Chicago—Novel software will enable physicians to transform data from standard magnetic resonance imaging (MRI) or computed tomography (CT) into 3-dimensional (3D) images with unprecedented variety and resolution, according to researchers from the University of Southern California's Keck School of Medicine, in Los Angeles. The investigators presented their experiences with this new technology as part of clinical research protocols in pediatric urology as well as their suggestions for other potential medical and surgical applications at this year's Clinical Congress of the American College of Surgeons (ACS).
The software program, called Volumap, which is being tested at 2 southern California hospitals, uses a computer analysis technique called automated volume acquisition to create 3D images. The software is helpful for identifying and treating urological abnormalities in children, such as hydronephrosis, ectopic ureters, ureteroceles, obstructive uropathies, and developmental aberrations of the kidneys, said Roger De Filippo, MD, assistant professor of urology at the Keck School of Medicine and an attending surgeon at Children's Hospital Los Angeles, who has been studying its use.
Grahic Jump Location
Novel software that transforms data from standard magnetic resonance imaging into 3-dimensional images can be used to isolate internal structures, such as the cerebral ventricles (left). The same dataset can be manipulated to make the cerebral arteries increasingly prominent (middle and right).
“Current imaging techniques are at the root of most diagnostic shortfalls,” said De Filippo. For example, conventional MRIs of the pelvic area are often confusing because many structures overlap and because limitations of the technology often mean the orientation of the images is far from optimal. However, the new imaging software, “has accurately depicted the genitourinary tract in every child from top to bottom,” he said.
An unpublished retrospective study of patients indicate that the 3D-imaging software's ability to improve the resolution of images can promote more accurate di agnosis of urological problems in children, said Paul Kokorowski, MD, a resident in the Department of Urology at the Keck School of Medicine. “Since we are now able to obtain submillimeter slices [0.1 mm to 0.7 mm], we are able to acquire a more accurate diagnosis,” said Kokorowski. This translates to finding “a better way to treat our patients because we could exactly see what was going on,” he added.
The imaging system eliminated the need for such additional tests as ultrasound, nuclear medicine scans, and computerized tomography in diagnosing children with urological abnormalities, the researchers said. It also has the potential to eliminate radiation exposure and sedation of children while they are being imaged because the Volumap software acquires 3D images within a few minutes compared with up to 1 hour for standard MRI sequencing.
The software was developed by Lee Schiel, of Medical Data Management (MDM/Early Response Imaging), a company based in San Bernardino, Calif. Schiel, who previously worked with the National Aeronautics and Space Administration and the California Institute of Technology, has developed similar software that was originally used to probe the interior of moon rocks and to detect dinosaur embryos within fossilized eggs. A more refined software algorithm is now being used in 3D-imaging systems for mobile MRI units servicing southern California. For the last 2 years, Schiel has worked at Children's Hospital Los Angeles in a collaboration with De Filippo that has led to the development of protocols for display of imaging of knees and shoulders in motion, along with diagnostic protocols in neurosurgery, ophthalmology, urology, and fetal medicine.
Schiel's software allows a physician to point, cut, crop, and trim images within infinite orthogonal planes. Instead of having to individually inspect 100 “slices” of 2-dimensional data placed on 12-panel radiology view boxes, physicians can (on their own laptop computers) slice through an acquired 3D image, rotate the axis (see online video here), and make varied sagittal or oblique sections, with the aim of a more precise evaluation of a patient's condition. Apart from its immediate application in diagnostics, proponents say that the software's true potential is providing a tool for such interventions as tumor resection, placement of drug delivery systems, and facilitating robotic surgery.
Researchers are also promoting the use of this technology in medical school education, as part of a virtual reality program to complement first-year cadaver work in the teaching of human anatomy. Another potential educational application is refining aspects of applied clinical anatomy in training surgical residents to deftly complete emergency procedures and to master surgical techniques.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Comments are moderated and will appear on the site at the discretion of the Journal of American Medical Association editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
Video
3D Imaging of Head and Neck Vasculature (00:04)
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.