Tuesday, January 24, 2017

The Starwars of Medical Holograms: True3D

 
 
After NASA’s Jet Propulsion Laboratory worked with Microsoft to give scientists specially designed rover vehicles that has allowed scientists better explore and learn more about Mars, collaborations have been occurring more and more frequently. Endless new discoveries are anticipated from similar collaborations which will benefit both education and technology. Fully digital curriculums will revolutionize archeological digs around the world, discoveries in astrology, and even allow art history professors to interact with century old masterpieces. Collaborations with students, professors of all specialties, and many other passionate individuals are working together to create similar innovative technology. (F)

ExoPixel recently came out with an innovative new system that allows doctors to view, manipulate, and dissect body parts that are re-created in mid-air above an ordinary desktop. Physicians and medical students can now view 2D medical imaging data like patient’s MRI’s and CT scans into fully interactive virtual reality images. The use of 2D digital scans have allowed doctors to see an individual patient's anatomy without cutting into the body. The primary focus will be dedicated to solving the clinical problem rather spending time and energy translating or imagining the image from a 2D image into realistic 3D one. Although the goal has been to train students in their preferred specialties, this True3D will also let doctors examine holographic scans to diagnose conditions and prepare for surgery. 

Already existing systems such as GE’s Vivid E9 to produce 3D visuals of the human anatomy that appear realistic and allows the individual to rotate and take the image apart on a flat screen. However, with EchoPixel these 3D images will also be interactive holograms. Microsoft’s newest product in virtual reality technology is the HoloLens headset. Medical students will be able to do a thorough examination of the human body and experience the anatomy in a hyper-realistic way.  Students and surgeons alike will be able to practice surgical procedures through these realistic holograms. By 2020, cadavers will be a thing of the past as case-based anatomy, teaching and learning using HoloLens and mixed virtual realities will take their place in the medical field. 
It has been recently reported that surgeons at Royal College have been officially exploring and using Microsoft HoloLens. HoloLens is a mixed reality headset that shows hovering 3D holograms. Doctors can also use HoloLens to explore entire brains through imaging especially those that are built from MRI scans. These images will be transformed from 2D MRI images into 3D images floating in front of their eyes. It has been estimated that within the next five years, people will learn from various technologies and mixed media that will stimulate reality for a richer education. (B)

Being able to dissect and play with a 3D image of bones, organs, and tissues along with all the actual fractures, displacements, cancer, tumor, or any other abnormality/damage will lower the chances of human error during operations. True 3D medical imaging will allow doctors who need to visualize abnormal or complex 3D structures for their surgeries. Surgeons will be able to create a step by step plan for each specific case for future surgeries.(B)

Case Western Reserve University and Cleveland Clinic partnered with Microsoft to build and revolutionize education for future healthcare leaders. With their combined efforts, they produced HoloLens which will replace cadavers with technology. Their goal was to create an approach that could avoid traditional cadaver-based training. Human anatomy has been taught and learned by students with the use of cadavers (definition: a dead body, especially a human body used for dissection for education purposes) and medical illustrations. Both these ways are 2 dimensional which can limit a students’ understanding and education. (D)
Introduction:
Like a scene out of Star Wars, Microsoft has created a product that captures the imagination of the mind. HoloLens not only creates holograms but lets you manipulate them with relative ease, using not only the wave of a finger but the look of an eye or a short verbal command. It can attach sound to these holograms, so that they get louder when you’re close to them and quieter when you’re farther away.

With HoloLens students, professors, and doctors alike can take parts in and out, rotate, and even see the pulsating of the blood rushing through organs. The new system allows for an instructor to teach and interact with an auditorium full of individuals while being hundreds of miles away from the location. Professors can provide their students with an in-depth examination of white and gray matter of the brain to the very fibers that allows for the highway of messages to travel to real patient case MRI’s locating and identifying the tumor. 

Every medical student can draw a picture of a normal heart even though it is a complicated structure. But, when the heart that is being studied has narrowing’s, aneurisms, and congenital abnormalities, 3D medical holograms can allow students to visualize these complications better. Visual diagrams would appear in space around the user indicating exactly what you need to do next. HoloLens headset will take learning traditional anatomy class to any location in the world. Once could for example visualize the aortic valve in addition to all the other components that make up the cardiac system in an undamaged or dissected way.
 
 
With a simple gesture of the hand (which rotates the holographic image of the human body to show a hidden organ) and the imagination of the human mind; these holograms can build anything into a 3D model in the physical space around you. Resembling many holographic objects and devices that Tony Stark’s Iron Man uses, HoloLens turns boring tasks into a game helping its users build healthy productive habits, better educate themselves, and perform better in their specialized fields. 

