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PubMed2006

Visible Korean Human: its techniques and applications.

Three recent studies have offered an unprecedented view of the human body. The Visible Human Project, the Visible Korean Human (VKH), and the Chinese Visible Human have featured the serial sectioning of whole cadavers, producing cross-sectional images that methodically catalogue gross human anatomy. By volumetric reconstruction, these cross-sectional images can be transformed into three-dimensional (3D) images of anatomic structures. Compiling these 3D images would create an invaluable library for medical education and research. The goal of this report is to promote the expansion of such a library of 3D anatomic images and to help users fully understand and utilize the serially sectioned images. To do this, we will discuss the fundamental techniques and equipment used in the VKH and its preliminary experiments. We will also address new applications of the VKH, including virtual brain surgery, virtual endoscopy, and virtual cardiopulmonary resuscitation via the development of virtual dissection software.

Anatomy↗
PubMed2006

Virtual reality techniques. Application to anatomic visualization and orthopaedics training.

Surgical training systems using virtual reality simulation techniques offer a cost-effective alternative to traditional training methods. In this sense, techniques for interactive visualization and virtual reality surgery have been one of the very important research areas. We describe various techniques we have used in developing a virtual reality system for anatomic visualization and training arthroscopic knee surgeons. Virtual models used in our systems are constructed from the Visible Human Project and Chinese Visible Human data sets. We present our various developments in segmentation, personal-computer-based real-time volume visualization, soft tissue deformation with topological change in real-time using finite element analysis, and soft tissue cutting with tactile feedback.

Arthroscopy↗
PubMed1995

The Visible Human data set: an image resource for anatomical visualization.

The National Library of Medicine (NLM) has long been a world leader in the archiving and distribution of the print-based images of biology and medicine. NLM has also been a pioneer in the use of computer systems to encode and distribute textual knowledge of the life sciences. NLM's Long Range Planning effort of 1985-86 foresaw a coming era where NLM's bibliographic and factual database services would be complemented by libraries of digital images, distributed over high speed computer networks and by high capacity physical media. The NLM Planning Panel on Electronic Imaging recommended that NLM should undertake the building of a digital image library consisting of computer-assisted tomography (CAT), magnetic resonance interferometry (MRI), and cryosection images of a representative, carefully selected and prepared male and female cadaver--the "Visible Human Project." The male Visible Human data set is now being made available through a license agreement with the NLM. A wide range of educational, diagnostic, treatment planning, and commercial uses is predicted. The Visible Human data set and its associated identification maps will serve as a "Boston Teapot" for medical imaging, a common public domain data set against which all medical imaging algorithms can be tested, and a cornerstone for future sets of related image libraries.

Adult↗
PubMed2005

Visible Korean human: improved serially sectioned images of the entire body.

The data from the Visible Human Project (VHP) and the Chinese Visible Human (CVH), which are the serially sectioned images of the entire cadaver, are being used to produce three-dimensional (3-D) images and software. The purpose of our research, the Visible Korean Human (VKH), is to produce an enhanced version of the serially sectioned images of an entire cadaver that can be used to upgrade the 3-D images and software. These improvements are achieved without drastically changing the methods developed for the VHP and CVH; thus, a complementary solution was found. A Korean male cadaver was chosen without anything perfused into the cadaver; the entire body was magnetic resonance (MR) and computed tomography (CT) scanned at 1.0-mm intervals to produce MR and CT images. After scanning, entire body of the cadaver was embedded and serially sectioned at 0.2-mm intervals; each sectioned surface was inputted into a personal computer to produce anatomical images (pixel size: 0.2 mm) without any missing images. Eleven anatomical organs in the anatomical images were segmented to produce segmented images. The anatomical and segmented images were stacked and reconstructed to produce 3-D images. The VKH is an ongoing research; we will produce a female version of the VKH and provide more detailed segmented images. The data from the VHP, CVH, and VKH will provide valuable resources to the medical image library of 3-D images and software in the field of medical education and clinical trials.

Adult↗
PubMed2000

The visible human anatomy of the lumbar erector spinae.

STUDY DESIGN: Image data of the male and female cadavers from the Visible Human Project were visualized and quantified. OBJECTIVE: To clarify the anatomy of the lumbar part of the human lumbar erector spinae muscles. SUMMARY OF BACKGROUND DATA: Recent studies have shown discrepancies in the description of the anatomy of the lumbar part of the lumbar erector spinae. The main differences concern whether lumbar fascicles of iliocostalis lumborum exist and whether the lumbar fascicles have direct attachments to the ilium or attach via the erector spinae aponeurosis. With the Visible Human Project from the U.S. National Library of Medicine, a new powerful basis for anatomic investigation has become available. METHODS: Software was produced to visualize sections oriented in any direction and with maximum resolution of the Visible Human male and female. Three-dimensional coordinates of anatomic structures in the image space could be marked in the cross-sectional images. The geometry and the physiologic cross-sectional areas of the erector spinae fascicles of lumbar origin were thus derived. RESULTS AND CONCLUSIONS: The study supports a classification of the lateral fascicles of the lumbar part of the lumbar erector spinae as part of iliocostalis lumborum. In both the male and the female, a large part of the erector spinae fibers of lumbar origin attached to the erector spinae aponeurosis. These results are of importance for biomechanical analysis of force transmission in the lumbar spine.

