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Volume rendering of visible human data for an anatomical virtual environment.

In this work, we utilize the axial anatomical human male sections from the National Library of Medicine's Visible Human Project to generate three-dimensional (3-D) volume representations of the human male subject. The two-dimensional (2-D) projection images were produced by combining ray tracing techniques with automated image segmentation routines. The resultant images provide accurate and realistic volumetric representations of the Visible Human data set which is ultimately needed in medical virtual environment simulation. Ray tracing techniques provide methods by which 2-D volume views of a 3-D voxel array can be produced. The cross-sectional images can be scanned at different angles to produce rotated views of the voxel array. By combining volume views at incremental angles over 360 degrees a full volumetric representation of the voxel array, in this case the human male data set, can be computer generated and displayed without the speed and memory limitations of trying to display the entire data array. Additional texture and feature information can be obtained from the data by applying optical property equations to the ray scans. The imaging effects that can be added to volume renderings using these equations include shading, shadowing, and transparency. The automated segmentation routines provide a means to distinguish between various anatomical structures of the body. These routines can be used to differentiate between skin, fat, muscle, cartilage, blood vessels, and bone. By combining automated segmentation routines with the ray-tracing techniques, 2-D volume views of various anatomical structures and features can be isolated from the full data set. Examples of these segmentation abilities are demonstrated for the human male data set which include volume views of the skeletal systems, the musculoskeletal system, and part of the vascular system. The methods described above allow us to generate lifelike images, NURBS surface models, and realistic texture maps of specific anatomical structures. We have the capability to generate images that are both accurate and lifelike, much like photographic anatomical atlases. We can also generate images, models, and textures that have the clarity of medical artwork/illustrations, by highlighting the coloring of the ray traced structures with conventional colors instead of the natural color of the specimen. We are currently in the process of generating a comprehensive reference atlas of volume rendered images of the human body, soon to be published by Mosby-Year Book. The segmentation techniques needed to create this atlas also offer the accuracy and realism needed to create surface models and texture maps for a virtual environment for surgery simulation.

Anatomy, Cross-Sectional↗

Augmented Reality for teaching endotracheal intubation: MR imaging to create anatomically correct models.

Clinical procedures have traditionally been taught at the bedside, in the morgue and in the animal lab. Augmented Reality (AR) technology (the merging of virtual reality and real objects or patients) provides a new method for teaching clinical and surgical procedures. Improved patient safety is a major advantage. We describe a system which employs AR technology to teach endotracheal intubation, using the Visible Human datasets, as well as MR images from live patient volunteers.

Computer Simulation↗

Applications and perspectives in anatomical 3-dimensional modelling of the visible human with VOXEL-MAN.

Up to now computerized interactive 3-dimensional (3D) atlases of human anatomy have been based on radiological data or artificial geometric models as spatial descriptions of morphological structures. Besides the obvious advantages of this data (e.g. already in digital format, geometrical correctness) the lack of high resolution anatomical slices of larger regions of the human body has prevented the use of more realistic anatomical data so far. Now, the Visible Human Project offers high quality anatomical slices of complete cadavers. Therefore, on the one hand, new opportunities for realistic virtual 3D models of anatomy are open. On the other hand, just the major advantages of the visible human data (e.g. realistic colors and textures, high resolution) result in new demands on the image processing and visualization techniques. This paper describes experience, solutions and results with a volume-based approach for building realistic anatomical 3D models.

Anatomy, Cross-Sectional↗

A cluster computer system for the analysis and classification of massively large biomedical image data.

The current trend in medical image acquisition is towards the generation of image datasets which are massively large, either because they exhibit fine x, y, or z resolution, are volumetric, are multispectral, or a combination of all of the preceding. Such images pose a significant computational challenge in their analysis, not only in terms of data throughput, but also in terms of platform costs and simplicity. In this paper we describe the role of a cluster of workstations together with two quite different application programming interfaces (APIs) in the quantitative analysis of anatomic image data from the visible human project using an MRF-Gibbs classification algorithm. We describe the typical architecture of a cluster computer, two API options and the parallelization of the MRF-Gibbs procedure for the cluster. Finally, we show speedup results obtained on the cluster and sample classifications of visible human data.

