Accuracy of 3-D Surface Rendering of 2-D Ultrasound Images of the Uterus Using a Novel Software in Mapping Uterine Fibroids.

OBJECTIVE: Three-dimensional surface rendering of 2-D ultrasound images of the uterus in mapping uterine fibroids is a fast-evolving imaging technique that holds great potential for gynecology. The purpose of this study was to assess the accuracy of 3-D surface rendering of 2-D ultrasound images of the uterus using a new Fibroid Mapping Reviewer Application (FMRA) software for mapping uterine fibroids as compared with the pathological evaluation of uterine fibroids in pre-menopausal women undergoing hysterectomy. METHODS: We enrolled women aged 35-55 y scheduled for hysterectomy for symptomatic fibroids at a tertiary care hospital from 2019 to 2021. Per pre-set guidelines, we recorded 2-D images and videos of the uterus with fibroids during the transvaginal ultrasound. The recordings were transferred through USB, loaded in the FMRA software and post-processed to generate a 3-D rendered uterus model. An experienced pathologist assessed and documented the gross examination details per a set protocol. We compared the pre-specified dimensions related to the size (L1, L2) and location (X, Y) of fibroids between the 3-D model and the pathologist's assessment of the hysterectomy specimen. RESULTS: A total of 25 fibroids in 25 women, the single largest per woman, were considered for analysis. The two methods had good correlation with respect to size (for L1, R² = 0.9723, and for L2, R² = 0.9784) and location (for X, R² = 0.9618, and for Y, R² = 0.9753). Inter-observer analysis revealed that measurements from two sonologists were reproducible (Cronbach's α = 0.9 for the L1, L2 and L3 dimensions of fibroids from the 3-D model). CONCLUSION: The FMRA is a novel tool for mapping fibroids. With its proven accuracy, it will be helpful in planning surgeries and during guided procedures for managing uterine fibroids.

Creating Virtual Models and 3D Movies Using DemoMaker for Anatomical Education.

Three-dimensional (3D) anatomy models have been used for education in health professional schools globally. Virtual technology has become more popular for online teaching since the COVID-19 pandemic. This chapter will describe a project in which a series of virtual anatomical models of organs and structures were developed for educational purposes, and it will describe in detail how to build three-dimensional (3D) movies using DemoMaker. Although setting up the 3D system was complicated and challenging, the process of reconstructing 3D models from radiographic images and the steps of creating animations and 3D movies are exponentially simpler. These efforts require minimal training, thus allowing most people to be able to engage in this modeling process and utilize the moviemaking steps. Amira® software and computed tomographic angiography (CTA) data were used to create 3D models of the lungs, heart, liver, stomach, kidney, etc. The anatomical locations of these structures within the body can be identified and visualized by recording information from multiple CTA slices using volume and surface segmentation. Ultimately, these virtual 3D models can be displayed via dual projectors onto a specialized silver screen and visualized stereoscopically by viewers as long as they wear 3D polarized glasses. Once these 3D movies are created, they can be played automatically on a computer screen, silver screen, 3D system playback screen, and video player, and they can be embedded into PowerPoint lecture slides. Both virtual models and movies are suitable for self-directed learning, face-to-face class teaching, and virtual anatomy education. Model animations and 3D movie displays offer students the opportunities to learn about anatomy and the anatomical positions of organs in the body and their 3D relationships to one another. By observing and studying these 3D models, students have the potential to be able to compartmentalize the anatomical information and retain it at a higher level than students learning corresponding anatomy without similar resources.

Feasibility and clinical value of virtual reality for deep infiltrating pelvic endometriosis: A case report.

Deep infiltrating pelvic endometriosis and its surgical management is associated with a risk of major postoperative complications. Magnetic Resonance Imaging (MRI) is recommended preoperatively in order to obtain the most precise mapping of the extent of endometriotic lesions. The aim of this work was to assess the feasibility and clinical interest of 3D modeling by surface rendering as a preoperative planning tool in a patient with deep infiltrating pelvic endometriosis. We report on a 42 years old patient with history of endometriosis and persistent pain underwent pre operative imaging with MRI that was consistent with deep infiltrating endometriosis. A 3D model of the deep infiltrating endometriosis was generated from the MRI and retrospectively compared to the intra-operative findings. The nodule's location and relationship to the uterus and the rectum was clearly defined by the 3D model and correlated with surgical findings. Virtual reality based on 3D models could be an interesting tool to assist in the preoperative planning of complex surgeries.

