Integrating muscle fiber orientation from visible human data into radiotherapy target volumes.

Objective.A major challenge in treatment of tumors near skeletal muscle is defining the target volume for suspected tumor invasion into the muscle. This study develops a framework that generates radiation target volumes with muscle fiber orientation directly integrated into their definition. The framework is applied to nineteen sacral tumor patients with suspected infiltration into surrounding muscles.Approach.To compensate for the poor soft-tissue contrast of CT images, muscle fiber orientation is derived from cryo-images of two cadavers from the human visible project (VHP). The approach consists of (a) detecting image gradients in the cadaver images representative of muscle fibers, (b) mapping this information onto the patient image, and (c) embedding the muscle fiber orientation into an expansion method to generate patient-specific clinical target volumes (CTV). The validation tested the consistency of image gradient orientation across VHP subjects for the piriformis, gluteus maximus, paraspinal, gluteus medius, and gluteus minimus muscles. The model robustness was analyzed by comparing CTVs generated using different VHP subjects. The difference in shape between the new CTVs and standard CTV was analyzed for clinical impact.Main results.Good agreement was found between the image gradient orientation across VHP subjects, as the voxel-wise median cosine similarity was at least 0.86 (for the gluteus minimus) and up to 0.98 for the piriformis. The volume and surface similarity between the CTVs generating from different VHP subjects was on average at least 0.95 and 5.13 mm for the Dice Similarity Coefficient and the Hausdorff 95% Percentile Index, showing excellent robustness. Finally, compared to the standard CTV with different margins in muscle and non-muscle tissue, the new CTV margins are reduced in muscle tissue depending on the chosen clinical margins.Significance.This study implements a method to integrate muscle fiber orientation into the target volume without the need for additional imaging.

Visible Korean based on true color sectioned images for making realistic digital human, twenty years' record: a review.

PURPOSE: Visible Korean (VK) consists of two-dimensional (2D) images and three-dimensional (3D) models. The VK is used in various educational tools and research sources for anatomy. In this paper, we report on the records of the VK over 20 years. METHODS: Research papers related to Visible Korean were reviewed. RESULTS: Through this report of VK records, we highlighted the essential points for making true color and ultra-high-resolution sectioned images of human and animal bodies, for making various 2D and 3D applications from the sectioned images, and for good use of the sectioned images and their applications. CONCLUSION: In this metaverse age that various virtual environments are required in medical education and research, the VK dataset meets the reality of virtual human models as fundamental data owing to the actual color and high resolution of the VK dataset.

The Visible Human Project.

This paper gives a flavor of Dr. Donald A.B. Lindberg's view of the expanding role of libraries, his curiosity, and his tolerance for taking educated risks, through the creation and nurturing of National Library of Medicine's Visible Human Project. That project produced the Visible Man and Visible Woman datasets and a suite of tools for presenting and analyzing those and similar datasets. The results are used in teaching anatomy and other medical school courses and in software from the open-source Insight Tool Kit (ITK) that is included in many if not most volume-reconstructing systems. This story is a bit personal. From the beginning we recognized and understood each other since we were both "boys from Brooklyn".

Visible Human Project® female surface based computational phantom (Nelly) for radio-frequency safety evaluation in MRI coils.

Quantitative modeling of specific absorption rate and temperature rise within the human body during 1.5 T and 3 T MRI scans is of clinical significance to ensure patient safety. This work presents justification, via validation and comparison, of the potential use of the Visible Human Project (VHP) derived Computer Aided Design (CAD) female full body computational human model for non-clinical assessment of female patients of age 50-65 years with a BMI of 30-36 during 1.5 T and 3 T based MRI procedures. The initial segmentation validation and four different application examples have been identified and used to compare to numerical simulation results obtained using VHP Female computational human model under the same or similar conditions. The first application example provides a simulation-to-simulation validation while the latter three application examples compare with measured experimental data. Given the same or similar coil settings, the computational human model generates meaningful results for SAR, B1 field, and temperature rise when used in conjunction with the 1.5 T birdcage MRI coils or at higher frequencies corresponding to 3 T MRI. Notably, the deviation in temperature rise from experiment did not exceed 2.75° C for three different heating scenarios considered in the study with relative deviations of 10%, 25%, and 20%. This study provides a reasonably systematic validation and comparison of the VHP-Female CAD v.3.0-5.0 surface-based computational human model starting with the segmentation validation and following four different application examples.

