For the Operating Room, a Whole New View

New technology combines 3-D and 2-D medical imagery to give surgeons the upper hand.

Think of it as X-ray vision for surgeons.

A new tool that merges different types of medical imagery, including video, would offer surgeons a new view in the operating room: one that’s layered, customizable and runs in real time.

It’s an anatomical mosaic that previously had to be pieced together in the surgeon’s mind, said James Hahn, a professor in the Department of Computer Science. Dr. Hahn led a team of GW researchers in developing the technology, outlined in a recent article published online in the Journal of Digital Imaging.

Various types of diagnostic imagery—like computed tomography (CT scans) and magnetic resonance imaging (MRI)—are used to best view different parts of the body, like soft tissue and bone. Typically they are captured before a procedure and studied separately, then also alongside images taken during surgery. Those might include live videos from an endoscope or laparoscope, which use a tiny light and camera to peer inside body cavities.

“So if you see something on the video you can’t really relate what you’re looking at to a particular location on the CT or MRI. You have to do it manually,” said Dr. Hahn.

The new tool, though, fuses the different imagery so they can be viewed together as one. Three-dimensional images like CTs and MRIs, which provide a sense of volume, are “wall-papered” in real time with the color and textural attributes provided by 2-D video.

The study, funded by the National Institutes of Health, focused specifically on building a digital tool for laryngoplasty—surgery to repair a defect in the larynx, the part of the throat containing the vocal cords. Last year two co-authors of the study, as PhD students, won the top prize at the annual School of Engineering and Applied Science R&D Showcase.

The advantages of three types of images each are isolated inside a single view: CT for seeing bone structures, MRI for soft tissues and positron emission tomography (PET scan) for the functionality of organs and tissues. (Image by Can Kirmizibayrak)

The technology also allows data to be filtered within different parts of the combined image, removing layers—like skin or an organ—to reveal areas hidden beneath. “It allows the surgeon to look at the patient and get more, as they say in the military business, situational awareness,” said Dr. Hahn, who is director of both GW’s Institute for Computer Graphics and Institute for Biomedical Engineering.

Filtered regions also can be moved in real time; for instance, a filter exposing the blood vessels beneath the skin can start at a patient’s cheek and be moved up the face, revealing the changing structure.

Manipulation and customization of the images, the researchers said, could be done with a traditional computer mouse, though anything touched in a surgical environment carries sterilization concerns. Dr. Hahn said he sees the most promise in using a depth-sensitive motion sensor, like Microsoft’s Kinect technology, that would allow the tool to be controlled by hand gestures.

Small studies conducted by his team so far have yielded “very good results” with the Kinect, he said. “There are pros and cons, obviously, but the results of the user studies indicate that it is actually quite accurate and quite reliable.”

Despite the potential Dr. Hahn sees for the new visualization technology developed by his lab, he suspects it—and others like it—won’t make their way into operating rooms in the very near future, and his team is beginning to study why that is.

Most visualization tools used in medicine are “quite primitive,” he said, with three-dimensional CT scans often being viewed in two-dimensions. “So we’re going to do some user studies to see: What are the factors that make effective medical visualizations? And what can we do to incorporate more sophisticated 3-D visualizations in the medical domain?”

Dr. Hahn also expects the new Science and Engineering Hall will be a boon to his research, particularly due to added space for his Motion Capture and Analysis Laboratory and plans to bring under one roof a mix of departments currently spread across a dozen buildings.

“We are very much into interdisciplinary collaboration,” he said. “I am looking forward to being located in the same building with other people working on similar problems so that we can collaborate much more effectively.”

Student Innovations On Display at SEAS R&D Showcase

Six graduate and two undergraduate students captured prizes worth a total of $14,000 for their research last week at the School of Engineering and Applied Science’s annual Research and Development Showcase.

The $5,000 grand prize winners were Anastasia Wengrowski and Rafael Jaimes, for their research on the metabolic demands of fast heart rhythms. Ms. Wengrowski and Mr. Jaimes are both Ph.D. students in the Department of Electrical and Computer Engineering. Their faculty adviser is Matthew Kay.

Second prize, worth $4,000, went to Ritu Bajpai, a D.Sc. student in the Department of Electrical and Computer Engineering who worked with adviser Mona Zaghlou on a project on UV-assisted alcohol sensors.

Third prize, worth $3,000, went to Ph.D. students Paul Moubarak and Zhou Ma, and junior Eric Alvarez, from the Department of Mechanical and Aerospace Engineering, who worked with adviser Pinhas Ben-Tzvi on designing their reversible docking interface for modular robotics.

The award for best undergraduate project, worth $2,000, went to two juniors from the Columbian College of Arts and Sciences—Nathaniel Diskint and Caitlin Keating—for their research on syringe flow regulation. Mr. Diskint is a biological anthropology student, and Ms. Keating is a psychology student. Their adviser is Michael Plesniak, a professor in the mechanical and aerospace engineering department.

Mr. Diskint and Ms. Keating are hoping to develop their research into a marketable product, and also are competing in the second round of GW’s $50,000 Business Plan Competition.

(Continue reading the full article in GW Today.)

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