Tag Archives: advanced imaging and modeling

Closing in on Anatomic Replication

Written on January 5, 2017 at 8:00 am, by

The purpose of medical imaging from the very beginning was to figure out ways to look inside the body and learn what’s going on structurally and physiologically. To that end, physicians used x-rays or performed exploratory surgeries for decades to identify disease or injury. Then came the ultrasound in the 1960s that gave clinicians real-time images of internal body structures using sound waves. Imaging techniques progressed even further in the 1970s with the advent of CT scans and MRI, which are both commonly used today.

Dr. Matthew Bramlet discusses importance of anatomic replication at AHA Heart Innovation Forum. It’s my belief that 3D modeling will be the next critical tool used by physicians to not only diagnose, but improve surgical planning, patient outcomes and the education of future clinicians. It has the power to essentially produce exact replications of soft tissue structures, improving understanding among doctors and patients alike. But first, it will take collaboration across the U.S. to make this a reality.

I recently spoke at the American Heart Association-Midwest Affiliate’s Heart Innovation Forum to advocate for imaging techniques that lead to anatomic replication. The Advanced Imaging and Modeling (AIM) team at Jump Simulation has come up with a semi-automated process to convert CT and MRI scans into 3D digital images that can be printed or integrated into virtual environments like augmented and virtual realities (AR and VR). What we’ve learned is that these nearly perfect 3D surrogates of anatomy can’t happen without working to create quality images from the start.

Garbage In, Garbage Out

The old adage “garbage in, garbage out” applies directly to 3D modeling. The standard across the nation for the last ten years has been to quickly produce images that might not have the best quality but lead to diagnosis in an efficient and productive manner. The ability to print or view these images in three-dimensions, though, requires a little more time and effort but leads to discoveries we’ve never seen before.

There is a quality standard that must be met each step along the continuum of 3D modeling translation. If the image is poor – fail. If the segmentation is poor – fail. If the print is poor – fail. If the VR translation is poor – fail. The focus of our cardiovascular imaging efforts at OSF HealthCare is to generate the highest quality images we can attain.

Most recently, we sent a quality focused 3D heart digital file to the incredible engineers at Caterpillar’s additive manufacturing lab. They have a printer that allows us to produce a heart in a soft enough material that can be cut with a scalpel, allowing surgeons to effectively practice on a patient’s heart before surgery. The result was incredible. Not only were we able to practice the surgery before the operation, but we were able to see anatomic detail like never before seen, prompting an entirely new set of possibilities where 3D printing could potentially improve patient care.

Making a Case for High-Quality Imaging Standards

There are many physicians around the U.S who understand the impact 3D modeling can have on surgical planning, patient outcomes and the education of future clinicians. In fact, a group of us are working with the National Institutes of Health and the American Heart Association to create accuracy and quality standards for the Jump Simulation-curated 3D Heart Library, an open-source digital repository of hearts with congenital defects on the NIH 3D Print Exchange. However, I recognize there are still some skeptics out there who don’t understand the value of this technology.

My experience with these models has been that they give surgeons a point of reference they haven’t had before, giving them the ability to make informed decisions before operating on patients. They make viewing anatomical images intuitive across all medical specialties. 3D models give patients and their families a better understanding of procedures they may have to undergo. They also allow educators to easily explain different types of congenital heart disease and what they look like to physicians looking to master the skill of diagnosis or surgery.

Physicians are busy and it’s difficult to put the time and effort into higher quality imaging. However, doing so leads to exact anatomic replications and, in my opinion, is the next big jump in medical imaging surrogacy. It’s going to take clinicians making medical decisions or planning surgery to be impacted by this for the advocacy to come through the clinical community.

Advancing Simulation Beyond Education

Written on December 15, 2016 at 9:10 am, by

Simulation in health care has powerful potential. For years, it’s been utilized to educate and train those seeking a career in medicine. It’s also been leveraged as a way to provide insights into latent health system flaws such as communication issues among clinicians or whether a medical facility has all the essential tools it needs to provide the best care possible.

u-of-i-innovation-space OSF HealthCare, through Jump Simulation and the University of Illinois, is expanding its use of simulation even further by leveraging it to design novel solutions in health care. The idea is to simulate problems discovered throughout the health care system so that engineers and clinicians can observe and brainstorm ways to fix these issues.

Using simulation as a design tool is still fairly new to health care systems around the U.S. But Jump Simulation and U of I have been collaborating on this type of work since the opening of Jump Trading Simulation & Education Center, so much so that there are now dedicated labs for these collaborative efforts in the newly minted space within Jump called OSF Innovation.

