SPECIAL EDITION
Collboration
Tele-immersion puts imagers at surgeons' side
Radiologists pay virtual visit to the operating room
By Karen Sandrick
Radiologists are trained to stack up 2D slices and formulate a 3D understanding of them. Surgeons, who spend all their time dealing with 3D objects, don't necessarily have the same ability to translate slices of anatomy to the operative field.
Dr. Jonathan Silverstein, director of the Center for Clinical Information at the University of Chicago, has been working with radiologists at UC and the University of Illinois at Chicago to develop a tele-immersion system that can project computer-generated images into a viewer's own world. This capability enables surgeons to superimpose anatomic images onto patients while they're operating.
At the present time, the system automatically generates images in layers of gray scale using DICOM data that surgeons can manipulate to select the visualizations they're interested in.
"Surgeons can get 3D views that show where vessels are in relation to a tumor. They can turn the views into different orientations to truly understand anatomic relationships, to see where a tumor is so they can reach out and get it," Silverstein said.
The goal is to enhance the exchange of information between radiologists and surgeons by allowing them to view the same images in the same orientation at the same time. The tele-immersion system sends clinical images to head-mounted displays that surgeons can see around and past. It will soon be tested in the operating room in a series of test cases to see how well it permits radiologists and surgeons to share the same virtual environment.
In preliminary testing, the tele-immersion system has been used successfully to transmit stereo images, similar to instant messaging, between radiologists who are viewing films in the reading room and distant surgeons.
"Instead of radiologists having to interrupt their work and run up to surgeons to show an image, they can drive a display to surgeons live. The physicians can change orientations, interact, and ask questions, while each is in their own environment," Silverstein said.
While tele-immersion is possible, it is not yet practical. The computers that run the system are too expensive and too big to bring into the OR, Silverstein said. And the display device still doesn't show a large enough area.
As a work-in-progress, however, it's promising. The research team has been able to open a channel that shows radiologists the patient from the surgeon's viewpoint. They have enabled surgeons and radiologists to share the same environment and draw circles or arrows on images to flag important structures and follow the surgical pathway together. Radiologists communicate directly with surgeons all along the way: "The tumor is just over here; you may want to turn this way." "I see where you're going, but it looks to me like you need to move the other way."
"It's the same kind of communication that goes on when the radiologist comes to the OR," says Silverstein. "But radiologists can do it without having to leave where they are."
