Radiotherapy (RT) uses ionising radiation to target and destroy cancer cells, relying on high-quality pretreatment
imaging to calibrate dose distribution and delivery to target volumes. Breath-hold techniques, such
as the "exhale breath-hold" used for pancreatic cancer patients, can enhance image quality and minimize
damage to healthy tissue by reducing organ motion during imaging and treatment.

To obtain these high-quality scans, patient health literacy and compliance are essential. This study aimed to
develop and evaluate an augmented reality (AR) mobile application to educate pancreatic cancer patients on
the "exhale breath-hold" technique and the stages of radiotherapy planning.
Using anonymized Digital Imaging and Communication in Medicine (DICOM) datasets from pancreatic
cancer patients, animated 3D models of thoracic and abdominal organs were digitally reconstructed to depict
organ position and motion during free-breathing and “exhale breath-hold” exercises.

The application was evaluated by 24 health care professionals (HCPs) using the standardized Reduced
Instructional Materials Motivation Survey (RIMMS) and System Usability Scale (SUS) questionnaires. The
RIMMS yielded high motivation scores in attention (M = 4.55 ± 0.679), relevance (M = 4.79 ± 0.438),
confidence (M = 4.79 ± 0.459), and satisfaction (M = 4.54 ± 0.821). The SUS produced a score of 83.96,
placing the application within the 90th percentile for usability.

The AR application effectively illustrated organ location and motion, emphasizing their relationship to the
pancreas for RT planning. These findings suggest that AR-based educational tools could potentially enhance
patient understanding of radiotherapy processes and offer a framework for future AR applications in RT.