Real-time Medical Visualization of Human Head and Neck Anatomy and its Applications for Dental Training and Simulation

The Digital Design Studio and NHS Education Scotland have developed ultra-high definition real-time interactive 3D anatomy of the head and neck for dental teaching, training and simulation purposes. In this paper we present an established workflow using state-of-the-art 3D laser scanning technology and software for design and construction of medical data and describe the workflow practices and protocols in the head and neck anatomy project. Anatomical data was acquired through topographical laser scanning of a destructively dissected cadaver. Each stage of model development was clinically validated to produce a normalised human dataset which was transformed into a real-time environment capable of large-scale 3D stereoscopic display in medical teaching labs across Scotland, whilst also supporting single users with laptops and PC. Specific functionality supported within the 3D Head and Neck viewer includes anatomical labelling, guillotine tools and selection tools to expand specific local regions of anatomy. The software environment allows thorough and meaningful investigation to take place of all major and minor anatomical structures and systems whilst providing the user with the means to record sessions and individual scenes for learning and training purposes. The model and software have also been adapted to permit interactive haptic simulation of the injection of a local anesthetic

Canine Gait Analysis: Interactive Online Tutorials for Veterinary Students

The purpose of this thesis is to produce interactive tutorials that veterinary students can use to explore concepts that are often difficult to conceptualize, including (a) change in joint function, (b) muscle action and innervation, and (c) recognizing and locating normal vs. abnormal structure and function. Elements of this thesis include a complete 3D skeleton constructed using a series of canine CT (DICOM) files, illustrated overlays on video footage of a dog undergoing examination, and short interactive self-assessment tools. Students will be able to deconstruct and toggle components of the skeleton, as well as view the animated skeleton superimposed over video footage of a dog in motion, to investigate numerous aspects of locomotion

Real-time Medical Visualization of Human Head and Neck Anatomy and its Applications for Dental Training and Simulation

The Digital Design Studio and NHS Education Scotland have developed ultra-high definition real-time interactive 3D anatomy of the head and neck for dental teaching, training and simulation purposes. In this paper we present an established workflow using state-of-the-art 3D laser scanning technology and software for design and construction of medical data and describe the workflow practices and protocols in the head and neck anatomy project. Anatomical data was acquired through topographical laser scanning of a destructively dissected cadaver. Each stage of model development was clinically validated to produce a normalised human dataset which was transformed into a real-time environment capable of large-scale 3D stereoscopic display in medical teaching labs across Scotland, whilst also supporting single users with laptops and PC. Specific functionality supported within the 3D Head and Neck viewer includes anatomical labelling, guillotine tools and selection tools to expand specific local regions of anatomy. The software environment allows thorough and meaningful investigation to take place of all major and minor anatomical structures and systems whilst providing the user with the means to record sessions and individual scenes for learning and training purposes. The model and software have also been adapted to permit interactive haptic simulation of the injection of a local anaesthetic

Creation of a Virtual Atlas of Neuroanatomy and Neurosurgical Techniques Using 3D Scanning Techniques