Digital Feast and Physical Famine: The Altered Ecosystem of Anatomy Education due to the Covid-19 Pandemic.

This article explores the effects of the coronavirus disease 2019 (Covid-19) pandemic on the evolution of both physical and digital cadavers within the unique ecosystem of the anatomy laboratory. A physical cadaver is a traditional and established learning tool in anatomy education, whereas a digital cadaver is a relatively recent phenomenon. The Covid-19 pandemic presented a major disturbance and disruption to all levels and types of education, including anatomy education. This article constructs a conceptual metaphor between a typical anatomy laboratory and an ecosystem, and considers the affordances, constraints, and changing roles of physical and digital cadavers within anatomy education through an ecological lens. Adaptation of physical and digital cadavers during the disturbance is analyzed, and the resiliency of digital cadaver technology is recognized. The evolving role of the digital cadaver is considered in terms of increasing accessibility and inclusivity within the anatomy laboratory ecosystem of the future.

Real color volume model of cadaver for learning cardiac computed tomographs and echocardiographs.

PURPOSE: It is difficult for medical students and novice clinicians to interpret cardiac computed tomographs and echocardiographs. This study was intended to help familiarize them with the clinical images of the heart by providing software to browse the various planes of a heart's volume model with real color and high resolution. METHODS: On the sectioned images of a male cadaver, the heart and adjacent structures were segmented to obtain color-filled images. Volume models of the sectioned images and color-filled images were reconstructed and sectioned to obtain three orthogonal planes and five standard oblique planes. The planes were inputted into lab-made browsing software, which was then distributed free of charge. RESULTS: Users of the software would hopefully progress as follows. After experiencing the real color and high resolution, they would become familiar with the grayscale and low resolution. After experiencing the automatic annotation of the basic heart structures, they would become familiar with the detailed structures. After experiencing the designated planes, they would become familiar with the arbitrary planes. After experiencing the still heart, they would become familiar with the moving heart during echocardiography. CONCLUSION: The software, with a user-friendly interface and realistic features, is expected to properly orient medical novices to cardiac computed tomography and echocardiography images.

The Visible Korean: movable surface models of the hip joint.

PURPOSE: In this study, we presented movable surface models to help medical students understand the multiaxial movements of the hip joint. The secondary objective was to demonstrate a simple method to make movable surface models for other researchers. METHODS: We used 166 surface models of the virtual human, and the commercial software was used for all the processes described in this study. Virtual joints were created for the hip joint of the surface models to simulate realistic movements of the joints. Bone surface models were processed to maintain the original shape of the bones during movement. Muscle surface models were processed to express deformation of the muscle shapes during movement. Next, the muscle and bone surface models were moved over six movements of the hip joint (flexion, extension, abduction, adduction, lateral rotation, and medial rotation). The surface models of these six movements were saved and packaged in a PDF file. RESULTS: The PDF file enabled users to see the stereoscopic shapes of the bones and muscles of the hip joint and to scrutinize the six movements on the X, Y, and Z axes of the joint. CONCLUSION: The movable surface models of the hip joint of this study will be helpful for medical students to learn the multiaxial movements of the hip joint. We expect to develop simulations of other joints that can be used in the education of medical students using the materials and methods described in this study.

Three-dimensional reconstruction of the upper limb from anatomical slices of the Korean visible human: simulation and educational application.