Within 15 minutes, students who used HoloLens devices reported that having the access to 3D images could have saved them dozens of hours in their usual anatomy labs and classrooms. The quicker students are able to learn the fundamental information of anatomy the more time they had to analyze and critically ponder the causes of diseases, cures, and possible treatments for prolongation of life. This technology has the potential to enrich the environment of education by combining the art of science and creativity of the human mind to imagination. The technology will encourage experimentation as students will be able to build, operate, and analyze all systems in a relatively easy way. Such advancement will also lead to deeper understanding and improved product design. (F)

Besides educational purposes, cases of children born with genetic defects such as ones where the heart grows abnormally will allow surgeons to operate on these patients, making the needed corrections in blood vessel connection in the right locations. After surgery, reviewing the procedure with a CT scan compared to having access to a 3D preview of the heart before the surgery can help the doctor be better understand the situation quicker and subsequently minimizing the possibility of any mistakes that can occur due to human error. (or even possible complications that can occur during surgery).
 
 
Then there are extremely unpopular and uncomfortable procedures that once people reach a certain age must undergo for health reasons. One example of such a procedure is having a colonoscopy where a colon scope is inserted and manipulated by the physician to see if there are any abnormalities. However, this new system will now give doctor’s a simulation of a patient’s colon as he or she examines the interior surfaces of the colon with a colon scope. A hundred percent of the interior surface of the large intestine will let doctors through CT scan images, to reproduce this tube-like colon, re-create it floating in space, and nothing has to actually enter the body. You can rotate the image at different angles, cut it in half and search the interior surface for polyps. It's a way of visualizing the colon that has great potential to improve how quickly you could look at 100 percent of the interior. (A)

What’s so great about this interactive virtual reality is that patients can also use HoloLens as an interactive tool to see exactly what their surgeon will do during the operation. This technology will benefit patients too, as their surgeons will be better prepared to operate on their broken or displaced bones in the operating room. Meanwhile, years of education and experience enable doctors to work effectively with 2D medical images, the rest of us often have a very hard time deciphering them. That highlights another intriguing application for virtual reality—patient education. It's a promising niche in an era when the public is demanding more information from their medical providers.
Vision Processing:
Welcome to the 21st century where everything is in 3D from movies to games to handheld technology. What 3D does, is that it creates the illusion of depth of images that are presented to the eyes. The eye is constructed to detect visual stimuli. When light hits the eye, it becomes focused onto the retina where it is then absorbed by a layer of photoreceptor cells. These photoreceptor cells convert light into electrochemical signals, for the brain to process the image. Photoreceptors are composed of rods and cones named after their shapes. Their function is to convert the light energy of the photon into a form of energy communicable to the nervous system and readily usable to the organism: This conversion is called ‘signal transduction’.

Rods are extremely sensitive, and can be triggered by a single photon. At very low light levels, visual experience is based solely on the rod signal. This explains why colors cannot be seen at low light levels: only one type of photoreceptor cell is active. Whereas, cones need a larger number of photons to be stimulated. In other words, cones function when there is an abundant amount of light. They are responsible for color vision and high acuity for tasks such as reading. Therefore, it is reasonable to conclude that these photoreceptors are concentrated in the fovea (the central region of the retina). Color vision depends on the presence of 3 different types of cones or the 3 primary colors (if you have ever taken an introduction to art class they are): (A) blue light, (B) green light, and (C) red light. In combination, these three cone types allow us to perceive color. 
 
Rods and cones are located on the retina’s outermost layer. The axon terminal is located close to the visual field and farthest from the brain as it releases glutamate neurotransmitter to bipolar cells. The cell body in contrast is located farther back and it contains the cell’s organelles. Past this region is the mitochondria of the cell which its main function is to supply energy ATP for its sodium potassium pump. The closest segment to the brain (aka: the farthest from view/ the outer segment) is the area of the photoreceptor that absorbs the light. This area is known as modified cilia, containing disks filled with opsin (molecule that absorbs photons and voltage gated sodium channels). 