Algorithms↗

Creating a high-resolution spatial/symbolic model of the inner organs based on the Visible Human.

Computerized three-dimensional models of the human body, based on the Visible Human Project of the National Library of Medicine, so far do not reflect the rich anatomical detail of the original cross-sectional images. In this paper, a spatial/symbolic model of the inner organs is developed, which is based on more than 1000 cryosections and congruent fresh and frozen CT images of the male Visible Human. The spatial description is created using color-space segmentation, graphic modeling, and a matched volume visualization with subvoxel resolution. It is linked to a symbolic knowledge base, providing an ontology of anatomical terms. With over 650 three-dimensional anatomical constituents, this model offers an unsurpassed photorealistic presentation and level of detail. A three-dimensional atlas of anatomy and radiology based on this model is available as a PC-based program.

Anatomy, Cross-Sectional↗

[Current problems in the data acquisition of digitized virtual human and the countermeasures].

As a relatively new field of medical science research that has attracted the attention from worldwide researchers, study of digitized virtual human still awaits long-term dedicated effort for its full development. In the full array of research projects of the integrated Virtual Chinese Human project, virtual visible human, virtual physical human, virtual physiome, and intellectualized virtual human must be included as the four essential constitutional opponents. The primary importance should be given to solving the problems concerning the data acquisition for the dataset of this immense project. Currently 9 virtual human datasets have been established worldwide, which are subjected to critical analyses in the paper with special attention given to the problems in the data storage and the techniques employed, for instance, in these datasets. On the basis of current research status of Virtual Chinese Human project, the authors propose some countermeasures for solving the problems in the data acquisition for the dataset, which include (1) giving the priority to the quality control instead of merely racing for quantity and speed, and (2) improving the setting up of the markers specific for the tissues and organs to meet the requirement from information technology, (3) with also attention to the development potential of the dataset which should have explicit pertinence to specific actual applications.

Anatomy, Cross-Sectional↗

A virtual surgical simulator for the lower limbs.

As the body of knowledge concerning human anatomy and physiology continues to grow, new techniques must emerge to convey it more efficiently to future health care professionals. Computer simulation, interaction and visualization technologies are now being used in the development of virtual training environments. This paper presents a real-time virtual surgical simulator that integrates scientific visualization tools into a surround-screen projection-based (SSPB) immersive environment. This environment focuses on procedures for the lower limbs; however, the techniques described can be applied to other portions of the body. The research consists of three phases: environment modeling, volume visualization and immersive surgical simulation. Environment modeling involved modeling an operating room with all of the relevant elements. The volume visualization phase required the application of marching cubes and decimation techniques to the Visible Human Project (VHP) dataset to generate models of the lower limbs. The simulator integrated modeling and volume visualization to facilitate the rehearsal of medical procedures and interaction with medical information. Interactive cutting, suturing and X-Ray CT placement over the virtual patient's legs were used to probe underlying structures. The simulator is intended to aid medical students in learning anatomy, physiology and radiological analysis without jeopardizing patient care.

Computer Simulation↗

HPCC and the National Information Infrastructure: an overview.

The National Information Infrastructure (NII) or "information superhighway" is a high-priority federal initiative to combine communications networks, computers, databases, and consumer electronics to deliver information services to all U.S. citizens. The NII will be used to improve government and social services while cutting administrative costs. Operated by the private sector, the NII will rely on advanced technologies developed under the direction of the federal High Performance Computing and Communications (HPCC) Program. These include computing systems capable of performing trillions of operations (teraops) per second and networks capable of transmitting billions of bits (gigabits) per second. Among other activities, the HPCC Program supports the national supercomputer research centers, the federal portion of the Internet, and the development of interface software, such as Mosaic, that facilitates access to network information services. Health care has been identified as a critical demonstration area for HPCC technology and an important application area for the NII. As an HPCC participant, the National Library of Medicine (NLM) assists hospitals and medical centers to connect to the Internet through projects directed by the Regional Medical Libraries and through an Internet Connections Program cosponsored by the National Science Foundation. In addition to using the Internet to provide enhanced access to its own information services, NLM sponsors health-related applications of HPCC technology. Examples include the "Visible Human" project and recently awarded contracts for test-bed networks to share patient data and medical images, telemedicine projects to provide consultation and medical care to patients in rural areas, and advanced computer simulations of human anatomy for training in "virtual surgery."