PURPOSE: Digital anatomy is a novel emerging discipline. Use of virtual reality brings a revolution in educational anatomy by improving retention and learning outcomes. Indeed, virtual dissection is a new learning tool for students and surgeons. Three-dimensional vectorial models of the human body can be created from anatomical slices obtained by lengthy series of cryosection from the visible human projects. The aim of this paper is to show how these mesh models could be embedded into an Acrobat® 3dpdf interface, to produce an easy-to-use fully interactive educational tool. METHODS: The learning of this method and its practical application were evaluated on a multicentric cohort of 86 people divided into 3 groups, according to the duration of their training (1, 2 or 3 days, respectively). Participants learned how to use the Mesh tool and how to model 3D structures from anatomical sections. At the end of the training, they were given a survey form. Participants were also asked to rate the training (Poor; Average; Good; Very Good; Excellent). RESULTS: Ninety four percent of the subjects rated the device as excellent and would continue to use digital anatomy in their practice. CONCLUSION: This result is the Diva3d® virtual dissection table, a powerful educational tool for anatomists and students. It could also be the basis of future simulation tools for hand surgeons training.

Web-based imaging viewer for real-color volumetric reconstruction of human visible project and DICOM datasets.

Anatomy remains a cornerstone of medical education. It is vital that students achieve a robust understanding of the spatial relationships between anatomical structures in three dimensions. Volumetric medical imaging studies and true-color cryosectional three-dimensional images of visible human datasets are useful for enhancing anatomy education. However, the software systems available for viewing these datasets have important limitations. A web-based application called Mulrecon Color, which can overcome a number of those limitations, is introduced. Mulrecon Color enables volumetric medical and full color cryosectional datasets to be explored without requiring installation, and can therefore be used on a broad range of desktop, mobile, and even virtual reality devices. The web-based application has an interface that resembles a DICOM viewer used in radiological practice, and can be used both in anatomical labs and off campus for self-study. The Mulrecon Color application is released as an open source tool. It can be retrieved at a project website where sample datasets are also available.

Peeled images and sectioned images from real-color volume models of foot.

PURPOSE: In all educational materials, the foot cannot be peeled from skin to the bone at constant intervals, like as real dissection. The aim of this study was to produce the peeled images which the foot structures can be peeled gradually along a skin-curved surface in real color, like a real dissection. In addition, the sectioned images of typical and atypical planes are presented in real color and high resolution. METHODS: From the sectioned images of real color, foot volume models were made using Photoshop, Matlab, and MRIcroGL. Peeled images and sectioned images of the typical planes were produced from the volume models. All images were placed into the browsing software. An atypical plane could be shown in a real-time using the volume models of the foot. RESULTS: Using the peeled images, in which the foot can be rotated at 5-degree intervals and stripped gradually at 0-30 mm depth, the foot anatomy could be learned precisely and efficiently. The sectional anatomy of the foot for radiology and orthopedic surgery could also be learned easily using the sectioned images of typical (horizontal, coronal, and sagittal) and atypical planes. CONCLUSION: The most significant merit of the volume models is that all outcomes can be displayed with proper colors of the body structures on any plane. By virtue of these merits, the volume models are useful for learning medical education, research, and clinical practice.

2D browsing software and 3D PDF of canine ear based on real color sectioned images / Software de navegación 2D y PDF en 3D del oído canino basado en imágenes seccionadas en color real

Dog ear is very important because of disease vulnerability. Therefore, gross anatomy and sectional anatomy on CT and MRI of the dog ear should be mastered by veterinarian. The purpose of this research was to present the digital atlases which high quality sectioned images and 3D models of detailed structures of dog ear could be displayed freely. In the sectioned images of a female beagle, ear structures were reconstructed by surface modeling to make 3D models. The sectioned images and 3D models were put into the browsing software and PDF file, respectively. Using the browsing software and the PDF file, gross and radiological anatomy of dog ear could be learned easily and accurately. The auditory tube of a dog was placed anterior to the tympanic cavity unlike human. The tensor tympani muscle of a dog was connected to the dorsal wall of the tympanic cavity with the malleus. No remarkable difference in the auditory ossicles, semicircular ducts, facial nerve, and endolymphatic duct was observed between dogs and humans. The software and the PDF file will be provided to other researchers freely to help contribute to veterinary research and education.

