Erasmus University Medical Centre develops interactive immersive 3-D
images
25 April 2006
Rotterdam, Netherlands & Mountain View California. Erasmus University
Medical Centre (Erasmus MC) in Rotterdam has developed 3D volume rendering
software, capable of converting 2D medical images to 3D. The software runs
in an immersive, interactive environment called I-space, developed at the
Center. It presents clinicians with new ways to investigate datasets from
all kinds of 3D imagery, including MRI and CT scans.
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A doctor examines
the MRI of a newborn with a malformation of development of the
cerebral cortex and cerebellum in the I-space environment powered by
SGI systems.
Image Courtesy of Erasmus Medical Center and Crosslinks |
For the commercial launch of the I-space model, the medical centre
selected Barco projectors and Silicon Graphics Prism visualization systems
as image generators to create the four-sided, 3x3x3 metre 3D world intended
for multidisciplinary collaboration.
Because the prototype model at Erasmus MC surpassed even the highest
expectations of researchers and clinicians, the medical centre spun off a
Rotterdam-based company, Crosslinks, which is now beginning to market
I-space to hospitals and medical centres throughout Europe in collaboration
with SGI and Barco.
The original I-space at Erasmus MC was developed in close cooperation
with medical staff that use the technology regularly for complex diagnoses.
While I-space, in theory, could be used for various virtual reality
applications the proprietary software is specifically targeted to the
medical and biology fields.
"We chose the Silicon Graphics system for I-space because we needed
hardware that was both suitable for high-performance computing and also
delivered superb graphical capabilities," said Ronald Nanninga, founder and
managing director of Crosslinks. "There are eight graphics pipes in the
system — you are actually standing inside the data — so we required a
visualization computer that is powerful enough to really do the rendering of
the 3D software in a very efficient way, and only SGI had the appropriate
solution. When we began working on the development of I-space, we used an
older SGI system, but with this brand new Prism, our performance really
improved. Frame rate has gone up from 4 to 15, and that tells you something
about how easy it is to move around large data sets, turn them around, and
zoom in and zoom out. It's easier to make a diagnosis together with other
medical personnel when the surgical reality is right in front of you, rather
than seeing it alone, just on a small computer screen."
A Silicon Graphics Prism visualization system with 8 Intel Itanium 2
processors, 8 ATI FireGL graphics processors and 12GB of memory is used to
drive I-space. I-space enables researchers to explore vast amounts of
genomics and proteomics data in an infinite 3D world. It also presents
clinicians with new ways to investigate datasets from all kinds of 3D
imaging modalities, including MRI and CT scans. I-space uses 8 Barco
projectors for the four walls: the floor, and the left, right and front. A
3D mouse uses four tracking devices — one in each corner, enabling the
system to recognize the relative position of the mouse — and a virtual
stick, which allows the user to touch an object, push it on one side, zoom
in/zoom out, and even slice the object. Stereoscopic glasses complete the
immersive 3D experience. I-space was specifically created to allow doctors
and researchers to discuss — among different disciplines — the data they are
all seeing in the immersive visualization.
"We built I-space ourselves in collaboration with the folks from SGI and
Barco," said Prof. Dr. Peter van der Spek, a geneticist by training who is
also an engineer. "Barco has the projectors, but the Silicon Graphics Prism
has all the graphics pipes that superbly work together with Barco. It's
cutting-edge technology and the power of Intel inside the Prism system is
also very important for us, so we are very, very happy with the technology
that drives I-space."
I-space at Erasmus Medical Center
At Erasmus MC, I-space is used for two reasons: research and clinical
diagnostics. The clinical application deals with medical visualization in 3D
of different modalities such as MRI scans, CT scans, and ultrasound images.
Doctors can walk through an MRI scan of a patient while discussing it with
their colleagues. Multidisciplinary discussions are routine. For instance,
for a patient with a brain tumour, the neurologist, with the neurosurgeon,
are together in I-space and can decide what the best strategy is to remove
the tumour from the brain. Or, for a person with a lung tumour, the thorax
surgeon is there with the lung specialist, and they look to see where the
tumour is positioned. Is it an area accessible to the thorax surgeon, and
how can he most optimally approach the tumour? Are there large blood vessels
going through the tumour? Is the tumor close to the heart? All of this has
to be taken into account when removing a tumour.
