Communications of the ACM
Technology Offers Virtual Visualization of the Human Body
"Plato's Cave" provides 3-D visualizations that allow physicians to maneuver around organs without making an incision.
Credit: Methodist Hospital, Houston
From a command center resembling the bridge of the Starship Enterprise, doctors at The Methodist Hospital have developed 3-D technology that enables them to view the human body like never before. With a video game controller, physicians visualize or "travel" under the skin, swooping past bones and surfing the bloodstream to the exact location requiring surgery or closer examination. Viewing a holographic image of the body through special glasses, physicians can then create more precise treatment plans for patients undergoing radiation therapy and surgery.
"This technology enables us to combine data from CT, MRI and PET scans and channel them into a single computer to generate one clear, comprehensive image," said Dr. E. Brian Butler, Chairman of Radiation Oncology at The Methodist Hospital in Houston and creator of "Plato's Cave." "The 3-D images allow us to view inside the patient, something we've been unable to do outside of surgery — until now."
In Plato's "Allegory of the Cave," prisoners saw shadows on a cave wall as reality and blindly accepted it as fact. One day, a prisoner escaped and actually saw the outside world; thus, his experience gave him a more expansive view of reality. Butler calls his venture "Plato's Cave" based on Plato's "Allegory of the Cave," a dialogue on knowledge and reality. Butler says his "Plato's Cave" is a new visual approach to medicine that opens up a whole new world for physicians and patients.
Currently, radiation oncologists have limited views of individual slices of the body. However, with this technology, physicians can see inside a patient's body. By using "Plato's Cave," these physicians can maneuver around organs in all directions, allowing them to see more clearly how radiation is deposited around tumors, adjacent organs, arteries, veins, and lymphatics.
"Previously, when we were planning a patient's treatment, the data might have indicated that a higher than desired dose of radiation would be delivered to a particular organ such as the spinal cord; yet, we were unable to visualize the precise location of that dose or divert it," Butler said. "Now, I am able to actually see the distribution and have the option to maneuver the excess dose away from the area and deposit it elsewhere."
Surgeons can also use this technology to their advantage. It will give them the ability to visualize, before the patient arrives in the operating room, potential anatomical obstacles that could complicate performing a procedure.
"For instance, if a surgeon is performing a liver resection, we can simulate removing part of the patient's liver, and with the push of a button determine how much of the remaining liver will be viable after the operation," Butler said. "If it's 20 percent or greater, the procedure can be performed; if less, it cannot. This will take surgical planning to a whole new level."
Butler says "Plato's Cave" will be used to conduct studies to determine optimal placement of the patient on the operating room table. This technology will enable surgeons to plan a procedure by performing a surgical simulation the day before. In the near future, surgeons will be able to take this technology into the operating room. Surgeons will have the ability to go directly to the area they mapped out the day before and perform the surgery with greater precision.
"With this new dual reality technology, Methodist is continuing in the pioneering footsteps of Dr. Michael E. DeBakey, who set the standard for heart surgery more than 50 years ago," Butler said.
This technology, developed in part by Paul E. Sovelius, Jr., a scientific computing and visualization specialist, was produced with partners BodyViz from Visual Medical Solutions, LLC; TeraRecon, Inc.; Mechdyne Corporation; Circle Twelve Inc; Fovia Inc.; Computational Engineering International, Inc.; and NEC Corporation of America.
Access videos of Plato's Cave at www.methodisthealth.com/mediavideos.
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