True-color 3D rendering of human anatomy using surface-guided color sampling from cadaver cryosection image data: A practical approach.

Three-dimensional computer graphics are increasingly used for scientific visualization and for communicating anatomical knowledge and data. This study presents a practical method to produce true-color 3D surface renditions of anatomical structures. The procedure involves extracting the surface geometry of the structure of interest from a stack of cadaver cryosection images, using the extracted surface as a probe to retrieve color information from cryosection data, and mapping sampled colors back onto the surface model to produce a true-color rendition. Organs and body parts can be rendered separately or in combination to create custom anatomical scenes. By editing the surface probe, structures of interest can be rendered as if they had been previously dissected or prepared for anatomical demonstration. The procedure is highly flexible and nondestructive, offering new opportunities to present and communicate anatomical information and knowledge in a visually realistic manner. The technical procedure is described, including freely available open-source software tools involved in the production process, and examples of color surface renderings of anatomical structures are provided.

Whole-Mount Immunofluorescence Protocol for 3D Imaging, Reconstruction, and Quantification of Fourth Pharyngeal Arch Artery Formation.

Pharyngeal arch arteries (PAA) are formed early during mouse embryogenesis and remodel soon thereafter into the aortic arch arteries. Failure of these vessels to form or remodel results in congenital heart defects. This protocol is designed to study the formation of the PAA using whole-mount immunofluorescence staining, followed by tissue clearing with benzyl alcohol/benzyl benzoate (BAAB) and imaging by confocal microscopy. The fine cellular resolution obtained with this technique allows the embryonic vasculature of the pharyngeal arch artery endothelium to be visualized by surface rendering and quantitatively analyzed by counting the number of endothelial cells in both the PAA and the vascular plexus surrounding them.

Three-dimensional reconstruction of magnetic resonance images of carp brain for brain control technology.

BACKGROUND: In the field of animal robot control, brain control technology is currently used to achieve control. It is usually necessary to accurately implant brain electrodes into the animal's brain movement area with the help of a brain stereotaxic apparatus, and apply electrical stimulation to achieve control of the animal. The prerequisite for accurate electrode implantation is to study the internal tissues of the carp skull. NEW METHOD: With the help of 3.0 T magnetic resonance imaging (MRI) instrument and 8_CH MRI scanning coil, carp brain magnetic resonance images was obtained. The visualization tool package VTK and the marching cube algorithm were used for surface rendering, the ray casting algorithm was used for volume rendering and reconstruction. RESULTS: The three-dimensional reconstruction results could show the carp skull surface contour and internal tissue details, and the measured coordinates after three-dimensional reconstruction of magnetic resonance images could be transformed into three-dimensional positioning coordinates suitable for brain stereotaxic apparatus. COMPARISON WITH EXISTING METHODS: The three-dimensional reconstruction images based on magnetic resonance could analyze the relative spatial position relationship between the surface structure of the carp's brain and the internal tissue at any angle, and the three-dimensional positioning coordinates of the brain could be obtained quickly and accurately. CONCLUSIONS: The visualization of carp brain magnetic resonance images based on marching cubes algorithm and ray projection algorithm could obtain ideal reconstruction effects, which could be used in the brain control technology of carp robot.

A reverse form of Linburg-Comstock variation with comments on its etiology and demonstration of interactive 3D portable document format.