Adult↗
PubMed2003

The superior epigastric artery does not pass through Larrey's space (trigonum sternocostale).

The passage of the superior epigastric artery (SEA), the terminal branch of the internal thoracic artery (ITA), through the inferior orifice of the thorax differs in different reports. According to some, it passes through Larrey's space (trigonum sternocostale), therefore through a diaphragmatic orifice, but according to others it passes in front of the diaphragm and the transverse abdominal muscle. The aim of this study was to determine the position of the SEA in its thoracoabdominal segment. We carried out a series of 14 dissections (10 on embalmed cadavers and 4 on unembalmed cadavers), and a study of images from the Visible Human Project. Dissections always led to the same conclusions. After having dissected the trigonum sternocostale, we observed that no vascular element was present in the space, which was obstructed downwards by the parietal peritoneum and limited forwards by the aponeurosis of the transverse abdominal muscle. Inferior digitations of transversus thoracis were joined with the transversus abdominis. The SEA passed in front of the plane formed by these two muscles while the sternal and costal parts of the diaphragm were behind this plane. Whatever the level of the section of the Visible Human Project, there was always a musculoaponeurotic plane between Larrey's space and the superior epigastric artery and both veins. Larrey's space, or trigonum sternocostale, was limited medially by the lateral border of the sternal part of the diaphragm, laterally by the medial border of the costal part of the diaphragm, and anteriorly by the musculoaponeurotic plane formed by the transversus thoracis above and the transversus abdominis, below without a clear boundary between those muscles. The SEA, the terminal branch of the ITA, passed in front of this musculoaponeurotic plane.

Diaphragm↗
PubMed2003

Creation of the Chinese visible human data set.

The United States Visible Human Project (VHP) created a digital image data set of complete human male (data acquisition finished in November 1994) and female (data acquisition finished in December 1995) cadavers in magnetic resonance imaging (MRI), computed tomography (CT), and anatomical (anatomic serial section) modes. VHP aroused worldwide enthusiasm for Visible Human Research (VHR), and the data set is being used in a variety of research and educational domains. The Visible Korean Human (VKH) male was produced in March 2001. To accelerate worldwide VHR and to promote virtual anatomy as a revolutionary break with conventional anatomy, more visible human data sets representative of different populations of the world are in demand. The Chinese Visible Human (CVH) male (created in October 2002) and female (created in February 2003) project achieved greater integrity of images, easier blood vessel identification, and were free of organic lesion (unlike the other visible human projects). We performed data acquisition, three-dimensional (3D) reconstruction, and visualization with improved technology to create CVH male and female. CVH is the first volumetric data representing a complete normal adult human male and female of an Asian population. This article presents the history of Chinese Visible Human cadavers and the methods and technology used to produce the data set.

Anatomy, Cross-Sectional↗
PubMed2005

[Topographical anatomy of the female pelvis in ultrasound].

AIM: Achieving a high quality gynaecological ultrasound examination requires thorough knowledge of topographic anatomy. To date, there are no guidelines for a standardised course of the examination. The goal of the study was to define exact planes by means of cross-sectional anatomy and then to standardise the gynaecological ultrasound examination with the transabdominal, introital and transvaginal technique. METHOD: We developed a software tool based on IDL (Interactive Data Language) for the female data set of the Visible Human Project which generates free determinable planes in the volume. The organs of the female pelvis were divided into landmark- and target structures according to the ultrasonic visibility and the variability of the position, shape and structure. From this, a course for the gynaecological ultrasound examination was created and verified on 65 patients each with an inconspicuous ultrasound finding. In addition, the average duration of the examination was determined. RESULTS: The landmark structures could be demonstrated in all patients. Five planes were defined for each technique, and the course of the whole examination with 15 exact planes was described. The average duration of the examination was 4.5 minutes. CONCLUSION: As of now, the digitally reconstructed anatomical illustrations have achieved the best image resolution and quality regardless of the position of the plane in the examination volume. The standardised course of the gynaecological ultrasound examination can serve as a basis for the improvement of training quality and the evaluation of a general gynaecological ultrasound screening.