La oreja del perro es importante debido a la vulnerabilidad de enfermedad. Por lo tanto, el veterinario debe conocer plenamente la anatomía macroscópica y la anatomía seccional en la TC y la RM del oído del perro. El objetivo de esta investigación fue presentar los atlas digitales que podían mostrar imágenes seccionadas de alta calidad y modelos 3D de estructuras detalladas de orejas de perro. En las imágenes seccionadas de una hembra Beagle, las estructuras de las orejas se reconstruyeron mediante modelado de superficie con el objetivo de crear modelos 3D. Las imágenes seccionadas y los modelos 3D se colocaron en un software de navegación y un archivo PDF. El uso de software de navegación y el archivo PDF permiten un aprendizaje fácil y preciso de la anatomía macroscópica y radiológica de la oreja de perro. El músculo tensor del tímpano de un perro estaba conectado a la pared dorsal de la cavidad timpánica con el martillo. No se observaron diferencias notables en los huesecillos auditivos, los conductos semicirculares, el nervio facial y el conducto endolinfático entre perros y humanos. El software y el archivo PDF estarán disponibles libremente para los investigadores para ayudar en la investigación y educación veterinaria.

Applied anatomy and three-dimensional visualization of the tendon-bone junctions of the knee joint posterolateral complex.

BACKGROUND: To conduct an anatomical study of the fibular collateral ligament (FCL), popliteus tendon (PT), biceps femoris tendon (BT) and popliteofibular ligament (PFL) of the knee joint posterolateral complex (PLC) at the femoral and fibular tendon-bone junctions based on the Chinese Visible Human (CVH) and American Visual Human Project (VHP) datasets and to determine their morphology, contact area, center points and mutual distances with the aim of providing assistance for surgical tunneling scheme. METHODS: Ten knee joint datasets were selected for segmentation and three-dimensional digital reconstruction. Histological sections images were used to establish criteria for the segmentation. The PLC tendon-junctions were observed and studied. RESULTS: The FCL and PT had constant attachment to the femur, and the FCL, BT and PFL had constant attachment to the fibula. The tendon-bone junctions of each PLC structure did not have a uniform morphology or the same contact area, but the location of the central point of the tendon-bone junction was similar and regularly attached. All measurements were smaller in the CVH dataset than VHP dataset. At the femoral tendon-bone junction, the average distance between the center points of the FCL and PT was 8.84 ±â€¯1.62 mm (7.73 ±â€¯1.44 mm in the CVH datasets and 9.50 ±â€¯1.38 mm in the VHP datasets). CONCLUSIONS: The authors propose a surgical tunneling scheme for femoral single-tunnel reconstruction in Chinese PLC reconstruction patients. The research data provide a theoretical basis and guidance for clinicians who need to design and select PLC surgical tunneling schemes.

The myodural bridge complex defined as a new functional structure.

PURPOSE: The connective tissue between suboccipital muscles and the cervical spinal dura mater (SDM) is known as the myodural bridge (MDB). However, the adjacent relationship of the different connective tissue fibers that form the MDB remains unclear. This information will be highly useful in exploring the function of the MDB. METHODS: The adjacent relationship of different connective tissue fibers of MDB was demonstrated based upon three-dimensional visualization model, P45 plastinated slices and histological sections of human MDB. RESULTS: We found that the MDB originating from the rectus capitis posterior minor muscle (RCPmi), rectus capitis posterior major muscle (RCPma) and obliquus capitis inferior muscle (OCI) in the suboccipital region coexists. Part of the MDB fibers originate from the ventral aspect of the RCPmi and, together with that from the cranial segment of the RCPma, pass through the posterior atlanto-occipital interspace (PAOiS) and enter into the posterior aspect of the upper cervical SDM. Also, part of the MDB fibers originate from the dorsal aspect of the RCPmi, the ventral aspect of the caudal segment of the RCPma, and the ventral aspect of the medial segment of the OCI, enter the central part of the posterior atlanto-axial interspace (PAAiS) and fuse with the vertebral dura ligament (VDL), which connects with the cervical SDM. CONCLUSIONS: Our findings prove that the MDB exists as a complex structure which we termed the 'myodural bridge complex' (MDBC). In the process of head movement, tensile forces could be transferred possibly and effectively by means of the MDBC. The concept of MDBC will be beneficial in the overall exploration of the function of the MDB.

