Visible Humans and the practice of medicine

BETHESDA, Md. (October 5, 1998 02:08 a.m. EDT http://www.nandotimes.com) --
Doctors in training to use a bronchoscope soon will be able to have 30 or more
of the procedures under their belts before they ever touch a human patient.

A new scanning technique lets surgeons do a "fly-through" of the colon without
requiring patients to endure the discomfort of an invasive scope.

Anatomy students can practice life-like dissections repeatedly with a virtual
scalpel before confronting an actual cadaver.

Brain surgeons embarking on a difficult journey inside the skull to remove a
tumor benefit from maps that give them precise dimensions of the mass, as well
as a blueprint of the surrounding brain tissue and related blood vessels.

These and hundreds of other medical innovations are or soon will be arriving
in the nation's medical schools and operating rooms thanks to the Visible
Humans, an executed Texas murderer and a Maryland housewife who died from a
heart attack, whose bodies are digitally immortal in the data banks of the
National Library of Medicine.

Four years after the three-dimensional images were released on the Internet,
library officials, academics and manufacturers gathered for two days last week
to consider some of the advances made possible by the computerized cadavers,
and what innovations lie ahead.

"For an investment of $1.4 million, we've gotten a remarkable return already,"
said Dr. Donald Lindberg, director of the library. The data sets already have
been licensed to nearly 1,000 scientists and developers in 41 countries.
They're free, other than carrying a requirement that users tell library
officials about the new products that result.

The virtual humans were selected from a group of bodies donated to science to
represent an average man and women, to become standard reference points for
human anatomy and dimensions.

Frozen and imaged in 1 millimeter and .33 mm slices, the electronic cadavers
are preserved in more than 6,800 images, 55 gigabytes of information. Their
body systems and individual organs can be manipulated in the blink of an eye
to morph from skin to muscle to bone, to flex and turn and model everything
from new surgical techniques to artificial body parts.

One product showcased at the conference was Internet Anatomy, an online
product being developed by Engineering Animation Inc. of Ames, Iowa.

"Although Internet Anatomy is meant as a supplement to dissection and not a
replacement, it can be superior to dissection because authentic gross anatomy
can be repeatedly removed, rotated and manipulated," said Carol Jacobson,
senior director of EAI Interactive. "Once you cut into or alter a structure
during a cadaver dissection, it is permanently destroyed,."

Another product being developed by doctors at Wake Forest University Medical
School, using data from the digital humans, is the "virtual colonoscopy," a
software package that allows physicians to scout the colon for pre-cancerous
lesions or polyps without undergoing a rectal probe.

Instead, doctors are able to construct a virtual colon for each patient using
information from a painless, 30-second CAT scan. "Colorectal cancer is the
second-leading cause of cancer death in the U.S. today (behind lung cancer).
But people are reluctant to undergo colorectal exams," said Dr. David Vining,
one the developers.

"Within six months, we hope to make this quick and easy colon cancer detection
method available nationwide, which should increase widespread screening and
save lives and money," he added.

At HT Medical in Rockville, Md., researchers have developed simulators that
let physicians practice two common but error-prone procedures, bronchoscopy
and intravenous catheterization, on a computer.

"The Centers for Disease Control estimates that 75 percent of the
complications arising from these procedures occur in the first 30 cases a
doctor does," said Greg Merrill, president of the firm. "With this device,
those first 30 experiences don't have to come at the expense of real
patients."

As colleagues demonstrated the lowering of the scope into the lungs for a
biopsy, a computer monitor showed a life-like journey, complete with tissue
contractions for breathing and heartbeat, and sporadic coughing brought about
by the insertion of the instrument.

Doctors at the Mayo Foundation and Clinic in Rochester, Minn., are using
software derived from the Visible Humans to practice patient-specific prostate
and brain surgery. "The data from the original images helped us to calibrate
our instruments for this rehearsal software," said John Camp, an imaging
scientist at the clinic.

While such simulations can now be done only at elite medical centers, Michael
Ackerman of the Visible Human Project said it is hoped that various
telemedicine techniques can spread the applications nationwide.

"Our hope is that eventually, even a doctor in rural Alaska will be able to
practice on patient-specific data before the actual surgery is performed,"
Ackerman said. He added another goal for the project is to make the images
"more accessible and understandable to the everyday user," with additional
software to isolate and label organs and systems.

by Lee Bowman
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Copyright 1998 Nando.net
Copyright 1998 Scripps Howard

janet paterson - 51/10 - almonte/ontario/canada
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