Neuroanatomy is one of the most challenging and fascinating topics within the human anatomy, due to the complexity and interconnection of the entire nervous system. The gold standard for learning neurosurgical anatomy is cadaveric dissections. Nevertheless, it has a high cost (needs of a laboratory, acquisition of cadavers, and fixation), is time-consuming, and is limited by sociocultural restrictions. Due to these disadvantages, other tools have been investigated to improve neuroanatomy learning. Three-dimensional modalities have gradually begun to supplement traditional 2-dimensional representations of dissections and illustrations. Volumetric models (VM) are the new frontier for neurosurgical education and training. Different workflows have been described to create these VMs -photogrammetry (PGM) and structured light scanning (SLS). In this study, we aimed to describe and use the currently available 3D scanning techniques to create a virtual atlas of neurosurgical anatomy. Dissections on post-mortem human heads and brains were performed at the skull base laboratories of Stanford University - NeuroTraIn Center and the University of California, San Francisco - SBCVL (skull base and cerebrovascular laboratory). Then VMs were created following either SLS or PGM workflow. Fiber tract reconstructions were also generated from DICOM using DSI-studio and incorporated into VMs from dissections. Moreover, common creative license materials models were used to simplify the understanding of the specific anatomical region. Both methods yielded VMs with suitable clarity and structural integrity for anatomical education, surgical illustration, and procedural simulation. We described the roadmap of SLS and PGM for creating volumetric models, including the required equipment and software. We have also provided step-by-step procedures on how users can post-processing and refine these images according to their specifications. The VMs generated were used for several publications, to describe the step-by-step of a specific neurosurgical approach and to enhance the understanding of an anatomical region and its function. These models were used in neuroanatomical education and research (workshops and publications). VMs offer a new, immersive, and innovative way to accurately visualize neuroanatomy. Given the straightforward workflow, the presently described techniques may serve as a reference point for an entirely new way of capturing and depicting neuroanatomy and offer new opportunities for the application of VMs in education, simulation, and surgical planning. The virtual atlas, divided into specific areas concerning different neurosurgical approaches (such as skull base, cortex and fiber tracts, and spine operative anatomy), will increase the viewer's understanding of neurosurgical anatomy. The described atlas is the first surgical collection of VMs from cadaveric dissections available in the medical field and could be a used as reference for future creation of analogous collection in the different medical subspeciality.La neuroanatomia è, grazie alle intricate connessioni che caratterizzano il sistema nervoso e alla sua affascinante complessità, una delle discipline più stimolanti della anatomia umana. Nonostante il gold standard per l’apprendimento dell’anatomia neurochirurgica sia ancora rappresentato dalle dissezioni cadaveriche, l’accessibilità a queste ultime rimane limitata, a causa della loro dispendiosità in termini di tempo e costi (necessità di un laboratorio, acquisizione di cadaveri e fissazione), e alle restrizioni socioculturali per la donazione di cadaveri. Al fine di far fronte a questi impedimenti, e con lo scopo di garantire su larga scala l’apprendimento tridimensionale della neuroanatomia, nel corso degli anni sono stati sviluppati nuovi strumenti e tecnologie. Le tradizionali rappresentazioni anatomiche bidimensionali sono state gradualmente sostituite dalle modalità 3-dimensionali (3D) – foto e video. Tra questi ultimi, i modelli volumetrici (VM) rappresentano la nuova frontiera per l'istruzione e la formazione neurochirurgica. Diversi metodi per creare questi VM sono stati descritti, tra cui la fotogrammetria (PGM) e la scansione a luce strutturata (SLS). Questo studio descrive l’utilizzo delle diverse tecniche di scansione 3D grazie alle quali è stato creato un atlante virtuale di anatomia neurochirurgica. Le dissezioni su teste e cervelli post-mortem sono state eseguite presso i laboratori di base cranica di Stanford University -NeuroTraIn Center e dell'Università della California, San Francisco - SBCVL. I VM dalle dissezioni sono stati creati seguendo i metodi di SLS e/o PGM. Modelli di fibra bianca sono stati generate utilizzando DICOM con il software DSI-studio e incorporati ai VM di dissezioni anatomiche. Inoltre, sono stati utilizzati VM tratti da common creative license material (materiale con licenze creative comuni) al fine di semplificare la comprensione di alcune regioni anatomiche. I VM generati con entrambi i metodi sono risultati adeguati, sia in termini di chiarezza che di integrità strutturale, per l’educazione anatomica, l’illustrazione medica e la simulazione chirurgica. Nel nostro lavoro sono stati esaustivamente descritti tutti gli step necessari, di entrambe le tecniche (SLS e PGM), per la creazione di VM, compresi le apparecchiature e i software utilizzati. Sono state inoltre descritte le tecniche di post-elaborazione e perfezionamento dei VM da poter utilizzare in base alle necessità richieste. I VM generati durante la realizzazione del nostro lavoro sono stati utilizzati per molteplici pubblicazioni, nella descrizione step-by-step di uno specifico approccio neurochirurgico o per migliorare la comprensione di una regione anatomica e della sua funzione. Questi modelli sono stati utilizzati a scopo didattico per la formazione neuroanatomica di studenti di medicina, specializzandi e giovani neurochirurghi. I VM offrono un modo nuovo, coinvolgente e innovativo con cui poter raggiungere un’accurata conoscenza tridimensionale della neuroanatomia. La metodologia delle due tecniche descritte può servire come punto di riferimento per un nuovo modo di acquisizione e rappresentazione della neuroanatomia, ed offrire nuove opportunità di utilizzo dei VM nella formazione didattica, nella simulazione e nella pianificazione chirurgica. L'atlante virtuale qui descritto, suddiviso in aree specifiche relative a diversi approcci neurochirurgici, aumenterà la comprensione dell'anatomia neurochirurgica da parte dello spettatore. Questa è la prima raccolta chirurgica di VM da dissezioni anatomiche disponibile in ambito medico e potrebbe essere utilizzato come riferimento per la futura creazione di analoga raccolta nelle diverse sotto specialità mediche

An investigation to examine the most appropriate methodology to capture historical and modern preserved anatomical specimens for use in the digital age to improve access: a pilot study

