Dextroscope changes the neurosurgical planning paradigm

Princeton 16 August 2006Imagine a technological breakthrough in which surgeons can virtually interact with imaging data and simulate their approach, all before a surgery ever begins. Well, it's here and now, thanks to Dextroscope. Six renowned institutions: Stanford University Hospital & Clinics, Hospital of the University of Pennsylvania, St. Louis University Hospital, University of Medicine and Dentistry of New Jersey, Cornell University/New York Presbyterian Hospital, and Johns Hopkins University Hospital are among the first to utilize this breakthrough imaging technology in the USA.

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Dextroscope is a virtual reality system which uses computer software to integrate tomographic images from CT and MRI into true 3D volumetric objects that can be viewed stereoscopically. A surgeon can perform a "virtual drill", if you will, by taking patient-specific images, and literally - or, rather, virtually - hold them, turn them, work with them, and evaluate different surgical approaches from any angle, long before ever laying a hand on the patient.

Dextroscope provides a deeper understanding of complex anatomical relationships and pathology for surgical planning and evaluation. Dextroscope utilizes two six-degree-of-freedom (6D) positional controllers, one in each hand, that work as extensions of the surgeon's hands, providing the ability to interact with patient images. In addition to pre-surgical planning, surgeons can show and explain to patients exactly what's going on, why, and what they plan to do to correct the problem.

"Dextroscope adds a higher level of sophistication to the most complex and demanding types of neurosurgery, while taking much of the mystery and uncertainty away", explained Joe Balogh, General Manager, Volume Interactions. "Ultimately, Dextroscope is an insight resource. It gives surgeons a clearer roadmap to follow which may improve their surgical confidence."

The University of Medicine and Dentistry of New Jersey (UMDNJ) is one of the first medical institutions in the United States to work with Dextroscope. At UMDNJ, neurosurgeons are now able to use this system to diagnose and treat neurological, temporal bone and spine disease, disorder and injury such as brain tumours, complex cerebral aneurysms, and neurological trauma.

"We can look at the brain or spine from any angle that we want, either in two dimensions or in three dimensions", stated Michael Schulder, MD, Vice Chairman of the Department of Neurological Surgery, UMDNJ-New Jersey Medical School. "We can rotate the model any way we want. And it's really like holding an actual model of a brain or a spine in your hand - except in this particular case, it's of a particular person. It's of the patient who's about to undergo surgery."

The other major medical institutions that have begun utilizing Dextroscope in the United States include: the Hospital of the University of Pennsylvania, Cornell University/New York Presbyterian Hospital, Stanford University Hospital and Clinics, St. Louis University Hospital, and Johns Hopkins University Hospital.

"This is breakthrough visualization technology, and it's been embraced by the institutions that are on the leading edge of academic medicine", stated Joe Balogh. "Dextroscope must be experienced to be believed. Being able to easily and intuitively visualize and interact with your patient's imaging data in true stereoscopic 3D is a unique experience. It literally adds a new dimension to surgical planning and medical education."

Dextroscope can be used by an individual or a small team of people who wish to review data simultaneously. It is ergonomically designed, so an individual can perform hours of delicate work without strain. A user is able to comfortably rest his or her arms, and can then "hold", view and interact with the images right in front of their eyes.

The system was developed by Volume Interactions, a Singapore-based developer of high-tech solutions for medical applications, specifically neurosurgery and advanced diagnostic imaging, which is part of the Bracco Group. It was formally introduced to the United States market in April 2006.

Volume Interactions Pte. Ltd. develops highly interactive stereoscopic 3D visualization systems for neurosurgical and interventional planning, advanced diagnostics and medical education. Based on proprietary virtual reality technology, the Dextroscope allows physicians to analyse 3D multi-modality imaging data with speed, comfort and precision. Volume Interactions provides synergistic solutions to the imaging technologies of the Bracco Group.

The Bracco Group is a provider of global diagnostic imaging solutions, with net sales of about 800 million euro per year. Bracco has operations in 115 countries and about 2200 employees, around 400 of whom work in R&D. Bracco invests approximately 15 percent of its annual turnover in R&D and has a portfolio of 1500 patents worldwide.

The Bracco Group is an expert in the diagnostic imaging market with an integrated product offering from a diverse roster of subsidiary companies. While Bracco is recognized internationally as a definitive market leader in its core business of contrast media, Bracco also markets key diagnostic imaging resources through the following companies: ACIST Medical Systems, a manufacturer of advanced contrast media injection systems and Singapore-based Volume Interactions, which also produces advanced 3D medical software.

Bracco also operates a high-level international research network, with three centres in Milan, Geneva, and Princeton. These centres develop products of the latest-generation diagnostic techniques, from X-ray and computed tomography (CT) to magnetic resonance imaging (MRI), echocontrast and nuclear medicine.

More news on the Dextroscope technology is available in the VMW March 2006 article Penn Neurosurgery goes 3D


Leslie Versweyveld

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