Improved Software to Browse the Serial Medical Images for Learning

Buried treasure - the teaching potential of Kodachrome slides brought into the digital age

Clinical images on Kodachrome slides have been used for decades in dermatologic education. While the technology to view these images is becoming obsolete, many training programs possess high-quality slides that have educational benefit. The University of Virginia Department of Dermatology possesses a collection of such slides that are currently being digitized and integrated into an educational software program. We present this article as a means of providing a uniform protocol for institutions with large Kodachrome collections to do the same. Our work has proven beneficial for both medical students interested in dermatology, allowing them to gain exposure to a variety of conditions that are not well emphasized in the general curriculum, as well as for dermatology residents, who use the program as a means to hone their diagnostic skills. Not only is there educational benefit to be derived from digitizing these slides but time is of the essence, as these slides can easily become damaged or degraded, and the technology needed to scan them is quickly becoming less available.

Real color volume model of cadaver for learning cardiac computed tomographs and echocardiographs

PURPOSE

It is difficult for medical students and novice clinicians to interpret cardiac computed tomographs and echocardiographs. This study was intended to help familiarize them with the clinical images of the heart by providing software to browse the various planes of a heart's volume model with real color and high resolution.

METHODS

On the sectioned images of a male cadaver, the heart and adjacent structures were segmented to obtain color-filled images. Volume models of the sectioned images and color-filled images were reconstructed and sectioned to obtain three orthogonal planes and five standard oblique planes. The planes were inputted into lab-made browsing software, which was then distributed free of charge.

RESULTS

Users of the software would hopefully progress as follows. After experiencing the real color and high resolution, they would become familiar with the grayscale and low resolution. After experiencing the automatic annotation of the basic heart structures, they would become familiar with the detailed structures. After experiencing the designated planes, they would become familiar with the arbitrary planes. After experiencing the still heart, they would become familiar with the moving heart during echocardiography.

CONCLUSION

The software, with a user-friendly interface and realistic features, is expected to properly orient medical novices to cardiac computed tomography and echocardiography images.

Adaptations in Anatomy Education during COVID-19

BACKGROUND

The impact of coronavirus disease 2019 (COVID-19) has profoundly affected education, with most universities changing face-to-face classes to online formats. To adapt to the COVID-19 pandemic situation, we adopted a blended learning approach to anatomy instruction that included online lectures, pre-recorded laboratory dissection videos, and 3D anatomy applications, with condensed offline cadaver dissection.

METHODS

We aimed to examine the learning outcomes of a newly adopted anatomy educational approach by 1) comparing academic achievement between the blended learning group (the 2020 class, 108 students) and the traditional classroom learning group (the 2019 class, 104 students), and 2) an online questionnaire survey on student preference on the learning method and reasons of preference.

RESULTS

The average anatomy examination scores of the 2020 class, who took online lectures and blended dissection laboratories, were significantly higher than those of the 2019 class, who participated in an offline lecture and dissection laboratories. The questionnaire survey revealed that students preferred online lectures over traditional large group lecture-based teaching because it allowed them to acquire increased self-study time, study according to their individual learning styles, and repeatedly review lecture videos.

CONCLUSION

This study suggests that a blended learning approach is an effective method for anatomy learning, and the advantage may result from increased self-directed study through online learning.

Sectioned and segmented images of the male whole body, female whole body, male head, and female pelvis from the Visible Korean

In the Visible Korean, serially sectioned images with real color and high resolution have been prepared from four cadaveric subjects: male whole body, female whole body, male head, and female pelvis. Recently, segmented images of the female whole body were manufactured, permitting the distribution of the complete four data sets. The purpose of this report was to promote the applications of sectioned and segmented images from the Visible Korean by announcing them. Reduced image data were loaded to self-developed browsing software; using the browsing software, the contents could be quickly grasped and evaluated by other investigators. The four data sets were compared to disclose the individual merits and demerits. The sectioned and segmented images showed the possibility to be used to reconstruct the stereoscopic volume and surface models of body structures. The Visible Korean is expected to contribute to the interactive simulation of medical learning and clinical practice.

Peeled images and sectioned images from real-color volume models of foot

PURPOSE

In all educational materials, the foot cannot be peeled from skin to the bone at constant intervals, like as real dissection. The aim of this study was to produce the peeled images which the foot structures can be peeled gradually along a skin-curved surface in real color, like a real dissection. In addition, the sectioned images of typical and atypical planes are presented in real color and high resolution.