Female↗
PubMed2006

Registration and segmentation for the high resolution visible human male images.

The Visible Human project by National Library of Medicine (NLM) resulted in two sets of cryosection images of a human male (VHM): low (LR) and high (HR) resolution. By leveraging the already registered and segmented LR images, we have successfully achieved the same for the entire HR image set. 3D models of human anatomical structures generated using this HR image set, presented in this paper, provide qualitative demonstration of the high accuracy of the HR registration and segmentation.

Humans↗
PubMed2007

A high-resolution anthropomorphic voxel-based tomographic phantom for proton therapy of the eye.

Proton therapy is increasingly used in medical treatments for cancer patients due to the sharp dose conformity offered by the characteristic Bragg peak. Proton beam interactions with the eye will be simulated using the MCNPX Monte Carlo code and available nuclear cross-section data to calculate the dose distribution in the eye gel and surrounding organs. A high-resolution eye model will be employed using a 3D geometrical voxel-based anthropomorphic head phantom obtained from the Visible Human Project (female data). Manual segmentation of the eye, carried out by the Medical Physics group at the University of Surrey resulted in 15 identified structures. This work emphasizes the use of a realistic phantom for accurately predicting dose deposition by protons.

Anthropometry↗
PubMed2005

Comparison of isotropic and orthotropic material property assignments on femoral finite element models under two loading conditions.

CT data has been widely used in the finite element modeling of bone. It can provide useful information on the geometrical topology and material properties of bone. Based on CT data, the assignment of bone material properties to finite element meshes is a fundamental step in the model generation. Most work done in this area has adopted isotropic assignment strategy due to its simplicity. However, bone material has been recognized as an orthotropic material. This work is aimed to investigate the effects of orthotropic material property assignment on femoral finite element model by comparing with isotropic material property assignment on the same model. There were 72 finite element models obtained from the frozen CT male dataset of visible human project. Based on the analysis results of the maximum equivalent Von Mises stress and the maximum nodal displacement, three parameters were defined to achieve this comparison. The results have shown that the differences between the two material property assignments are small under two loading conditions (double-leg standing and single-leg standing) investigated in this work.

Adult↗
PubMed2005

Applications of virtual reality in aesthetic surgery.

BACKGROUND: Virtual reality has a long history in plastic and reconstructive surgery, with uses ranging from anatomical demonstration to craniofacial surgical planning. The purpose of this article is to add to the literature a computer graphics-based resource for aesthetic surgery. METHODS: Deformation tools, virtual cameras, and other components of Alias's Maya 4.0 were used to perform virtual surgical procedures on a detailed model of superficial facial anatomy. This three-dimensional model of superficial facial anatomy, derived from the National Library of Medicine's Visible Human Project, was also "aged" in Maya at key depths of anatomical dissection. Adobe's After Effects 5.5 was used for animation postproduction work for all animations. RESULTS: Three-dimensional computer animations were developed to illustrate techniques in aesthetic surgery. Another animation was created that simulates facial aging at various levels of anatomical dissection. CONCLUSIONS: Computer modeling and animation have the potential to play an important role in education, surgical planning, development, and other aspects of aesthetic surgery.

Computer Simulation↗
PubMed2004

Fluence-to-dose conversion coefficients for monoenergetic proton beams based on the VIP-Man anatomical model.

A new set of fluence-to-absorbed dose and fluence-to-effective dose conversion coefficients has been calculated for high-energy protons using the whole-body anatomical model VIP-Man, which was developed from the high-resolution transverse colour photographic images of the National Library of Medicine's Visible Human Project. For 10 monoenergetic proton beams between 20 and 10,000 MeV, organ dose calculations were performed using the Monte Carlo code MCNPX under six different irradiation geometries: anterior-posterior, posterior-anterior, left lateral, right lateral, isotropic and rotational. The absorbed dose results for 24 major organs of VIP-Man are presented and compared with those based on mathematical phantoms reported in the literature. The discrepancies (generally within 40%) in organ dose and effective dose estimates are attributed to the use of different transport models employed by different Monte Carlo codes.

Adult↗
PubMed2005

Designing a virtual reality model for aesthetic surgery.

