human knowledge in the palm of our hands.
Good deal, right? Well, the unyielding pervasion of digital technology into our lives provides its own set of problems. There’s this old maxim in programming which advances that it’s generally easier to enhance hardware than it is to improve the software. If you think about it for a moment it makes sense. Hardware is far more modular than software. Hardware invites iteration. It’s easier to pack on processors and ram inside of a computer than it is to visualize software that will efficiently take advantage of that hardware. I think a similar analogy can be applied to naming the technology which is constantly being released: It’s almost easier to visualize this technology than it is to name it, differentiate it and integrate it into the lexicon.
Don’t believe me? Quick, tell me what the difference is between AR and VR! “Aren’t they the same thing?” you may ask. That’s a negative. For one, AR stands for Augmented Reality and VR stands for Virtual Reality.
Let’s start with a quick definition, one which is going to make our lives considerably easier. XR refers to Extended Reality.Forbes defines XR as “An umbrella term used to describe immersive technologies that can merge the physical and virtual worlds”. AR/VR/MR fall under this umbrella, so when someone mentions XR, they could be referring to either one of these technologies, some combination of these technologies, or all of these technologies. Put simply, AR/VR/MR are subcategories of XR, the same way that chicken, beef and lamb are subcategories of meat 🍖
Now, I’m sure that many of you reading this have experienced some manifestation of XR. Remember View-Masters? They were relatively primitive devices which visually combined 2 images to visualize the illusion of depth and three dimensions. A couple generations of children were inflicted with the trauma of being compelled to examine boring family vacation photos through these things.

If you were/are a member of the U.S. Military, you’ll recall that part of weapons training involved undergoing a VR simulation. For a while, Samsung offered free VR headsets and content during a promotion. The point is, XR is contacting an ever growing portion of our lives. This wasn’t always the case, as until very recently, there were very few spaces outside of academia, government, or private industry which had the capabilities to display digital XR. Even then, the technology wasn’t really there. Digital technology like this isn’t very practical if you need Stonehenge sized computer towers to run it. Now that XR technology has evolved to the point of practicality and accessibility, it is remunerative to understand the different components of XR.
So far, I’ve given a very broad overview of XR. Now, let’s descend into the details. Below, we’ll describe what each of these Extended Realities are, and we’ll classify which category our product, Dicom Director, falls into.
AR
AR stands for “Augmented Reality”. North of 41 states that “Augmented Reality (AR) is a live, direct or indirect view of a physical, real-world environment whose elements are augmented (or supplemented) by computer-generated sensory input such as sound, video, graphics or GPS data”.
Essentially, the visual perspective we have of the real world is augmented or supplemented by other elements, most commonly computer generated graphics. An almost canonical example of AR is the video game known as Pokémon Go. We’re not going to dive into the details of how this game is played. All we’re concerned about are the Pokemon (the creatures), which appear on the screen for players when certain conditions are met. Examine the image below of a Pokemon named “Mewtwo” being captured by the camera. The Mewtwo isn’t really there. If the player exits the app and points their camera towards the direction of where the Mewtwo was projected, all they would capture are trees and snow. The Mewtwo augments(spices up) the reality which the user experiences.

Google has been experimenting with AR infused maps. These maps display bright, conspicuous graphics which provide assistance to people experiencing difficulty with their vision.

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VR
OK, so far we’ve inspected what a physical, real-world environment looks like with a couple shiny objects within it. AR doesn’t completely envelop the physical world.
VR, on the other hand, dominates the environment. VR is an abbreviation for Virtual Reality and “It is a computer-generated simulation of an environment or 3-dimensional image where people can interact in a seemingly real or physical way”
In other words, VR makes you feel like you’re somewhere else. It simulates another environment.
The video game industry 🎮has been toying with XR for about 3 decades now. In fact, Nintendo placed enough confidence in VR(and in their furiously aggressive marketing department), that in 1995, they released their Virtual Boy console. This device attempted to emulate VR, but the entire endeavor failed spectacularly. The technology didn’t prove sufficient, and the Virtual Boy headset even provoked headaches.
To contrast how drastically things have improved in VR, view the following video:
Now, that is a compelling experience! The visual and auditory senses are occupied with all the neat colors, sounds and designs appearing on the screen. The physical, real world space which the player occupies is perceived by them to be the world in the game. It is only when the player removes their headset will they “return” to the real world.
Perhaps a more relatable outcome of the new generation of XR technologies is that companies are frequently using VR modules to train employees. Verizon has been using VR to prepare their employees for robberies they may experience and towards the end of 2019, Walmart had trained more than 1 million employees using virtual reality

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MR
Mixed Reality, or MR, advances VR even further. MR intends to not only dominate the environment which the user perceives, but to also to populate this environment with objects which are aware of its limitations. Virtual objects are mapped onto the physical view. Contrast this with AR, which simply overlays objects over the physical realm.
A striking instance of MR is that of a computer generated puppy aware of your presence inside of the alternate reality. You can play with this puppy, and it will react to your behavior. This puppy will also be aware of the boundaries and the other objects in the environment. Microsoft’s Hololens is capable of producing MR realms like the one displayed in this video:
The physical and the digital worlds are blended, or mixed.
Dicom Director and XR
First, let’s clarify exactly what it is we do at DICOM Director. DICOM Director is the next generation of medical imaging, offering an augmented reality/virtual reality system for viewing MRIs and CT scans in 3D. The categories of XR which our product falls into are AR and VR.

The methods in which medical images are currently viewed are anachronistic. Medical images are prisoners of the second dimension. Doctors such as radiologists, interventionalists, and surgeons perform anachronistic rituals involving wrestling, sometimes pleading, with light sources in order to obtain an acceptable view of a medical image. Okay great, eventually the study is properly illuminated, but…
We occupy a 3 dimensional world. so it’s only natural that we’re comfortable with 3D visuals. DICOM Director’s 3D holographic renderings of CTs and MRIs dramatically improves visualization of complex anatomic relationships, allowing a new level of pre-operative planning, intra-operative image guidance and post-operative case review.
By wielding the power of the third dimension, physicians will be equipped with superior information which will guide their decisions in caring for their infirm patients. This will generate better care and outcomes for patients, which is what every doctor should desire.
AR/VR has already been adopted by respected professional bodies such as the time tested Royal College of Surgeons. Furthermore, a few Health Education Campuses in the United States have shifted to exclusively employing AR/VR technology to teach anatomy.
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