PURPOSE: Two most common variations of flexor pollicis longus include its accessory head and its connection with the flexor digitorum profundus of the index (Linburg-Comstock variation). In addition, while three-dimensional (3D) screening has widely been used in anatomical education, its use as reporting tool in anatomical research is still limited. The objective of this study is to report a previously unrecognized form of the accessory head of flexor pollicis longus, discuss the potential etiology of Linburg-Comstock variation, and pilot the 3D scanning of a large-scale anatomical structure. METHODS: An unusual tendon slip was discovered during a routine dissection in the anterior compartment of the right forearm of a 54-year-old male cadaver. A 3D scanner was used to capture the surface topography of the specimen and an interactive portable document format (PDF) was created. RESULTS: An anomalous tendon was found originating from the lateral aspect of the flexor digitorum profundus muscle. This variant tendon then inserted onto the medial surface of the flexor pollicis longus tendon before entering the carpal tunnel. The variation resembles a reverse form of Linburg-Comstock variation, because pulling this variant tendon resulted in simultaneous flexion of the interphalangeal joint of thumb. CONCLUSION: Surgeons should be aware of the reverse Linburg-Comstock variation, because it may not be detectable by the conventional provocative testing. Linburg-Comstock variation may be classified as an anatomical variant or a secondarily acquired condition depending on its type. Our demonstration of interactive 3D-PDF file highlights its potential use for delivering anatomical information in future cadaveric studies.

External surface anatomy of the postfolding human embryo: Computer-aided, three-dimensional reconstruction of printable digital specimens.

Opportunities for clinicians, researchers, and medical students to become acquainted with the three-dimensional (3D) anatomy of the human embryo have historically been limited. This work was aimed at creating a collection of digital, printable 3D surface models demonstrating major morphogenetic changes in the embryo's external anatomy, including typical features used for external staging. Twelve models were digitally reconstructed based on optical projection tomography, high-resolution episcopic microscopy and magnetic resonance imaging datasets of formalin-fixed specimens of embryos of developmental stages 12 through 23, that is, stages following longitudinal and transverse embryo folding. The reconstructed replica reproduced the external anatomy of the actual specimens in great detail, and the progress of development over stages was recognizable in a variety of external anatomical features and bodily structures, including the general layout and curvature of the body, the pharyngeal arches and cervical sinus, the physiological gut herniation, and external genitalia. In addition, surface anatomy features commonly used for embryo staging, such as distinct steps in the morphogenesis of facial primordia and limb buds, were also apparent. These digital replica, which are all provided for 3D visualization and printing, can serve as a novel resource for teaching and learning embryology and may contribute to a better appreciation of the human embryonic development.

Identification of the Facial Colliculus in Two-dimensional and Three-dimensional Images.

The facial colliculus (FC), an important landmark for planning a surgical approach to brainstem cavernous malformation (BCM), is a microstructure; therefore, it may be difficult to identify on magnetic resonance imaging (MRI). Three-dimensional (3D) images may improve the FC-identification certainty; hence, this study attempted to validate the FC-identification certainty between two-dimensional (2D) and 3D images of patients with a normal brainstem and those with BCM. In this retrospective study, we included 10 patients with a normal brainstem and 10 patients who underwent surgery for BCM. The region of the FC in 2D and 3D images was independently identified by three neurosurgeons, three times in each case, using the method for continuously distributed test results (0-100). The intra- and inter-rater reliability of the identification certainty were confirmed using the intraclass correlation coefficient (ICC). The FC-identification certainty for 2D and 3D images was compared using the Wilcoxon signed-rank test. The ICC (1,3) and ICC (3,3) in both groups ranged from 0.88 to 0.99; therefore, the intra- and inter-rater reliability were good. In both groups, the FC-identification certainty was significantly higher for 3D images than for 2D images (normal brainstem group; 82.4 vs. 61.5, P = .0020, BCM group; 40.2 vs. 24.6, P = .0059 for the unaffected side, 29.3 vs. 17.3, P = .0020 for the affected side). In the normal brainstem and BCM groups, 3D images had better FC-identification certainty. 3D images are effective for the identification of the FC.

Detection of cervical spine trauma: Are 3-dimensional reconstructed images as accurate as multiplanar computer tomography?

INTRODUCTION: This study was conducted to assess the diagnostic accuracy of three-dimensional computed tomography (3D-CT) in detection of cervical spine injuries in symptomatic post-trauma patients using multiplanar computed tomography (MP-CT) as reference standard. APPROACH: This cross-sectional study was conducted at Aga Khan University from July 2016 to January 2017. Patients were included using a non-probability, consecutive sampling. MP-CT and 3D- CT images were obtained and evaluated by a senior radiologist to identify cervical spine injuries. RESULTS: 205 patients were included in the study. For fractures, 3D-CT images had sensitivity of 71%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 96.8% and diagnostic accuracy of 97%. For dislocations, 3D-CT reported sensitivity of 83.34%, specificity of 100%, positive predictive value of 100% and negative predictive value of 99.5% and diagnostic accuracy of 99.5%. CONCLUSION: 3D-CT has good diagnostic accuracy for injuries of the cervical spine but must be reviewed simultaneously with multiplanar CT images.