METHODS

From the sectioned images of real color, foot volume models were made using Photoshop, Matlab, and MRIcroGL. Peeled images and sectioned images of the typical planes were produced from the volume models. All images were placed into the browsing software. An atypical plane could be shown in a real-time using the volume models of the foot.

RESULTS

Using the peeled images, in which the foot can be rotated at 5-degree intervals and stripped gradually at 0-30 mm depth, the foot anatomy could be learned precisely and efficiently. The sectional anatomy of the foot for radiology and orthopedic surgery could also be learned easily using the sectioned images of typical (horizontal, coronal, and sagittal) and atypical planes.

CONCLUSION

The most significant merit of the volume models is that all outcomes can be displayed with proper colors of the body structures on any plane. By virtue of these merits, the volume models are useful for learning medical education, research, and clinical practice.

Dawn of the Visible Monkey: Segmentation of the Rhesus Monkey for 2D and 3D Applications

BACKGROUND

To properly utilize the sectioned images in a Visible Monkey dataset, it is essential to segment the images into distinct structures. This segmentation allows the sectioned images to be compiled into two-dimensional or three-dimensional software packages to facilitate anatomy and radiology education, and allows them to be used in experiments involving electromagnetic radiation. The purpose of the present study was to demonstrate the potential of the sectioned images using the segmented images.

METHODS

Using sectioned images of a monkey's entire body, 167 structures were segmented using Adobe Photoshop. The segmented images and sectioned images were packaged into the browsing software. Surface models were made from the segmented images using Mimics. Volume models were made from the sectioned images and segmented images using MRIcroGL.

RESULTS

In total, 839 segmented images of 167 structures in the entire body of a monkey were produced at 0.5-mm intervals (pixel size, 0.024 mm; resolution, 8,688 × 5,792; color depth, 24-bit color; BMP format). Using the browsing software, the sectioned images and segmented images were able to be observed continuously and magnified along with the names of the structures. The surface models of PDF file were able to be handled freely using Adobe Reader. In the surface models, the space information of all segmented structures was able to be identified using Sim4Life. On MRIcroGL, the volume model was able to be browsed and sectioned at any angle with real color.

CONCLUSION

Browsing software, surface models, and volume models are able to be produced based on the segmentation of the sectioned images. These will be helpful for students and researchers studying monkey anatomy and radiology, as well as for biophysicists examining the effects of electromagnetic radiation.

Effects of Reading a Free Electronic Book on Regional Anatomy with Schematics and Mnemonics on Student Learning

BACKGROUND

To help medical students learn anatomy effectively in limited hours, a regional anatomy book enhancing students' memorization was developed.

METHODS

Only anatomical terms essential for basic cadaver dissection are included along with schematic figures which enable memorization of complicated anatomical structures. Learning comics and comic strips that depict anatomy mnemonics and jokes were appended and sentences were written to be comfortably readable. The electronic book titled "Visually Memorable Regional Anatomy" has been distributed without payment or registration. With the help of 246 volunteer students from three Korean medical schools, the book's learning effects were evaluated.

RESULTS

These students' book reading led to increase in their anatomy scores, including written examination scores and tag examination scores. It was an encouraging result that almost 20% of students spontaneously read the book no matter who presented their lecture or examination. A webpage version of the book was visited by thousands of users.

CONCLUSION

The book with unique features may suggest a new perspective in the field of anatomy learning. After having acquaintance with essential structures from reading the book, students are able to and willing to study more from other resources.

Advanced Sectioned Images of a Cadaver Head with Voxel Size of 0.04 mm

BACKGROUND

The sectioned images of a cadaver head made from the Visible Korean project have been used for research and educational purposes. However, the image resolution is insufficient to observe detailed structures suitable for experts. In this study, advanced sectioned images with higher resolution were produced for the identification of more detailed structures.

METHODS

The head of a donated female cadaver was scanned for 3 Tesla magnetic resonance images and diffusion tensor images (DTIs). After the head was frozen, the head was sectioned serially at 0.04-mm intervals and photographed repeatedly using a digital camera.

RESULTS

On the resulting 4,000 sectioned images (intervals and pixel size, 0.04 mm³; color depth, 48 bits color; a file size, 288 Mbytes), minute brain structures, which can be observed not on previous sectioned images but on microscopic slides, were observed. The voxel size of this study (0.04 mm³) was very minute compared to our previous study (0.1 mm³; resolution, 4,368 × 2,912) and Visible Human Project of the USA (0.33 mm³; resolution, 2,048 × 2,048). Furthermore, the sectioned images were combined with tractography of the DTIs to elucidate the white matter with high resolution and the actual color of the tissue.