BACKGROUND: Aesthetic surgery deals in large part with the manipulation of soft-tissue structures that are not amenable to visualization by standard technologies. As a result, accurate three-dimensional depictions of relevant surgical anatomy have yet to be developed. This study presents a method for the creation of detailed virtual reality models of anatomy relevant to aesthetic surgery. METHODS: Two-dimensional histologic sections of a cadaver from the National Library of Medicine's Visible Human Project were imported into Alias's Maya, a computer modeling and animation software package. These two-dimensional data were then "stacked" as a series of vertical planes. Relevant anatomy was outlined in cross-section on each two-dimensional section, and the resulting outlines were used to generate three-dimensional representations of the structures in Maya. RESULTS: A detailed and accurate three-dimensional model of the soft tissues germane to aesthetic surgery was created. This model is optimized for use in surgical animation and can be modified for use in surgical simulators currently being developed. CONCLUSIONS: A model of facial anatomy viewable from any angle in three-dimensional space was developed. The model has applications in medical education and, with future work, could play a role in surgical planning. This study emphasizes the role of three-dimensionalization of the soft tissues of the face in the evolution of aesthetic surgery.

Computer Simulation↗
PubMed2004

Physical and computer modelling of blood flow in a systemic-to-pulmonary shunt.

UNLABELLED: The aim of this work was the application of computer and physical in vitro simulation methods for estimating surgery procedure hemodynamics. The modified Blalock-Taussig (mB-T) palliative surgical procedure is performed to increase the pulmonary blood flow in children with congenital heart defects. Such a systemic-to-pulmonary shunt yields substantial modification in the blood flow within the large blood vessels. The objective of the present study was to investigate basic characteristics of the flow, flow pattern and pressure-flow efficiency, before and after opening of the mB-T graft. METHODS: The model was based on the vessel geometry obtained from the Visible Human Project and included the arch of aorta, the three arteries branching from the arch, the pulmonary trunck, and the left and right pulmonary arteries. The graft was added between the left subclavian artery and the left pulmonary artery. The glass model of the vessels was produced and investigated in a physical model of the cardiovascular system with an artificial ventricular device as the blood pump. Flow rate and hydrostatic pressure were measured at the inlet to and outlets from the glass model and in a few points within the system. Laser flow visualization was also performed. Computer simulations were done using the boundary conditions from the physical model. RESULTS: The opening of the mB-T graft changed flow distribution in all branches (including inflow). A complex flow pattern with large eddies and channelling of the flow in the vicinity of the graft and within it was observed in flow visualization and in computer simulations. Because of that complexity the local measurements of hydrostatic pressure at the vessel wall could not predict the average flow rate. The reversed flow in the graft was observed during the systole. CONCLUSIONS: The complex flow pattern developed in the physical model of the mB-T graft. The channelling of the flow and the formation of large eddies may yield high shear stress and modify blood properties. The rigid wall model can describe only some flow characteristics observed in vivo. Computer simulation is a very fast and accurate method which permits earlier qualification of cardiac surgeons on how to change cardiac vascular blood flow after operations.

Arteriovenous Shunt, Surgical↗
PubMed1997

Patient specific color texture mapping of CT-based anatomical surface models utilizing cryosection data.

In traditional medical imaging modalities, color and texture information can add considerable information for diagnostics. Presently, multimodal images of a patient are unregistered and referenced independent of each other, or registered and fused into a single hybrid volume. Doctors and other medical professionals need to be able to visualize and interrogate, on a per-patient basis, a wide variety of 2D and 3D data representations that can be created from non-invasive imaging modalities, such as MRI and CT. In addition, any colorization that may be applied to the image data is strictly based on tissue density, radiation emission, or magnetic signature, and not on any physiological foundation. In order for "true-to-life" color information to be incorporated with non-invasive imaging techniques, and for it to be of consistent quality across the entire body, a single whole-body cryosection specimen with associated medical image data is needed. The National Library of Medicine's Visible Human Project offers just such a specimen. Using the full-body medical image data along with the cryosection images of the Visible Human subject, a set of color lookup tables for all visually well defined structures and organs can be created. As a result, patient-specific colorization based on real tissue color and characteristics can be incorporated into traditional intensity-based imaging modalities. The primary goal of this work has been to create CT color lookup tables for all visually well-defined structures in the Visible Human male cryosection data set. The subsequent goal has been to develop a method for stripping textures from a volumetric data set for polygonal models and non-uniform rational B-spline (NURBS) models, also generated from the volumetric data.

Color↗
PubMed2006

The United States military's thigh trauma simulator.

Computer-generated virtual environments bring the potential to practice complex mental and physical tasks in safe and controlled conditions. When applied to medical procedures, they could allow students to gain experience with a wide variety of cases, in optimal order, and with no patient risk. The United States military is funding the development of a virtual environment to present a variety of health care providers, including orthopaedic surgeons, with case scenarios based on thigh trauma resulting in femur fractures. Data from the Visible Human project are being used to create the underlying virtual anatomy. This paper discusses an effort to imbue models created from the Visible Human male with thigh trauma related to femur fractures and to display the results in clinically relevant ways including virtual fluoroscopy and radiography, ultrasound, palpation, and nonclinical but educationally useful methods including transparency.

Computer Simulation↗