The Impact of Acoustic Clutter on Large Array Abdominal Imaging.

Abdominal imaging suffers from a particularly difficult acoustic environment-targets are located deep and overlying tissue layers with varying properties generate acoustic clutter. Increasing array size can overcome the penetration and lateral resolution problems in ideal conditions, but how the impact of clutter scales with increasing array extent is unknown and may limit the benefits in vivo. Previous ex vivo experimental work showed the promise of large arrays but was technically limited to a length of 6.4 cm and to only partial sampling of the array elements. We present an extension of those studies using the Fullwave simulation tool to create a 10 cm ×2 cm matrix array with full lateral element sampling. We used a numerical model of the abdomen based on the maps of tissue acoustical properties and found that propagation through the modeled abdominal layers generated on average 25.4 ns of aberration and 0.74 cm of reverberation clutter across the array extent. Growing the full aperture from 2 to 10 cm improved contrast by 8.6 dB and contrast-to-noise ratio by 22.9% in addition to significantly improving target resolution. Alternative array strategies that may be useful for implementation-mismatched aperture sizes or a swept synthetic aperture-also produced improved quality with growing aperture size. These results motivate the development of larger diagnostic imaging arrays for the purpose of high-resolution imaging in challenging environments.

A dual-stream deep convolutional network for reducing metal streak artifacts in CT images.

Machine learning and deep learning are rapidly finding applications in the medical imaging field. In this paper, we address the long-standing problem of metal artifacts in computed tomography (CT) images by training a dual-stream deep convolutional neural network for streak removal. While many metal artifact reduction methods exist, even state-of-the-art algorithms fall short in some clinical applications. Specifically, proton therapy planning requires high image quality with accurate tumor volumes to ensure treatment success. We explore a dual-stream deep network structure with residual learning to correct metal streak artifacts after a first-pass by a state-of-the-art interpolation-based algorithm, NMAR. We provide the network with a mask of the streaks in order to focus attention on those areas. Our experiments compare a mean squared error loss function with a perceptual loss function to emphasize preservation of image features and texture. Both visual and quantitative metrics are used to assess the resulting image quality for metal implant cases. Success may be due to the duality of information processing, with one network stream performing local structure correction, while the other stream provides an attention mechanism to destreak effectively. This study shows that image-domain deep learning can be highly effective for metal artifact reduction (MAR), and highlights the benefits and drawbacks of different loss functions for solving a major CT reconstruction challenge.

True-color face peeled images with botulinum toxin injection sites and anatomic landmarks / Imágenes de color verdadero de rostros sin piel con puntos de inyección de toxina botulínica y puntos de referencia anatómicos

To allow students and surgeons to learn the sites for botulinum toxin injection, new types of educational images are needed because MRI, CT, and sectioned images are inadequate. This article describes browsing software that displays face peeled images that allow layers along the curved surface of the face to be peeled gradually in even depths across the surface. Two volume models of the head were reconstructed from sectioned images and segmented images of Visible Korean, respectively. These volume models were peeled serially at a thickness of 0.2 mm along the curved surface of the facial skin to construct the peeled images and peeled segmented images. All of the peeled images were marked with botulinum toxin injection sites, facial creases and wrinkles, and fat compartments. All peeled images and the text information were entered into browsing software. The browsing software shows 12 botulinum toxin injection sites on all peeled images of the anterior and lateral views. Further, the software shows 23 anatomic landmarks, 13 facial creases and wrinkles, and 7 face fat compartments. When a user points at any structure on the peeled images, the name of the structure appears. Our software featuring the peeled images will be particularly effective for helping medical students to quickly and easily learn the accurate facial anatomy for botulinum toxin injection sites. It will also be useful for explaining plastic surgery procedures to patients and studying the anatomic structure of the human face.