Anatomico-pathological specimens constitute a valuable component of many medical museums or institutional collections but can be limited in their impact on account of both physical and intellectual inaccessibility. Further concerns relate to conservation as anatomical specimens may be subject to tissue deterioration, constraints imposed by spatial or financial limitations of the host institution, or accident-based destruction. In awareness of these issues, a simple and easily implementable methodology to increase accessibility, impact and conservation of anatomical specimens is proposed which combines photogrammetry, object virtual reality (object VR), and interactive portable document format (PDF) with supplementary historical and anatomical commentary. The methodology was developed using wet, dry, and plastinated specimens from the historical and modern collections in the Museum of Anatomy at the University of Glasgow. It was found that photogrammetry yielded excellent results for plastinated specimens and showed potential for dry specimens, while object VR produced excellent photorealistic virtual specimens for all materials visualised. Use of PDF as output format was found to allow for the addition of textual, visual, and interactive content, and as such supplemented the virtual specimen with multidisciplinary information adaptable to the needs of various audiences. The results of this small-scale pilot study indicate the beneficial nature of combining these established techniques into a methodology for the digitisation and utilisation of historical anatomical collections in particular, but also collections of material culture more broadly

Embedding interactive, three-dimensional content in portable document format to deliver gross anatomy information and knowledge

The Portable Document Format (PDF) is likely the most widely used digital file format for scholarly and scientific electronic publishing. Since format specification version 1.6, three-dimensional (3D) models in Universal 3D (U3D) format can be embedded into PDF files. The present study demonstrates a repertoire of graphic strategies and modes of presentation that exploit the potentials of 3D models embedded in PDF to deliver anatomical information and knowledge. Three-dimensional models and scenes representing anatomical structures generated by 3D surface scanning or by segmentation from either clinical imaging data or cadaver sectional images were converted into U3D format and then embedded into PDF files using both freely and commercially available software. The relevant steps and required software tools are described. Built-in tools in Adobe Acrobat and JavaScript scripting both were used to pre-configure user interaction with 3D contents. Eight successive proof-of-concept examples of increasing complexity are presented and provided as supplementary material, including both unannotated and annotated 3D specimens, use of bitmap-textures, guided navigation through predetermined 3D scenes, 3D animation, and interactive navigation through tri-planar sectional human cadaver images. Three-dimensional contents embedded in PDF files are generally comparable to multimedia and dedicated 3D software in terms of quality, flexibility, and convenience, and offer new unprecedented opportunities to deliver anatomical information and knowledg

A recommended workflow methodology in the creation of an educational and training application incorporating a digital reconstruction of the cerebral ventricular system and cerebrospinal fluid circulation to aid anatomical understanding

BACKGROUND: The use of computer-aided learning in education can be advantageous, especially when interactive three-dimensional (3D) models are used to aid learning of complex 3D structures. The anatomy of the ventricular system of the brain is difficult to fully understand as it is seldom seen in 3D, as is the flow of cerebrospinal fluid (CSF). This article outlines a workflow for the creation of an interactive training tool for the cerebral ventricular system, an educationally challenging area of anatomy. This outline is based on the use of widely available computer software packages. METHODS: Using MR images of the cerebral ventricular system and several widely available commercial and free software packages, the techniques of 3D modelling, texturing, sculpting, image editing and animations were combined to create a workflow in the creation of an interactive educational and training tool. This was focussed on cerebral ventricular system anatomy, and the flow of cerebrospinal fluid. RESULTS: We have successfully created a robust methodology by using key software packages in the creation of an interactive education and training tool. This has resulted in an application being developed which details the anatomy of the ventricular system, and flow of cerebrospinal fluid using an anatomically accurate 3D model. In addition to this, our established workflow pattern presented here also shows how tutorials, animations and self-assessment tools can also be embedded into the training application. CONCLUSIONS: Through our creation of an established workflow in the generation of educational and training material for demonstrating cerebral ventricular anatomy and flow of cerebrospinal fluid, it has enormous potential to be adopted into student training in this field. With the digital age advancing rapidly, this has the potential to be used as an innovative tool alongside other methodologies for the training of future healthcare practitioners and scientists. This workflow could be used in the creation of other tools, which could be developed for use not only on desktop and laptop computers but also smartphones, tablets and fully immersive stereoscopic environments. It also could form the basis on which to build surgical simulations enhanced with haptic interaction

3D printing the pterygopalatine fossa : a negative space model of a complex structure

Purpose : The pterygopalatine fossa is one of the most complex anatomical regions to understand. It is poorly visualized in cadaveric dissection and most textbooks rely on schematic depictions. We describe our approach to creating a low-cost, 3D model of the pterygopalatine fossa, including its associated canals and foramina, using an affordable “desktop” 3D printer. Methods:  We used open source software to create a volume render of the pterygopalatine fossa from axial slices of a head computerised tomography scan. These data were then exported to a 3D printer to produce an anatomically accurate model. Results:  The resulting ‘negative space’ model of the pterygopalatine fossa provides a useful and innovative aid for understanding the complex anatomical relationships of the pterygopalatine fossa. Conclusion: This model was designed primarily for medical students; however, it will also be of interest to postgraduates in ENT, ophthalmology, neurosurgery, and radiology. The technical process described may be replicated by other departments wishing to develop their own anatomical models whilst incurring minimal costs.Publisher PDFPeer reviewe