Colonoscopy tutorial software made with a cadaver's sectioned images.

Novice doctors may watch tutorial videos in training for actual or computed tomographic (CT) colonoscopy. The conventional learning videos can be complemented by virtual colonoscopy software made with a cadaver's sectioned images (SIs). The objective of this study was to assist colonoscopy trainees with the new interactive software. Submucosal segmentation on the SIs was carried out through the whole length of the large intestine. With the SIs and segmented images, a three dimensional model was reconstructed. Six-hundred seventy-one proximal colonoscopic views (conventional views) and corresponding distal colonoscopic views (simulating the retroflexion of a colonoscope) were produced. Not only navigation views showing the current location of the colonoscope tip and its course, but also, supplementary description views were elaborated. The four corresponding views were put into convenient browsing software to be downloaded free from the homepage (anatomy.co.kr). The SI colonoscopy software with the realistic images and supportive tools was available to anybody. Users could readily notice the position and direction of the virtual colonoscope tip and recognize meaningful structures in colonoscopic views. The software is expected to be an auxiliary learning tool to improve technique and related knowledge in actual and CT colonoscopies. Hopefully, the software will be updated using raw images from the Visible Korean project.

Virtual Endoscopic and Laparoscopic Exploration of Stomach Wall Based on a Cadaver's Sectioned Images.

We intended to determine that virtual endoscopy and laparoscopy of the stomach based on serially sectioned cadaver images is beneficial. Therefore, the outlines between the gastric wall and lumen were traced using the new female data of the Visible Korean to build a volume model. While the outlines were expanded at appropriate thicknesses, the stomach was observed endoscopically and laparoscopically in comparison with a chosen sectioned image. Four layers (mucosa, submucosa, muscular layer, and serosa) of the stomach were discernible by their proper colors in the sectioned images. All layers except the submucosa were identified in the endoscopic and laparoscopic views by using consistent colors. The stepwise expansion of the outlines revealed thickness of each layer as well as whether the thickness was uniform. Our ideas and the Visible Korean images could be a robust resource of virtual reality learning for medical students and clinicians.

Hip joint ligaments, a cadaver imaging study for education / Ligamentos de cadera, un estudio cadavérico imagenológico para educación

The stereoscopic morphology of the iliofemoral, pubofemoral, and ischiofemoral ligaments in hip joint is hard to understand, either in anatomy books or from cadaver dissection. To aid in understanding, three-dimensional models were built from the sectioned images of cadaver hip, which demonstrate fine components better than CTs and MRIs. In the female data of Visible Korean project, the ligaments and neighboring structures were recognized and outlined in detail. Successively, the outlines were stacked and reconstructed to manufacture their surface models by using the sophisticated computer method. The surface models were overlapped with the original sectioned images, which enhanced comprehension of the hip joint anatomy. With the surface models, hip joint was hyperextended to suggest the function of the ligaments. The graphic data of the surface reconstructed hip ligaments are expected to be the source of interactive simulators for anatomy and surgery of the hip joint.

La morfología estereoscópica de los ligamentos iliofemoral, pubofemoral e isquiofemoral de la articulación de la cadera es difícil de entender, ya sea a partir de lo hallado en los libros de anatomía como en la disección de cadáveres. Para ayudar en su comprensión, se construyeron modelos tridimensionales a partir de imágenes de secciones cadavéricas de la cadera, que demuestran de mejor manera los componentes finos, en comparación a las imágenes de tomografía axial computada y resonancia magnética nuclear. En los datos obtenidos del "Visible Korean Project", correspondientes a mujeres, los ligamentos de la articulación y sus estructuras vecinas fueron reconocidos y descritos en detalle. Sucesivamente, se identificaron los contornos y se reconstruyeron para la fabricación de modelos de superficie, mediante el uso de un sofisticado método informático. Los modelos de superficie se asociaron con las imágenes de sección originales, que aumentaron la comprensión de la anatomía de la articulación de la cadera. En los modelos de superficie se provocó la hipertensión de la articulación de la cadera para permitir evidenciar la función de los ligamentos. Se espera que los datos gráficos obtenidos de los modelos de superficie de los ligamentos de la cadera sirvan como fuente para el desarrollo de simuladores interactivos que permitan el estudio de la anatomía y la cirugía de la articulación de la cadera.

Portable document format file showing the surface models of cadaver whole body.