Computer Communication Networks↗

Estimation of out-of-plane vertebra rotations on radiographic projections using CT data: a simulation study.

This study extends previous research concerning in vivo intervertebral motion by means of single-plane fluoroscopy in an attempt to overcome 2D analysis limitations. Knowledge of out-of-plane vertebra rotations will extend the results provided by planar kinematic studies, which is particularly important for lateral bending investigation where axial rotation accompanies side bending, but is also valuable in sagittal analysis (e.g. indicating an absence of coupled axial rotation). Combining a fluoroscopic projection of a vertebra with volumetric information provided by CT data, vertebra 3D position can be estimated. Out-of-plane vertebral rotations are estimated by comparing Digitally Reconstructed Radiographs (DRRs) in different orientations with a reference fluoroscopic projection, maximising the image cross-correlation index. DRRs have been computed from CT-data using a ray-casting algorithm. In this work a feasibility study of the method was performed by means of a computer simulation. To this end the CT volume (vertebra L4, segmented) provided by the Visible Human Project was utilised and reference fluoroscopic projections were simulated in different orientations adding various levels of noise. Accuracy and precision of the proposed method was determined. Error analysis reveals that an accuracy of less than 1 degree can be achieved in computation of out-of-plane vertebral angles.

Algorithms↗

Virtual reality in the operating room of the future.

In cooperation with the Max-Delbrück-Centrum/Robert-Rössle-Klinik (MDC/RRK) in Berlin, the Fraunhofer Institute for Computer Graphics is currently designing and developing a scenario for the operating room of the future. The goal of this project is to integrate new analysis, visualization and interaction tools in order to optimize and refine tumor diagnostics and therapy in combination with laser technology and remote stereoscopic video transfer. Hence, a human 3-D reference model is reconstructed using CT, MR, and anatomical cryosection images from the National Library of Medicine's Visible Human Project. Applying segmentation algorithms and surface-polygonization methods a 3-D representation is obtained. In addition, a "fly-through" the virtual patient is realized using 3-D input devices (data glove, tracking system, 6-DOF mouse). In this way, the surgeon can experience really new perspectives of the human anatomy. Moreover, using a virtual cutting plane any cut of the CT volume can be interactively placed and visualized in realtime. In conclusion, this project delivers visions for the application of effective visualization and VR systems. Commonly known as Virtual Prototyping and applied by the automotive industry long ago, this project shows, that the use of VR techniques can also prototype an operating room. After evaluating design and functionality of the virtual operating room, MDC plans to build real ORs in the near future. The use of VR techniques provides a more natural interface for the surgeon in the OR (e.g., controlling interactions by voice input). Besides preoperative planning future work will focus on supporting the surgeon in performing surgical interventions. An optimal synthesis of real and synthetic data, and the inclusion of visual, aural, and tactile senses in virtual environments can meet these requirements. This Augmented Reality could represent the environment for the surgeons of tomorrow.

Computer Simulation↗

Web-based three-dimensional Virtual Body Structures: W3D-VBS.

Major efforts are being made to improve the teaching of human anatomy to foster cognition of visuospatial relationships. The Visible Human Project of the National Library of Medicine makes it possible to create virtual reality-based applications for teaching anatomy. Integration of traditional cadaver and illustration-based methods with Internet-based simulations brings us closer to this goal. Web-based three-dimensional Virtual Body Structures (W3D-VBS) is a next-generation immersive anatomical training system for teaching human anatomy over the Internet. It uses Visible Human data to dynamically explore, select, extract, visualize, manipulate, and stereoscopically palpate realistic virtual body structures with a haptic device. Tracking user's progress through evaluation tools helps customize lesson plans. A self-guided "virtual tour" of the whole body allows investigation of labeled virtual dissections repetitively, at any time and place a user requires it.