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 knowledge.

Half-scan artifact correction using generative adversarial network for dental CT.

Half-scan image reconstruction with Parker weighting can correct motion artifacts in dental CT images taken with a slow scan-based dental CT. Since the residual half-scan artifacts in the dental CT images appear much stronger than those in medical CT images, the artifacts often persist to the extent that they compromise the surface-rendered bone and tooth images computed from the dental CT images. We used a variation of generative adversarial network (GAN), so-called U-WGAN, to correct half-scan artifacts in dental CT images. For the generative network of GAN, we used a U-net structure of five stages to take advantage of its high computational efficiency. We trained the network using the Wasserstein loss function on the dental CT images of 40 patients. We tested the network with comparing its output images to the half-scan images corrected with other methods; Parker weighting and the other two popular GANs, that is, SRGAN and m-WGAN. For the quantitative comparison, we used the image quality metrics measuring the similarity of the corrected images to the full-scan images (reference images) and the noise level on the corrected images. We also compared the visual quality of the surface-rendered bone and tooth images. We observed that the proposed network outperformed Parker weighting and other GANs in all the image quality metrics. The computation time for the proposed network to process 336×336×336 3D images on a GPU-equipped personal computer was about 3 s, which was much shorter than those of SRGAN and m-WGAN, 50 s and 54 s, respectively.

A concise survey on 3D modeling in the science of anatomy.

This report provides a concise overview of the rendering and utilization of three-dimensional models in the field of anatomy. Anatomical three-dimensional virtual models are widely used for educational purposes, preoperative planning, and surgical simulations because they simply allow for interactive three-dimensional navigation across the human organs or entire body. Virtual three-dimensional models have been recently fabricated as accurate replicas of the anatomical structures thanks to advances in rapid prototyping technology.

Three-Dimensional Surface Rendering of ESCRT Proteins Microscopy Data Using UCSF Chimera Software.

Visualization of subcellular localization of ESCRT proteins and their interactions with different cellular compartments are critical to understand their function. This approach requires the generation of an important amount of 3D fluorescence microscopy data that is not always easy to visualize and apprehend.We describe a step-by-step protocol for 3D surface rendering of confocal microscopy acquisitions using the free software UCSF-Chimera, generating snapshots and animations to facilitate analysis and presentation of subcellular localization data.

Imaging Acetabular Fractures.

Acetabular fractures are encountered by radiologists in a wide spectrum of practice settings. The radiologist's value in the acute and long-term management of acetabular fractures is augmented by familiarity with systematic computed tomography-based algorithms that streamline and simplify Judet-Letournel fracture typing, together with an appreciation of the role of imaging in initial triage, operative decision making, postoperative assessment, prognostication, and evaluation of complications. The steep increase in incidence of acetabular fractures in the elderly over the past several decades places special emphasis on familiarity with geriatric fracture patterns.

A novel approach to segmentation and measurement of medical image using level set methods.

The study proposes a novel approach for segmentation and visualization plus value-added surface area and volume measurements for brain medical image analysis. The proposed method contains edge detection and Bayesian based level set segmentation, surface and volume rendering, and surface area and volume measurements for 3D objects of interest (i.e., brain tumor, brain tissue, or whole brain). Two extensions based on edge detection and Bayesian level set are first used to segment 3D objects. Ray casting and a modified marching cubes algorithm are then adopted to facilitate volume and surface visualization of medical-image dataset. To provide physicians with more useful information for diagnosis, the surface area and volume of an examined 3D object are calculated by the techniques of linear algebra and surface integration. Experiment results are finally reported in terms of 3D object extraction, surface and volume rendering, and surface area and volume measurements for medical image analysis.

High-quality slab-based intermixing method for fusion rendering of multiple medical objects.

