It’s the end of the world

Advanced imaging techniques have reached beyond radiology for some time, a fact widely recognized but not embraced by radiological societies, at least not until late last week. That's when the Society for Computer Applications in Radiology (SCAR) became the Society for Imaging Informatics in Medicine (SIIM).

It was an official recognition that our world is changing, a fact underscored by Volume Interactions, a Bracco company, which unveiled at the SIIM meeting its Dextroscope virtual reality system. Put on the stereoscopic glasses, grasp a six-degree-of-freedom controller in your left hand, a stylus in your right, and you're ready to pick a patient's brain - literally. A trigger on the controller allows the user to grasp a volumetric reconstruction of MR and CT data (although any number of other digital data sets can be added). A trigger on the stylus creates an instant craniotomy. Push forward and tissue evaporates in front of a virtual probe. Pull the trigger to latch onto a plane and make the brain appear or disappear in slabs with a push or pull.

"It provides depth perception and an understanding of the relationships of the anatomy, along with a high degree of interactivity," said Joe Balogh, general manager of Volume Interactions.

The current configuration is designed for surgical planning and evaluation, but really, there are no limits to its applications, other than the need for high-quality digital data. These might be of a brain or a spine or a heart, such as the cardiovascular images coming off 64-slice CT scanners.

"Wherever there is value in seeing something in stereoscopic 3D, this could help," Balogh said.

The demo I saw on the floor of the SIIM conference was mesmerizing but nonetheless reminiscent of an experience I'd had maybe a half-dozen years ago at the RSNA meeting. There, I was one of 30 or so participants who viewed a disembodied brain floating in virtual space. The difference is that Dextroscope has been productized. It is available to anyone with $200,000 to spare. And the engine behind it is a far cry from the souped-up Silicon Graphics computer that drove my previous exposure to virtual reality.

Balogh spoke of the "supercomputer" behind Dextroscope as he reached under the tabletop on the SIIM exhibit floor and pulled back a 6-inch-wide door to reveal a desktop HP computer.

"The processing has gotten a lot faster with just standard hardware and video and graphics cards," he said.

There it was, the little engine that could, one of tens or hundreds of thousands - maybe millions - that are changing the world from the way we do things now to how things will be done in the future. It is the latest proof, and certainly not the last, that computing power continues to advance, expanding the reach of medical imaging and forcing an end of the world as we know it.