CONCLUSION

The sectioned images will be used for diverse research, including the applications for the cross sectional anatomy and three-dimensional models for virtual experiments.

Real-Color Volume Models Made from Real-Color Sectioned Images of Visible Korean

BACKGROUND

Volume models made from magnetic resonance images on computed tomographs can produce horizontal, coronal, sagittal, and oblique planes that are used widely in clinics, although detailed structures cannot be identified. Existing real color volume models are mostly commercial and their production methods have not been released. The aim of this study was to distribute free of charge, real-color volume models produced from sectioned images with the production method.

METHODS

The original voxel size of sectioned images was increased appropriately so that the volume model could be handled by typical personal computers. By using Dicom Browser and MRIcroGL, the sectioned images were processed to become the volume models.

RESULTS

On the MRIcroGL, the resultant volume model with the voxel size of 0.5 × 0.5 × 0.5 mm³ could be displayed and freely rotated. By adjusting variables of the software, desired oblique planes could be produced instantly. With overlay function, a model of segmented structure can be overlapped to the entire volume models. The sectioned images with high quality and the segmentation data of Visible Korean enabled the identification of detailed anatomical structures on the planes.

CONCLUSION

The volume models can be used by medical students and doctors for learning sectional anatomy. Other researchers can utilize the method of this study to produce volume models from their own sectioned images.

New Viewpoint of Surface Anatomy Using the Curved Sectional Planes of a Male Cadaver

BACKGROUND

The curved sectional planes of the human body can provide a new approach of surface anatomy that the classical horizontal, coronal, and sagittal planes cannot do. The purpose of this study was to verify whether the curved sectional planes contribute to the morphological comprehension of anatomical structures.

METHODS

By stacking the sectioned images of a male cadaver, a volume model of the right half body was produced (voxel size 1 mm). The sectioned images with the segmentation data were also used to build another volume model. The volume models were peeled and rotated to be screen captured. The captured images were loaded on user-friendly browsing software that had been made in the laboratory.

RESULTS

The browsing software was downloadable from the authors' homepage (anatomy.co.kr). On the software, the volume model was peeled at 1 mm thicknesses and rotated at 30 degrees. Since the volume models were made from the cadaveric images, actual colors of the structures were displayed in high resolution. Thanks to the segmentation data, the structures on the volume model could be automatically annotated. Using the software, the sternocleidomastoid muscle and the internal jugular vein in the neck region, the cubital fossa in the upper limb region, and the femoral triangle in the lower limb region were observed to be described.

CONCLUSION

For the students learning various medical procedures, the software presents the needed graphic information of the human body. The curved sectional planes are expected to be a tool for disciplinary convergence of the sectional anatomy and surface anatomy.

Homepage to distribute the anatomy learning contents including Visible Korean products, comics, and books

The authors have operated the homepage (http://anatomy.co.kr) to provide the learning contents of anatomy. From the homepage, sectioned images, volume models, and surface models—all Visible Korean products—can be downloaded. The realistic images can be interactively manipulated, which will give rise to the interest in anatomy. The various anatomy comics (learning comics, comic strips, plastination comics, etc.) are approachable. Visitors can obtain the regional anatomy book with concise contents, mnemonics, and schematics as well as the simplified dissection manual and the pleasant anatomy essay. Medical students, health allied professional students, and even laypeople are expected to utilize the easy and comforting anatomy contents. It is hoped that other anatomists successively produce and distribute their own informative contents.

Three Software Tools for Viewing Sectional Planes, Volume Models, and Surface Models of a Cadaver Hand

BACKGROUND

The hand anatomy, including the complicated hand muscles, can be grasped by using computer-assisted learning tools with high quality two-dimensional images and three-dimensional models. The purpose of this study was to present up-to-date software tools that promote learning of stereoscopic morphology of the hand.

METHODS

On the basis of horizontal sectioned images and outlined images of a male cadaver, vertical planes, volume models, and surface models were elaborated. Software to browse pairs of the sectioned and outlined images in orthogonal planes and software to peel and rotate the volume models, as well as a portable document format (PDF) file to select and rotate the surface models, were produced.

RESULTS

All of the software tools were downloadable free of charge and usable off-line. The three types of tools for viewing multiple aspects of the hand could be adequately employed according to individual needs.

CONCLUSION

These new tools involving the realistic images of a cadaver and the diverse functions are expected to improve comprehensive knowledge of the hand shape.