BETHESDA, MdThe Visible Human Project has become a virtual reality
beyond the expectations of many. Already, researchers are
experimenting with the computerized anatomies of a man and woman,
seeking ways to use them to the benefit of medical education,
diagnostics, and surgery.
Using specialized software, physicians can reconstruct enormous
amounts of digital information into three-dimensional images, which
they can rotate, examine, take apart, and reassemble.
"This is an entirely new, exciting medical tool, based on
computer science, that will allow us to study human anatomy,"
said Steven Phillips, MD, of the Iowa Heart Center, Des Moines, who
chairs the Board of Regents of the National Library of Medicine
(NLM). "Physicians and scientists are already using this tool to
substitute for cadavers, to plan surgery, and to do colonoscopies."
Dr. Phillips spoke during a demonstration of some of the medical
advances evolving from the Visible Human Project at a 2-day meeting
sponsored by the NLM. "Applications of this tool are really
unlimited," he said.
At the Mayo Clinic, physicians are using the visible man to rehearse
prostate cancer operations in order to reduce complications and time
in surgery. Richard A. Robb, PhD, and his colleagues have coupled
datasets from the Visible Human Project with a patient's own scans
and a computer program that rapidly renders high-resolution 3D images
(see Figures 1, 2,
Such renderings are useful for studying spatial dimensions and
relationships, he said, and allow surgeons to visually plan and
rehearse an operation in advance. In addition, the models can be
updated in real time for more realistic surgical simulations.
"It should be possible to scan the patient in the morning,
process the data, show it to the surgeon in the afternoon, and help
him or her go through the rehearsal and understand the anatomy
preparatory to the surgery the next morning," Dr. Robb said.
"Ultimately, with the advances in computer technology, we'll be
able to have these kinds of capabilities on line in the operating room."
Mark Wax, MD, and his coworkers at the State University of New York
at Stony Brook envision a virtual colonoscopy simulator that would
replace costly and uncomfortable colon cancer screening procedures
with a noninvasive scan.
Software developed by computer scientist Ari Kaufman, PhD, converts
CT scans of a patient into a 3D image of a colon through which the
researchers can "fly" via the computer, looking for signs
of polyps or cancer.
"We envision this as an easier way for patients to go through an
initial screening," Dr. Wax said. "We are still working on
differentiating actual masses from retained stool, but if we are able
to use this technique to screen a large number of patients and then
select a small group for routine colonoscopy, we can cut costs,
screen more patients, and catch polyps at a premalignant size."
A Bargain at $1.4 Million
The federal investment in developing the dataset derived from slicing
and scanning the two cadavers totals $1.4 million. "So it is
really very small, when you consider what all research costs,"
Dr. Phillips said.
Currently, 650 licensees in 26 countries are turning the data into
usable software and other products, added Michael Ackerman, PhD, the
NLM's Visual Human Project manager. "It's evolved to the place
where we hope that the visible humans will do for surgery and
medicine what the flight simulator has done for aviation," Dr.
One licensee, Engineering Animation, Inc. (EAI) of Ames, Iowa, has
spent more than $5 million in technology development, says Michael S.
Sellberg, a senior project manager at EAI.
One example is the company's Dissectable Human CD-ROM ($49.95), a
series of interactive, 3D-rendered anatomical atlases. It includes
the male skeletal, muscular, cardiovascular, nervous, digestive,
respiratory, endocrine, urinary, reproductive, and lymphatic systems.
Published by Mosby-Year Book, Inc., the atlas is intended as an
educational tool for college and medical students, and for use by
Researchers at the meeting expressed confidence that the training,
diagnostic, and surgical improvements emerging from the Visible Human
Project will help physicians better manage costs as well as patients.
"This is a brand new technology," Dr. Phillips said.
"These tools will absolutely cut the costs of future medicine
and future care."
Dr. Robb suggested that this will happen through the use of
high-resolution images to help train physicians to understand human
anatomy at a lower cost, and the use of patient-specific anatomy.
More detailed information is available from the Visible Human
Project, National Library of Medicine, 8600 Rockville Pike, Bethesda,
MD 20894; Fax: 301-402-4080; email: firstname.lastname@example.org.