Additional clinical applications
- Gynecology and Obstetrics. Children can be monitored during fetal
development. En utero, Erasmus takes ultrasound images and projects them
in 3D in I-space, where the complete fetus can be examined from all
possible angles. Doctors monitor the shape of the face -- Is there a
cleft in the face? A cleft in the lip? -- and can actually count to make
sure there are five fingers on each hand and five toes developing on
each foot.
- Cardiac Infarction. If heart contractions are not occurring
optimally due to temporary lack of oxygen — cardiac infarction — doctors
can examine live, beating hearts within I-space to see which part of the
heart is actually paralyzed due to what's known in medical shorthand as
"infarc."
- Training doctors in 3D. To see where the particular organs are
positioned in the body, in 3D, is an educational application of the
I-space.
"We use the I-space for very different reasons," said Prof. Prof. Dr. van
der Spek. "We render the images, scan the images, into the I-space with the
Silicon Graphics computer. We stack the images on top of each other and then
we project them. We can do all kinds of very sharp visualizations, which in
turn allow us to do very precise measurements on the MRI scans, on CT scans
or on ultrasound images. We can zoom in really close, within the scan, to
make it larger, to make it more obvious where to look for the clinician.
This is a very multidisciplinary effort where we open up the IT box for the
doctor and his colleagues, because we store the patients' images for the
doctors and process and serve them. The very strong graphics capacity of the
SGI equipment, including its software and the OpenGL graphics libraries,
allows us to visualize, really, life in 3D."
Translational Medicine
The research application of I-space with the Silicon Graphics system
deals with genomics data mining and proteomics data mining for translational
medicine. At Erasmus MC, a 32-processor SGI Origin 3800 server runs an
Oracle database with clinical and molecular data. The configuration allows
the researchers to actually link and integrate the data as well as visualize
it in a very efficient manner. Based on the now-occurring convergence of
molecular imaging and genomics, translational medicine couples knowledge
from patients' data with other patients, in a vast database, aimed at
personalized treatment of diseases. The two different fields of molecular
imaging and genomics require the imaging of the patient scan with the
molecular aspects, coupled with the use of genomic strategies, to come up
with to novel biomarkers.
Biomarkers recognize, in a very specific way, the type of tumour.
Researchers around the world are dedicated to finding biomarkers that are
unique for certain types of cancers. For example, if a patient has a Type A
biomarker for a tumour, doctors prescribe certain medication and a specific
treatment. But if the tumour is a Type B biomarker, a completely different
intervention procedure would be prescribed.
The benefits are tremendous, as revealed in a medical paper published by
Erasmus MC in December 2005 describing the genomics application of studies
of a certain type of slow-growing brain tumours (oligodendroglioma). By
using a genomic strategy, Prof. Dr. van der Spek reports that doctors can
decide up-front whether a patient will be chemo-sensitive or
chemo-resistant.
"Chemotherapy is an absolutely awful treatment and if, in advance, you
can decide whether your patient will or will not respond to the treatment,
that's very important information to help you make the decision of whether
you are going to prescribe chemotherapy or whether you are immediately going
to push the patient towards the operating theatre," said Prof. Dr. van der
Spek. "So we use the genomic strategy in combination with the medical
imaging in the I-space run by the SGI computer in this new paradigm of
translational medicine."
"SGI technology has long been a leader in biomedical research and drug
discovery. The introduction of I-space brings SGI and partners Barco and
Crosslinks to the forefront of both medical research and clinical
applications, opening up the amazing possibilities of multidisciplinary
collaboration of doctors and surgeons for the specific treatment of
individuals," said Afshad Mistri, market segment manager, Sciences, SGI. "We
are at the dawn of a new era of personalized medicine, made possible by
advances in science and SGI technology."
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