On May 4th 1999, NASA demonstrated the telemedical use of 3D patient images, transmitted over a high-capacity computer network to five remote sites, for diagnostic, surgical, and training purposes. The initiative was aimed to improve patient care from a distance by supporting remote collaboration of physicians at different locations on earth. The operation should be seen in the light of future space travel, when astronauts will need to have access to medical advice, training and care from distant sites. This "Virtual Collaborative Clinic" concept will not merely benefit the spacecraft crews travelling to the International Space Station and to other planets, but primarily patients, situated in isolated parts of our own planet.
For the "Virtual Collaborative Clinic" demonstration five workstations were interconnected, of which three in California, one in New Mexico, and one in Ohio. These five participants were all linked to the NASA site at Moffett Field, where the concept is under development at Ames' Center for Bioinformatics. The telemedicine demonstration featured expert physicians from the Cleveland Clinic at the NASA Glenn Research Center; Stanford University Medical Center; Salinas Valley Memorial Hospital, which was interacting from the University of California in Santa Cruz; the Northern Navajo Medical Center in Shiprock; and Ames. The doctors visualized images of patients' hearts, skulls and other body parts in 3D.
Each physician performed a specific procedure on a 3D stereo image of the virtual patient. The other doctors were able to follow every action in near real time on computer screens at their respective remote sites. To analyse and discuss the virtual patient cases, the specialists used the World2World high-fidelity 3D imaging software, developed by Engineering Animation, Inc. This system has been integrated into NASA software to create a linked version of the NASA data viewer, as to synchronize the manipulation of objects between the five viewing stations. As a multi-user and client-server-based networking solution for Intranet, Internet, Local Area Network, and Wide Area Network configurations, World2World allows the physician to generate collaborative and distributed 3D real time interactive simulation environments.
NASA Ames also utilized a Silicon Graphics Onyx2 workstation, in order to render each image, before transmitting the 3D data to the distant locations for manipulation. From the Ames Research Center site, Stanford expert Dr. Michael Stephanides simulated facial reconstructive surgery, which was also driven by the Onyx2 system. This workstation is based on SGI's renowned ccNUMA architecture and combines an astonishing performance and speed to a record-setting bandwidth and robust parallel compute technology. The Cleveland Clinic discussed the case of a patient suffering from an enlarged heart chamber. Images in 3D of the cardiac functioning before and after the chamber reducing surgical intervention were shown.
At Salinas site, an infant's defective heart beating was treated, while Navajo, Cleveland, and Salinas Hospitals presented results of cardiac surgery. The "Virtual Collaborative Clinic" demonstration was organized to show the potential of remote diagnostics, treatment and surgery planning, as well as tele-operating. The Ames Center for Bioinformatics plans to promote tele-guided surgery by a general practitioner or a robot operator on earth or on board of a spacecraft. Systems could be developed to scan space patients with sonic machines. Remotely collaborating experts on earth might be able to plan a medical procedure which could be transmitted for performance by an astronaut physician.
Dr. Muriel Ross, head of NASA's research at Ames, suggests the possibility of surgical try-outs in virtual reality after which the most adequate procedure can be stored in computer memory to be used in the actual operation. There also have been discussions to project computer images onto the patient in order to guide physicians during surgical interventions. For more details, you can consult the ongoing work at Ames by clicking through to the home page of the Center for Bioinformatics.