In the Visible Korean project, 642 three-dimensional (3D) surface models have been built from the sectioned images of a male cadaver. It was recently discovered that popular PDF file enables users to approach the numerous surface models conveniently on Adobe Reader. Purpose of this study was to present a PDF file including systematized surface models of human body as the beneficial contents. To achieve the purpose, fitting software packages were employed in accordance with the procedures. Two-dimensional (2D) surface models including the original sectioned images were embedded into the 3D surface models. The surface models were categorized into systems and then groups. The adjusted surface models were inserted to a PDF file, where relevant multimedia data were added. The finalized PDF file containing comprehensive data of a whole body could be explored in varying manners. The PDF file, downloadable freely from the homepage (http://anatomy.co.kr), is expected to be used as a satisfactory self-learning tool of anatomy. Raw data of the surface models can be extracted from the PDF file and employed for various simulations for clinical practice. The technique to organize the surface models will be applied to manufacture of other PDF files containing various multimedia contents.

Accessible and informative sectioned images and surface models of a cadaver head.

The sectioned images and surface models of a cadaver head in the Visible Korean Project would be more beneficial if they were accessible and informative. To this aim, 3 policies were established: (1) the data are promptly obtainable and observable; (2) the graphic data are accompanied by explaining the anatomic terms; and (3) two-dimensional images and three-dimensional models are shown together. According to the policies, the following were attempted. Two hundred thirty-five couples of sectioned images and outlined images (intervals, 1 mm) of the head were prepared. Browsing software was developed where the 2 corresponding images were displayed simultaneously. In addition, the structures in the images were recognized with the aid of automatic labeling. From the outlined images, surface models of 178 head structures were constructed. The two-dimensional surface models including the sectioned images were embedded into the three-dimensional surface models. All the models were categorized into systems and arranged to be inputted to a PDF (portable document format) file. The finalized PDF file containing comprehensive head data could be explored on Adobe Reader. If the user clicked on the surface models, their anatomic names were highlighted. The sectioned images, outlined images, and surface models in the browsing software and PDF file can be downloaded from the homepage (anatomy.co.kr) free of charge. The state-of-the-art graphic information will hopefully assist medical students in learning head anatomy. In addition, the raw data are expected to contribute to the various clinical practice simulations.

Three-dimensional surface models of detailed lumbosacral structures reconstructed from the Visible Korean.

Unlike volume models, surface models representing hollow, three-dimensional images have a small file size; allowing them to be displayed, rotated, and modified in real time. Therefore, surface models of lumbosacral structures can be effectively used for interactive simulation of, e.g., virtual lumbar puncture, virtual surgery of herniated lumbar discs, and virtual epidural anesthesia. In this paper, we present surface models of extensive lumbosacral structures which can be used in medical simulation systems. One-hundred and thirty-eight chosen structures included the spinal cord, lumbar and sacral nerves, vertebrae, intervertebral discs, ligaments, muscles, arteries, and skin. The structures were outlined in the sectioned images from the Visible Korean. From these outlined images, serial outlines of each structure were stacked. Adopting commercial software (3D-DOCTOR, Maya), an advanced surface reconstruction technique was applied to create a surface model of the structure. In the surface models, we observed the anatomical relationships of the lumbosacral structures (e.g., cauda equina and ligaments) in detail. Additionally, the portions of some spinal nerves that could not be outlined were drawn and added to the surface models. These constructed models will hopefully facilitate development of high quality medical simulation of the lumbosacral region.

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.

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.

Visible Korean Human: another trial for making serially-sectioned images.

In this ongoing study, we are trying to make Visible Korean Human (Mar 2000--Feb 2005). The complete MRIs and CTs of the Korean cadaver's entire body are scanned. The cadaver is serially-sectioned at 0.2 mm thickness without any missing images. The anatomical structures in the sectioned images are segmented. The Visible Korean Human is expected to be more helpful than Visible Human in the following ways. First, the Korean data will be more helpful in diagnosing and treating the patients belonging to the yellow race. Second, MRIs and CTs of the entire body at 1 mm thickness will be more helpful in studying the MRIs and CTs. Third, sectioned images without any missing images will be more helpful in making the complete 3D images. Fifth, small pixel size (0.2 mm x 0.2 mm) and thin thickness (0.2 mm) of sectioned images will be more helpful in showing the small anatomical structures greater than 0.2 mm. Sixth, the additional segmented images will be more helpful in making the 3D image and virtual dissection software. The Visible Korean Human will be the basis for making better 3D image and virtual dissection software which will be more helpful in medical education.