Four Labs, One Purpose

All four labs are located on the fourth floor of the Jump facility. Two will be dedicated to the ongoing work Jump Sim has established with the University of Illinois’ Colleges of Medicine and Engineering through Jump Applied Research for Community Health through Engineering and Simulation (ARCHES). The other two rooms are committed to projects in Advanced Imaging and Modeling.

All four assignments pair clinicians and engineers to develop medical education technology that will advance the clinical agenda at OSF. This is part of a larger effort by the University of Illinois re-thinking how it innovates around curriculum.

Two of the projects utilizing innovation lab space were recently awarded a continuation of Jump ARCHES funding. One team of individuals from OSF HealthCare, U of I, Illinois Neurological Institute, and Bradley University is creating a device to teach young health care professionals to practice feeling and identifying abnormal muscle behaviors in patients with brain lesions. The goal is to expand training to more than just neurologists so that OSF can increase the number of patients served.

The second development is focused on producing an avatar-based system to communicate with patients at the time of discharge so they fully understand their medical instructions before going home. The system could also be used to train medical students to communicate with patients in a simulated environment. The
dikshant-pradhan-working-on-orthopedic-trainerultimate goal of the project led by clinicians and engineers from U of I and OSF is to reduce readmission rates at area hospitals.

The two labs devoted to work in Advanced Imaging and Modeling are leveraging virtual and augmented reality technologies like the Oculus Rift and HTC Vive to revolutionize how clinicians and radiologists view anatomy and advance how human anatomy is taught to medical students.

Nurture, Validate and Disseminate

The intention of committing space for collaborative work among clinicians and engineers is to support teams with great ideas and provide technical and clinical expertise to advance their projects. Each of the teams selected to use the lab space within Jump will get to do so for up to a year. From there, these ventures can be validated within the simulation space at Jump and throughout the OSF Healthcare System.

Completed projects could eventually find a home within the University of Illinois’ curriculum and disseminated to its various medical campuses. It’s this ongoing collaboration between OSF and U of I that makes Jump Simulation a one-of-a-kind facility.

The Importance of 3D Modeling in Healthcare

Written on January 14, 2016 at 7:25 am, by

3D heart modelIt was more than two years ago when I got wind of Jump purchasing a 3D printer. As a pediatric cardiologist, all I could think of is how this tool could revolutionize imaging of the tiniest of hearts and change the course of a patient’s life.

Jump ran with this idea of converting 2-dimensional images of the heart into exact 3D printed replicas that surgeons could hold in their hands and utilize for surgical planning. These models have improved the surgical outcomes for many patients, and led to the creation of the National Institutes of Health 3D Heart Library.

Our imaging and modeling methods have grown significantly since the first heart was printed. We now have a team of engineers at Jump and University of Illinois working to advance the diagnostic effectiveness of imaging tests around the world.

AIMing for a Better View

The Advanced Imaging and Modeling (AIM) program at Jump is improving the exact replication process of anatomical structures using emerging 3D technologies.

There’s a solid foundation at Jump to print pediatric hearts and other hollow organs using a refined manual process. But how do you effortlessly look inside the solid structures of the brain, liver, or even the pathology of tumors? Solving this issue could be a major breakthrough in healthcare.

Here’s a great example of the work we’re achieving.

 


This is a 3D model of a patient with lung cancer observed over four points in time. It was created in collaboration with Dr. Beth Ripley from the University of Washington. The yellow represents the cancer within this person’s lung. The thing I didn’t appreciate until this rendering was made is how invasive this cancer is and how it wraps around the organs. The result of this work is improved understanding and an incredible tool for cross-specialty communication.

2D vs 3D

Doctors all over the world are currently working with so-called “surrogates of anatomy” from CT and MRI scans. These images have a 3D data set but are viewed within the scope of 2D—leaving an opening for different types of interpretation.

Radiologists spend their whole careers looking at complex 2D images with the goal of conveying that information to clinicians who don’t have the same background. In many cases, specialists making medical decisions have to walk through these images several times to fully understand them.

This is where new 3D technologies such as augmented and virtual realities and holographic displays come into play. 3D modeling can make viewing anatomical images intuitive across all clinical specialties leading to better diagnoses, surgical planning, education, and outcomes. The simplicity of these models also allows for better communication with families.

The overall goal of AIM is to create a future state where clinicians can interact with human anatomy and pathology in a way they’ve never been able to do before. There’s so much untapped potential for improved understanding with 3D modeling. I look forward to a new reality where 3D analysis of medical images outweighs 2D—changing healthcare outcomes for the better.