Abstract:Chinese acupuncture practitioners primarily depend on muscle memory and tactile feedback to insert needles and accurately target acupuncture points, as the current workflow lacks imaging modalities and visual aids. Consequently, new practitioners often learn through trial and error, requiring years of experience to become proficient and earn the trust of patients. Medical students face similar challenges in mastering this skill. To address these challenges, we developed an innovative system, MRUCT, that integrates ultrasonic computed tomography (UCT) with mixed reality (MR) technology to visualize acupuncture points in real-time. This system offers offline image registration and real-time guidance during needle insertion, enabling them to accurately position needles based on anatomical structures such as bones, muscles, and auto-generated reference points, with the potential for clinical implementation. In this paper, we outline the non-rigid registration methods used to reconstruct anatomical structures from UCT data, as well as the key design considerations of the MR system. We evaluated two different 3D user interface (3DUI) designs and compared the performance of our system to traditional workflows for both new practitioners and medical students. The results highlight the potential of MR to enhance therapeutic medical practices and demonstrate the effectiveness of the system we developed.