Para permitir que los estudiantes y cirujanos aprendan los sitios para la inyección de toxina botulínica, se necesitan nuevos tipos de imágenes educativas ya que las imágenes de MRI, CT e imágenes seccionadas son inadecuadas. Este artículo describe el software de navegación que muestra imágenes de cara sin piel que permiten que las capas a lo largo de la superficie curva de la cara se despeguen gradualmente en profundidades uniformes a lo largo de la superficie. Se reconstruyeron dos modelos de volumen de la cabeza a partir de imágenes seccionadas e imágenes segmentadas visibles, respectivamente. En estos modelos de volumen se retiró la piel en serie con un grosor de 0,2 mm a lo largo de la superficie curva de la cara para construir las imágenes sin piel y las imágenes segmentadas sin piel. Todas las imágenes sin piel se marcaron con puntos de inyección de toxina botulínica, arrugas y arrugas faciales y compartimientos de grasa. Todas las imágenes despegadas y la información de texto se ingresaron en el software de navegación. El software de navegación muestra 12 sitios de inyección de toxina botulínica en todas las imágenes de las vistas anterior y lateral. Además, el software muestra 23 puntos de referencia anatómicos, 13 pliegues y arrugas faciales y 7 compartimentos de grasa facial. Cuando un usuario selecciona cualquier estructura en las imágenes sin piel, aparece el nombre de la estructura. Nuestro software con las imágenes sin piel será particularmente efectivo para ayudar a los estudiantes de medicina a aprender rápida y fácilmente la anatomía facial precisa para los sitios de inyección de toxina botulínica. También será útil para explicar los procedimientos de cirugía plástica a pacientes y estudiar la estructura anatómica del rostro humano.

A visible human body slice segmentation method framework based on OneCut and adjacent image geometric features.

As a recent research hot issue, obtaining the accurate 3 D organ models of Visible Human Project (VHP) has many significances. Therefore, how to extract the organ regions of interest (ROI) in the large-scale color slice image data set has become an urgent issue to be solved. In this paper, we propose a method framework based on OneCut algorithm and adjacent image geometric features to continuously extract the main organ regions is proposed. This framework mainly contains two parts: firstly, the OneCut algorithm is used to segment the ROI of target organ in the current image; secondly, the foreground image (obtained ROI) is corroded into several seed points and the background image (other region except for ROI) is refined into a skeleton. Then the obtained seed points and skeleton can be transmitted and mapped onto the next image as the input of OneCut algorithm. Thereby, the serialized slice images can be processed continuously without manual delineating. The experimental results show that the extracted VHP organs are satisfactory. This method framework may provide well technic foundation for other related application.

Four learning tools of the Visible Korean contributing to virtual anatomy.

PURPOSE: The sectioned images of a male's whole body were used for making the four learning tools: the first tool to show the sectioned and color-filled images; the second tool to show surface models of individual structures; the third tool to show a volume model that was continuously peeled; the fourth tool to show a volume model that was freely sectioned. This study was intended to propose the possible learning effects of the four tools. METHODS: The fourth tool that was recently developed to facilitate oblique sectioning and rotation of the volume model in real time. RESULTS: The four learning tools had their own characteristics, so that they could be separately used for specific achievements. Further, the combination of the tools based on the same raw data may result in a synergic effect. All the tools can be downloaded from the Visible Korean homepage (anatomy.co.kr) gratis. CONCLUSIONS: With the four learning tools, students may experience virtual dissection simulation regardless of the place, time, or economic status. Such free learning tools and commercial learning tools need to be improved to compensate and compete with each other.

