Embodiments of the present disclosure relate to systems and techniques for accessing data stores of medical images and displaying the medical images in substantially real-time to provide information in an interactive user interface. Systems are disclosed that may advantageously provide highly efficient, intuitive, and rapid dynamic interaction with two- and three-dimensional medical image data using hand gestures. The systems may include interactive user interfaces that are dynamically updated to provide tracking of a users hand in a virtual 3D space by two- and/or three-dimensional image data. A user may use the systems described herein to more quickly, thoroughly, and efficiently interact with image data including two-dimensional images, three-dimensional image data, and/or series of image data, as compared to previous systems.