Effektive Workflow Evaluation & Interface Design for iMRI Planning Software

Translating Research into Clinical Practice.

How can processes in image-guided tumor diagnostics and treatment be simplified to reduce the strain on both patients and medical staff – How does the workflow evaluation for this new type of medical procedure look like? This questions lie at the core of the STIMULATE 2 research project, in which USE-Ing. contributed its expertise in usability engineering and human-centered design. Unlike diagnostic MRI, iMRI demands fast, intuitive control of imaging parameters while operating inside the MRI bore. Existing systems are too complex, too slow, and detached from the realities of live decision-making. In collaboration with internationally renowned research institutions and clinical partners, the project aimed to analyze workflows in image-guided diagnostics and therapy — and to develop practical, user-centered solutions that bring research closer to clinical application.

Human-centered Design of an MRI Operating Environment

To understand and optimize how clinicians interact with interventional MRI systems (such as the interventional MRI suite by Siemens Healthineers), USE-Ing. developed a multimodal method for capturing and analyzing workflow processes during minimally invasive diagnostics and therapies.
Together with partners from the Otto von Guericke University Magdeburg and the Hannover Medical School, an experimental operating room was designed — enabling controlled evaluations and the development of human-machine interface prototypes for interventional MRI systems.

Why existing systems fall short:

• No dedicated interface exists for interventional MRI yet.
• Current MRI control software stems from diagnostic workflows.
• The MRI system is not built for live in-bore operation.
• The current MRI planning software is overloaded with irrelevant options and slow mode switching.

Workflow Evaluation & Usability Engineering

From the start, the project followed an evidence-based usability engineering process according to IEC 62366-1 combining qualitative and quantitative evaluation methods.
During early lab sessions, task walkthroughs and behavioral observations were conducted using a liver biopsy as a representative procedure — chosen for its complex coordination between image-based navigation, needle placement, and time-critical decisions.

Our human-centered design process followed the four ISO 9241-210 phases: understanding context, specifying requirements, creating solutions, and evaluating outcomes. Early workflow analyses identified bottlenecks such as fragmented navigation and inefficient needle handling.

To capture the multidimensional nature of iMRI interaction, classic usability tests were complemented with:

• Motion tracking to analyze body positioning and movement in confined MRI spaces

• Eye-tracking to measure attention shifts between screens and interface elements

• Team-based simulations reflecting real clinical coordination

• Preliminary use error analysis aligned with ISO 14971

These methods revealed key bottlenecks — such as missed functions, visual overload under stress, and task conflicts between team members — which directly informed the next design iteration.

GUI Prototype: UX-Design for In-Bore Interaction

Findings from the simulated interventions shaped a new interface prototype specifically tailored for interventional MRI.
Traditional MRI control software, primarily designed for diagnostic use, proved unsuitable for live procedures — offering excessive configuration options, frequent mode switches, and poor support for time-sensitive actions.

USE-Ing. therefore developed a domain-specific prototype that focused on procedural efficiency and clinical relevance. It was built around three design priorities:

• Needle Path Planning — The radiologist can adjust entry and target points while inside the MRI bore. Real-time feedback removes menu switching and preserves a sterile workflow.

• Sequence Handling — A single, card-based interface consolidates sequence selection, editing, and organization in one place.

• Adaptive Top Bar — Replaces rigid sidebars with a collapsible top layout to maximize image visibility during live navigation.

The interface followed the four phases of ISO 9241-210 (Human-Centered Design Process) and integrated usability engineering activities according to IEC 62366 and ISO 14971. Iterative evaluation cycles incorporated feedback from clinicians, engineers, and MRI specialists, refining both the design and interaction logic.

Formative Evaluation: Tested Under Realistic, Time-Constrained Conditions

The high-fidelity GUI prototype underwent a formative usability evaluation with interventional radiologists and medical technologist for radiology (MTR/MT-R ) in a time-constrained simulation reflecting real procedural stress levels.
The study included:

• Simulated task sequences (e.g., patient setup, sequence selection, needle trajectory planning)

• Eye-tracking and motion-capture data collection

• Observational walkthroughs and post-task interviews

The tests were designed to reflect real team dynamics between radiologist and assistant (MTRA), providing insights into coordination, timing, and mutual awareness.
Participants consistently highlighted improved clarity, intuitive workflows, and faster access to key controls — particularly for needle path adjustments and sequence planning, which demonstrated substantial usability gains over conventional MRI interfaces.

The formative usability evaluation simulated real iMRI scenarios under time pressure with interventional radiologists and MTRAs. Participants highlighted improved clarity, faster sequence control, and intuitive trajectory handling — confirming measurable gains in workflow efficiency and user confidence.

 

Bringing Human Factors into Medical Imaging Innovation

This project demonstrates how focused Human Factors Engineering transforms research prototypes into promising solutions evaluated in real clinical iMRI workflows — proving that even these complex MRI workflows can be made intuitive and error-resistant through user-centered design.
Through STIMULATE 2, USE-Ing. contributes to shaping the next generation of interventional MRI systems — grounded in empirical usability data, multimodal analysis, and clinical collaboration.
Our mission in this project: translating human-centered iMRI research into technologies that support radiologists and medical technologist for radiology and enhance patient care.

Learn more about our usability engineering services for medical devices.

Research Campus STIMULATE, Subproject: Workflow Evaluation and Interface Design iMRI Solutions, Funding Code: 13GW0473D