The visualization of multiple 3D objects has been increasingly required for recent applications in medical fields. Due to the heterogeneity in data representation or data configuration, it is difficult to efficiently render multiple medical objects in high quality. In this paper, we present a novel intermixing scheme for fusion rendering of multiple medical objects while preserving the real-time performance. First, we present an in-slab visibility interpolation method for the representation of subdivided slabs. Second, we introduce virtual zSlab, which extends an infinitely thin boundary (such as polygonal objects) into a slab with a finite thickness. Finally, based on virtual zSlab and in-slab visibility interpolation, we propose a slab-based visibility intermixing method with the newly proposed rendering pipeline. Experimental results demonstrate that the proposed method delivers more effective multiple-object renderings in terms of rendering quality, compared to conventional approaches. And proposed intermixing scheme provides high-quality intermixing results for the visualization of intersecting and overlapping surfaces by resolving aliasing and z-fighting problems. Moreover, two case studies are presented that apply the proposed method to the real clinical applications. These case studies manifest that the proposed method has the outstanding advantages of the rendering independency and reusability.

Computed anatomical modelling of the optic pathway and oculomotor system using magnetic resonance imaging.

This study presents a computer-based tool for three-dimensional (3D) visualization of the optic pathway and oculomotor system using 3D high-resolution magnetic resonance imaging (MRI) datasets from a healthy subject. The 3D models were built as wireframe grids co-registered with MRI sections. First, 3D anatomical models were generated of the visual pathway from the eyeball to the primary visual cortex and of the cranial oculomotor nerves from the brain stem to the extrinsic eye muscles. Second, a graphical user interface allowed individual and group visualization, translation, rotation and zooming of the 3D models in different spatial positions simultaneously with MRI orthogonal cut planes. Educational and clinical applications are also discussed.

Can Three-Dimensional Reconstructed Image Replace Medical Photograph? / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In recent years, medical recording by digital photography has become a useful tool in every field. Developments in digital techonology have enabled digital X-ray techniques as well as three-dimensional imaging tools such as CT and MRI. Digital data are processed to form three-dimensional images of the patient body and to provide virtual endoscopy. This study aims to widen the application of 3D images for medical recording. SUBJECTS AND METHOD: CT data from five patients with neck mass were used to make gross 3D images showing the lesion site with the aid of 3D-doctor 4.0 and RAPIDIA 3D ver. 2.8 (INFINITT healthcare , Seoul, Korea). Surface rendered images and volume rendered images were compared with the medical photos regarding identification, visibility of lesion, measuring, multidirectional view and reproducibility. RESULTS: 3D images could show real surface contour of the patients, including lesion sites. Shapes shown by the 3D images are exactly the same as the medical photographs, thus it was possible to measure the length and angles and view the image in any directions by rotating. CONCLUSION: Surface rendered and volume rendered images can be used as pre-operative recording tools.

Three-Dimensional Brain Surface Rendering Imaging of Cortical Dysplasia

PURPOSE: The study was to evaluate the localization of the abnormal gyral and sulcal patterns obtained by means of brain surface rendering imaging. MATERIALS AND METHODS: Nineteen patients with cortical dysplasia who underwent brain surface rendering MR imaging were included in this study. We acquired MP-RAGE sequence and created the 3-D surface rendering MR images by using VoxelPlus(R). Anatomical locations and configurations of abnormal gyri and sulci were reviewed. RESULTS: Abnormal gyral and sulcal patterns were seen 18 in 19 patients. The configuration and orientation of affected gyri and sulci were clearly evaluated in the brain surface rendering images. In a lissencephaly, the a cortex was not delineated and showed markedly thick and smooth gyral pattern. In a schizencephaly, there were wheel shaped broad gyral pattern around the cleft. In a hemimegalencephaly, an affected hemisphere were enlarged and displayed thick and wide gyral pattern. In CBPS, the insular cortex was exposed and the gyri of the lesion were thickened. In focal cortical dysplasia, there were irregular serrated or thick and enlarged gyri. CONCLUSION: Brain surface rendering MR imaging is useful for the evaluation of a detailed gyral pattern and accurate involvement site of abnormal gyri.