Anatomy↗

[Scientific significance and prospective application of digitized virtual human].

As a cutting-edge research project, digitization of human anatomical information combines conventional medicine with information technology, computer technology, and virtual reality technology. Recent years have seen the establishment of, or the ongoing effort to establish various virtual human models in many countries, on the basis of continuous sections of human body that are digitized by means of computational medicine incorporating information technology to quantitatively simulate human physiological and pathological conditions, and to provide wide prospective applications in the fields of medicine and other disciplines. This article addresses 4 issues concerning the progress in virtual human model researches as the following: (1) Worldwide survey of sectioning and modeling of visible human. American visible human database was completed in 1994, which contains both a male and a female datasets, and has found wide application internationally. South Korea also finished the data collection for a male visible Korean human dataset in 2000. (2) Application of the dataset of Visible Human Project (VHP). This dataset has yielded plentiful fruits in medical education and clinical research, and further plans are proposed and practiced to construct a Physical Human and Physiological Human . (3) Scientific significance and prospect of virtual human studies. Digitized human dataset may eventually contribute to the development of many new high-tech industries. (4) Progress of virtual Chinese human project. The 174th session of Xiangshang Science Conferences held in 2001 marked the initiation of digitized virtual human project in China, and some key techniques have been explored. By now the data-collection process for 4 Chinese virtual human datasets have been successfully completed.

Anatomy, Cross-Sectional↗

The visible animal project: a three-dimensional, digital database for high quality three-dimensional reconstructions.

The "Visible Animal Project" (VAP) is comprised of axial anatomic cryosections and corresponding CT and MR images of a mature dog. The digital database is used for the creation of three-dimensional computer graphics of canine anatomy. The technique of cryodissection is described in detail. The combining of the corresponding CT and MR images, and cryosections as well as the data processing for the creation of three-dimensional reconstructions is presented and examples are shown. For the first time a complete high-resolution three-dimensional database of a dog is available, which can be used as the base for further high quality three-dimensional reconstructions, similar to the "Visible Human Project" (VHP).

Anatomy, Cross-Sectional↗

Anatomy online: presentation of a detailed WWW atlas of human gross anatomy--reference for medical education.

We present an online anatomy atlas based on the Visible Human Project (VHP) of the US National Library of Medicine. The objective is to provide original unlabeled as well as labeled sections of the human body of high quality and resolution on the Internet, for use in basic and continuing medical education. For a representative overview of the body, 370 axial sections were selected from the male and female data base of the VHP with special regard to regions of clinical interest. Each section is accompanied by its corresponding computer tomography (CT) image and, if available, magnetic resonance images (MRI) for quick and easy comparison of morphologic and radiologic structures. The sections can be studied unlabeled or labeled according to the current Terminologia Anatomica. A linked vocabulary with more than 850 terms explains the labeling. Animations of the sections as well as of CT and MR images allow for further visualization of the topographic relationships of anatomical structures. The responses to the project indicate that students and physicians regard the Internet Atlas of Human Gross Anatomy as a most useful aid for learning and reviewing anatomical details. The atlas is accessible on: http://www.uni-mainz.de/FB/Medizin/Anatomie/workshop/vishuman/Eready.html.

Anatomy, Artistic↗

Finite element analysis of the strain distribution in the humeral head tubercles during abduction: comparison of young and osteoporotic bone.