Rods and cones have special pigmented proteins that change their tertiary structure when they absorb light. Each protein is called an opsin which is bound to one pigment molecule called retinal and together are called rhodopsin. This membranous photoreceptor protein, ‘opsin’ is derived from vitamin A. So with this background information on the biology of how vision is processed lets see if there are any possible risks or long term effects to using this type of technology to eyesight.
Risks of Use:
For overall best quality of these virtual 3D images requires good binocular vision. Unfortunately, if individuals suffer from binocular vision disorder (ex: strabismus, eye misalignment, crossed or wandering eye), they may not be able to view or experience 3D stereoscopic content as comfortably as individuals with regular vision. *A small percentage of people have a pre-existing binocular vision disorder that they might not be aware of until they try viewing 3-D images. Consider consulting an eye doctor if you are not able to view the 3D effect clearly and comfortably.*

First few sessions with HoloLens, individuals may experience discomfort inducing temporary feelings of nausea, motion sickness, dizziness, disorientation, headache, fatigue, eye strain, or dry eyes. So it is important to take breaks until these feelings of discomfort subside. When using mixed or virtual reality often leads to motion sickness and related symptoms occur when there is a mismatch between what the eyes see and what the physical body perceives. With time the body will adapt and adjust itself when using HoloLens. 

If you experience discomfort, stop using HoloLens and rest until you feel better. Sitting still in a well-lit environment can help speed recovery from disorientation. If you feel disoriented, avoid activities that require balance, coordination, or other capabilities until you recover. Be sure the display is properly calibrated. Take note of the type of content you were viewing and other aspects of the situation in which the discomfort occurred so you can adjust or ease into the situation next time.
It is extremely important to take precautions with HoloLens such as using it in a well-lit room, avoid usage when drowsy or fatigued, or if there is history in the family tree of relatives of seizures or epilepsy. 

A very small percentage of the world population experience seizures when they are exposed to flashing lights or specific light patterns found in video games. This condition is known as ‘photosensitive epileptic seizures’. Many individuals are not diagnosed or unaware that they have this condition until they experience these epilepsies or seizures. Symptoms to look out for include lightheadedness, altered vision, eye or face twitching, jerking or shaking of arms or legs, disorientation, confusion, or momentary loss of awareness. Seizures may also cause loss of consciousness or convulsions that can lead to injury from falling and hitting objects that are located nearby. 
 Controversy:
Microsoft’s HoloLens, the holographic headset, does have its drawbacks though. When wearing the headset, the common person is used to the 3D visual images/ holograms that are produced from movie cameras (which themselves are equipped with very different hardware and programing), the individual’s field of view is going to be significantly smaller. This is going to occur because there is a limited field of vision for a person to see the whole hologram. The individual has to move their head, and even in some cases move their whole body to see the rest of the 3D virtual reality. The larger the image he or she wants to see in 3D the farther away he or she must stand to see the full image. In other words, it will be easier to view and examine a tiny model such as the human heart compared to a hologram of an entire city.  

As of today, using and being exposed to 3D images and/or mixed realities is not known to damage vision or cause any binocular vision disorders. HoloLens can be worn over glasses and used with contact lenses. It should be placed between 51 and 74 (this is known as the ‘interpupillary distance’ which is the eye measurement of the distance between two pupils) needed to view HoloLens’ holograms comfortably. If the optics are properly designed (which they seem to be), there should be no side effects to your vision or eyes. At worst the HoloLens will cause your eyes to be tired due to long periods of use. Therefore, in general some holograms may work better than others for different people. Or it will take some people more time to adapt or adjust to the technology. It has been advised that those who experience more discomfort than normal should consider taking more frequent and longer breaks until they are completely used to seeing the virtual images.
 
Concluding Remarks:
It is very difficult to imagine or understand what the headset can accomplish even in one’s own living room. Microsoft’s HoloLens is predicated to be the mainstream of gaming, entertainment, and industrial settings 15 years from today. HoloLens is mainly targeted for games and videos inside homes as a product design inside businesses. It is reasonable to conclude that this product only seems to work best in a limited number of scenarios-at least for now. Although holograms can provide a version of reality right in front of you, your mind still has to function to place itself where you need to be to see what you want. In other words, the smaller the field of view, the harder you have to work to figure out where to move for the image to fit into your task. Its limitations are primarily if one wants to apply the device into more than a gaming device which no technology has been able to accomplish. 

Although, this product seems to have it all there are concerns that this might be another distraction from reality and everything that goes along with living life to the fullest. So, many people may not be interested in spending their free time from working in the office to coming home to strap hardware on their faces instead of spending time in nature, the real world, and with the people that make up their life. Such technology could be the next biggest distraction from reality and things that really matter in life.

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in Loving Memory:

*Please note! These images are not mine. (screencap links from StarWars:A New Hope were found here: https://starwarsscreencaps.com/star-wars-episode-iv-a-new-hope-1977/ ) If any are yours please let me know so that I can give you credit for them! Also the people in the images have no relation to the diseases, illnesses, or cancers I write about. Thanks so much & enjoy~


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