Modelado vectorial tridimensional del corazón y los vasos coronarios a partir de cortes anatómicos del proyecto Korean Visible Human / Visible Human Project: a new computarized virtual dissection table as a learning tool for students and anatomy teachers

La disección virtual es una herramienta educativa sumamente valiosa en anatomía. Es particularmente útil cuando hay escasez de cadáveres o en los casos en que la disección no sea posible por motivos religiosos o éticos. En este trabajo los autores presentan una reconstrucción 3D de un corazón masculino a partir de la información del proyecto Korean Visible Human, realizado en el marco de asociaciones de la cátedra de anatomía digital de la UNESCO creada recientemente en la Universidad Descartes. La segmentación manual de 1640 cortes anatómicos se logró a través del software Winsurf, produciendo un modelo vectorial 3D interactivo del corazón y la anatomía que lo rodea. Se reconstruyeron ochenta y cuatro estructuras, incluyendo el corazón y sus vasos (27 estructuras), tráquea, esófago, pulmones, cayado aórtico, vena cava inferior, riñones, sistema esquelético conformado por 58 estructuras, entre ellas: esternón, cartílagos costales, vértebras torácicas y discos intervertebrales, sacro, coxales y piel. El modelo vectorial 3D obtenido se exportó en formato PDF 3D produciendo una verdadera herramienta de disección virtual a través de la interfaz de Acrobat: las estructuras anatómicas pueden individualizarse y manipularse interactivamente como 84 objetos 3D separados. Además, se pueden agregar "etiquetas" con el nombre de cada elemento anatómico. Esta nueva mesa de disección virtual computarizada es una herramienta simple y poderosa tanto para alumnos como para docentes de anatomía. Además, resulta ser la base para futuras herramientas de simulación que contribuirán al entrenamiento de cirujanos

The virtual dissection is a remarkable learning tool in anatomy. It is particularly useful in the case of lack of cadavers or if anatomical dissection is impossible due to ethical or religious reasons. The authors present here a 3D reconstruction of the female's heart from the Visible Korean human data, made in the frame of the projects of the UNESCO chair of digital anatomy created recently at the Descartes University.The manual segmentation of 1640 anatomical slices was achieved with the Winsurf ® software producing an interactive 3D vectorial model of the heart and surrounding anatomy. Eighty four anatomical structures were reconstructed, including the heart and its vessels (27 structures), trachea, oesophagus, lungs, aortic arch, superior vena cava, azygos system, inferior vena cava, right and left kidneys, skeletal system (58) structures including: sternum, xiphoid process, clavicles, ribs, costal cartilage, thoracic vertebrae, intervertebrales discs, sacrum, hip bones, and femurs) and skin. The obtained 3D vectorial model was exported in 3D PDF format, producing a true virtual dissection tool through the Acrobat's interface: the anatomical structures can be individually and interactively manipulated as 84 separated 3D objects. 3D labels can be added with the name of each anatomical element. This new computerized virtual dissection table is a simple and powerful learning tool for students and anatomy teachers. It is also the basis of future simulation tools for surgeon's training

A 3-Dimensional Anatomical Education Model in Postpartum Perineal Laceration Care: A Pre-Post Intervention Study.

OBJECTIVE: The aim of this study was to investigate the effects of postpartum patients introduction to and interaction with a virtual 3-dimensional (3D) pelvic model on the self-care, knowledge, and anxiety parameters. METHODS: The model was designed from computed tomography data displaying the involvement of the levator ani in a fourth-degree perineal laceration. This 3D model was used to educate postpartum day 1 patients at the bedside. Patient data were collected using a pre and post questionnaire assessing knowledge, anxiety, and confidence in perineal wound self-care. RESULTS: Thirty-six patients were enrolled with a median age of 28.5 years (interquartile range, 31, 21.75 years) and a median parity of 1 (interquartile range, 2, 1). Patient use of the tool significantly decreased patient anxiety regarding perineal lacerations (P < 0.01) and significantly increased patient knowledge on what part of their vagina was lacerated during vaginal delivery (P < 0.01). CONCLUSIONS: Reviewing a 3D model of perineal lacerations with patients on postpartum day 1 is associated with less anxiety and increased knowledge of pelvic floor anatomy. These pilot data represent a preliminary investigation into the relations between 3D model of perineal lacerations and a range of patient outcomes.