Medical & Biological Engineering & Computing https://doi.org/10.1007/s11517-019-02044-4 ORIGINAL ARTICLE Using game controller as position tracking sensor for 3D freehand ultrasound imaging Vei Siang Chan 1 · Farhan Mohamed 1 · Yusman Azimi Yusoff 1 · Dyah Ekashanti Octorina Dewi 2 · Alfiera Anuar 3 · Mohamad Amir Shamsudin 4 · Wey Sheng Mong 1 Received: 16 April 2018 / Accepted: 26 August 2019 © International Federation for Medical and Biological Engineering 2019 Abstract Position tracking has been widely used in medical applications, especially in 3D ultrasound imaging, where it has transformed the 2D slice limitation into 3D volume with bigger clinical impacts. As a game controller can also produce position tracking information, it has the potential to act as a low-cost and portable position tracker for ultrasound probes. This paper aims to investigate the feasibility of a game controller to perform as a position tracker and to design its implementation in 3D ultrasound imaging. The study consists of data acquisition and 3D ultrasound reconstruction for visualization. The data acquisition is accomplished by capturing the 2D ultrasound frame and its relative positional and orientation data by using an ultrasound probe and game controller respectively. These data are further reconstructed to produce 3D ultrasound volume for visualization. Our experiments include game controller position tracker testing and 3D ultrasound reconstruction on baby phantom. The results have confirmed that the game controller performance was closely aligned with that of in a robot arm. Also, the 3D ultrasound reconstruction implementation has revealed promising outcomes. With these features, the function of the currently available ultrasound probes can be prospectively improved using a game controller position tracker effectively. Keywords Ultrasound · Medical imaging · 3D reconstruction · Medical visualization · 2D ultrasound probe · 3D imaging · Game controller · Position tracking 1 Introduction Ultrasound (US) imaging has been widely known for its advantages compared with other imaging modalities. It ranges from real-time imaging, nonradiation exposure, noninvasive, and affordable cost to capabilities of measuring  Vei Siang Chan vschan2@live.utm.my 1 School of Computing, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia 2 School of Biomedical Engineering & Health Sciences, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia 3 Media and Games Innovation Centre of Excellence, Institute of Human Centre Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia 4 School of Electrical Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia many physiological parameters [1]. Vast developments in computer processor technology have enhanced the US imaging functions in terms of imaging quality, accuracy and reliability, effectiveness and convenience, portability, and durability. Its applications also have expanded following the medical demands, not only for diagnostic per se but also for treatment and surgical guidance [2]. The advancements of conventional two-dimensional ultrasound (2DUS) probe have provided an excellent tomographic image of the object, enabling for easier understanding of pathological interpretation and easily obtaining a mentally constructed impression of volumetric three-dimensional (3D) anatomy of the scanned object by merely sweeping the 2DUS probe along the surface [3]. However, volumetric quantitative analysis and visualization are still difficult to achieve through 2DUS imaging, especially for large and long objects. Additionally, precise probe localization may be more difficult due to lack of full volumetric view of the object [4, 5]. This means that when the physician needs to re-scan the same anatomy part for treatment or diagnosis purpose, it is very time-consuming for him or her to obtain the same part again [6].