AIM: The aim of this work was to design an accurate 3D digital model of the humerus and rotator cuff muscles. This model was then used to study strain distribution in humeral tubercles according to bone density. MATERIALS AND METHODS: The geometry of bone and muscle structures was reproduced using SURFDRIVER software, based on anatomical sections, CT scans and MRI images from the Visible Human Project image library. The contours were transferred to PATRAN software to rebuild volumes and mesh them. Calculations of strains and their distribution were performed using NASTRAN software. All the elements were considered to be isotropes. RESULTS: The study of the distribution of stress magnitude according to the type of bone modeled, shows that some stresses in cortical bone are greater than those in cancellous bone and are also greater in old bone, implying more deformation in old bone at constant force. This study also shows that stresses do not penetrate deeply into cancellous tissue. CONCLUSION: Observing the simulation results led understanding of the pathology of certain fractures of the proximal end of the humerus. This study also helped explain why certain types of osteosynthesis fail due to tubercles reconstruction failures.

Bone Density↗

French mirror site of the NPAC visible human viewer: first year evaluation.

The NPAC visible human viewer (NPAC VHV), graphical interface written in JAVA, freely accessible by the Web, allows the display of anatomic cross-sections of the Visible Human Project developed by the National Library of Medicine. In April 1997, the Medical Media Library of Lyons undertook the construction of a French-language mirror site of the NPAC VHV. The aim of this work is to evaluate first year utilisation of this site. From May 1st, 1997 to April 30th, 1998, the mirror site was consulted 34,752 times. In 45.14% of cases, the request came from France, in 4.42% of cases from Belgium, in 3.98% from Canada and in 2.12% from Switzerland. Other connections came either from a country responsible for fewer than 1% of connections or from unidentified computers. Data analysis showed a peak of connections between 15:00 and 17:00, and an increased number of connections from September to March 1998. The NPAC VHV is housed in 5 sites in the world. It is a software very simple to use. As the figures have no legends, it is more appropriate for group teaching than for self-teaching.

Anatomy, Cross-Sectional↗

The effect of muscle loading on the simulation of bone remodelling in the proximal femur.

A large number of finite element analyses of the proximal femur rely on a simplified set of muscle and joint contact loads to represent the boundary conditions of the model. In the context of bone remodelling analysis around hip implants, muscle loading affects directly the spatial distribution of the remodelling signal. In the present study we performed a sensitivity analysis on the effect of different muscle loading configurations on the outcome of the bone remodelling simulation. An anatomical model of the femur with the implanted stem in place was constructed using the CT data of the Visible Human Project dataset of the National Institute of Health. The model was loaded with three muscle force configurations with increasing level of complexity. A strain adaptive remodelling rule was employed to simulate the post-operative bone changes around the implant stem and the results of the simulation were assessed quantitatively in terms of the bone mineral content changes in 18 periprosthetic regions of interest. The results showed considerable differences in the amount of bone loss predicted between the three cases. The simplified models generally predicted more pronounced bone loss. Although the overall remodelling patterns observed were similar, the bone conserving effect of additional muscle forces in the vicinity of their areas of attachment was clear. The results of this study suggest that the loading configuration of the FE model does play an important role in the outcome of the remodelling simulation.

Adaptation, Physiological↗

Modelling slow wave activity in the small intestine.

We have developed an anatomically based model to simulate slow wave activity in the small intestine. Geometric data for the human small intestine were obtained from the Visible Human project. These data were used to create a one-dimensional finite element mesh of the entire small intestine using an iterative fitting procedure. The electrically active components of the intestinal walls were modelled using a modified Fitzhugh-Nagumo cell model embedded within a longitudinal smooth muscle layer and a layer containing Interstitial Cells of Cajal. Within these layers, the monodomain equation was used to describe slow wave propagation. To solve the monodomain equation, a high-resolution finite difference grid, with an average spatial resolution of 0.95 mm, was embedded within each finite element. The resulting simulations of intestinal activity agree with the experimental observation that slow wave frequency gradually declines from 12 cycles per minute (cpm) in the duodenum to 8 cpm at the terminal ileum. Furthermore, the simulations demonstrated a decrease in conduction velocity with distance along the small intestine (10.7 cm/s in the duodenum, 5.1cm/s in the jejunum and 1.4 cm/s in the ileum), matching experimental recordings from the canine small intestine. We conclude that the framework presented here is capable of qualitatively simulating normal slow wave activity in an anatomical model of the small intestine.

Finite Element Analysis↗